Physiotherapists’ Attitudes, and Barriers of Delivering Cardiopulmonary Rehabilitation for Patients with Heart Failure in Saudi Arabia: A Cross-Sectional Study

Aldhahir, Abdulelah M.; Alhotye, Munyra; Alqahtani, Jaber S; AlDraiwiesh, Ibrahim A.; Alghamdi, Saeed M; Alsulayyim, Abdullah S; Alqarni, Abdullah; Khormi, S.K.; Zahrani, Eidan M. Al; Rajeh, Ahmed M Al; Aldabayan, Yousef S; Siraj, Rayan A.; Tawhari, Naif A; Alhazmi, Faisal M; Najmi, Ayat A; Alwadeai, Khalid S; Alwafi, Hassan

doi:10.2147/jmdh.s386519

Cited by 9 publications

(10 citation statements)

References 42 publications

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“…Another study investigated the barriers to referal system to CR in SA in heart failure disease among physiotherapists views and their preference to deliver the CR was hospital-based CR program which is in line with our results. 17,29,30 Our results support that lack of CR centers in SA was the most barriers to refer to CR in SA. Moreover, the results of the semi-structure interview in agreement with our results as the most important barriers to refer cardiac patients and to establish CR in the western region in SA was lack or insufficient CR centers in western region of SA.…”

supporting

confidence: 75%

Barriers to Establishing Outpatient Cardiac Rehabilitation in the Western Region of Saudi Arabia: A Cross-Sectional Study

Khushhal¹,

Alsubaiei²

2023

JMDH

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Background:The core of cardiac rehabilitation (CR) is structured exercise training. CR reduces 28-56% hospital readmission rate, and around 25% increases cardiorespiratory fitness but the number of outpatients CR centers in Saudi Arabia (SA) is very limited and there is a need to establish outpatient CR (Phase III) in SA. Furthermore, the awareness of outpatient CR in SA is unknown. Aim: To determine the main barriers to establishing an outpatient CR program (Phase III) in the western region of SA, as well as assess the awareness of outpatient CR (Phase III) in the western region of SA. Methods: A cross-sectional study survey was conducted between March -July 2021 among physiotherapists, cardiologists and the cardiac surgeon using a questionnaire distributed electronically to determine the awareness level of outpatient CR and barriers to establishing outpatient CR (Phase III) in the western region of SA. Frequencies and percentages were used to report the variables. Results: Of the 141 participants who completed the online survey, our findings showed that 131 (93%) were aware of CR but only 29 (21%) were aware of the four phases of CR. There were three main barriers to establishing CR: lack of appropriate CR 135 (96%); lack of awareness among healthcare professions of CR and its benefits 134 (95%) and the lack of healthcare providers trained in CR 133 (94%). There was a significant relationship between physiotherapists and cardiologists' responses on agreeing to all barriers to establishing CR in SA (r=0.69, P =0.03). Conclusion:To overcome the barriers to establishing CR outpatient centers in the western region of SA, it is recommended to provide more CR outpatient training programs to healthcare providers and raise the awareness of the CR phases, its benefits, and the risk factors for developing cardiac diseases among healthcare providers.

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supporting

confidence: 75%

Barriers to Establishing Outpatient Cardiac Rehabilitation in the Western Region of Saudi Arabia: A Cross-Sectional Study

Khushhal¹,

Alsubaiei²

2023

JMDH

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“…Participants in this study also perceived the lack of well-trained staff as a major barrier to PR referral, in concordance with the current literature. 13 19 21 26 Studies show that Saudi Arabia suffers from a severe shortage of healthcare professionals and that only limited specialties participate in the management of COPD. 27 28 Evidence suggests that COPD management is much better if performed by a multidisciplinary team, 28 29 highlighting the need for an integrated approach.…”

Section: Discussionmentioning

confidence: 99%

Healthcare providers’ attitudes, beliefs and barriers to pulmonary rehabilitation for patients with chronic obstructive pulmonary disease in Saudi Arabia: a cross-sectional study

Aldhahir

Alqahtani²,

AlDraiwiesh³

et al. 2022

BMJ Open

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ObjectivesTo assess the attitude of healthcare providers (HCPs) towards the delivering of pulmonary rehabilitation (PR) to patients with chronic obstructive pulmonary disease (COPD) and identify factors and barriers that might influence referral.DesignA cross-sectional online survey consisting of nine multiple-choice questions.SettingsSaudi Arabia.Participants980 HCPs including nurses, respiratory therapists (RT) and physiotherapists.Primary outcome measuresHCPs attitudes towards and expectations of the delivery of PR to COPD patients and the identification of factors and barriers that might influence referral in Saudi Arabia.ResultsOverall, 980 HCPs, 53.1% of whom were men, completed the survey. Nurses accounted for 40.1% of the total sample size, and RTs and physiotherapists accounted for 32.1% and 16.5%, respectively. The majority of HCPs strongly agreed that PR would improve exercise capacity 589 (60.1%), health-related quality of life 571 (58.3%), and disease self-management in patients with COPD 589 (60.1%). Moreover, the in-hospital supervised PR programme was the preferred method of delivering PR, according to 374 (38.16%) HCPs. Around 85% of HCPs perceived information about COPD, followed by smoking cessation 787 (80.3%) as essential components of PR besides the exercise component. The most common patient-related factor that strongly influenced referral decisions was ‘mobility affected by breathlessness’ (64%), while the ‘availability of PR centres’ (61%), the ‘lack of trained HCPs’ (52%) and the ‘lack of authority to refer patients’ (44%) were the most common barriers to referral.ConclusionPR is perceived as an effective management strategy for patients with COPD. A supervised hospital-based programme is the preferred method of delivering PR, with information about COPD and smoking cessation considered essential components of PR besides the exercise component. A lack of PR centres, well-trained staff and the authority to refer patients were major barriers to referring patients with COPD. Further research is needed to confirm HCP perceptions of patient-related barriers.

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“…We used a modified version of a questionnaire that was previously designed, created, and validated by Aldhahir et al [ 17 , 18 , 19 , 20 ]. The questionnaire included eight closed-ended multiple-choice questions.…”

Section: Methodsmentioning

confidence: 99%

“…Our findings showed that a supervised hospital-based program with stress management as an essential component was the preferred method of delivering CR, but CR centers were lacking [ 16 ]. To promote the implementation of the CR program in Saudi Arabia, it is essential to assess nurses’ perception of the delivery of CR programs for patients with HF, given that nurses are part of the CR team [ 17 ]. In addition, the barriers and factors that potentially affect decisions to refer HF patients to the CR program from the perspective of nurses should be considered.…”

Section: Introductionmentioning

confidence: 99%

Nurses’ Perception of, and Barriers to, Delivering Cardiopulmonary Rehabilitation for Heart Failure Patients: A National Survey in Saudi Arabia

Aldhahir

2022

IJERPH

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Background: Heart failure (HF) patients require a holistic management approach to improve their clinical outcomes. Cardiopulmonary rehabilitation (CR) is a core component of HF patients’ management and is supervised by a multidisciplinary team including nurses. Nursing attitudes regarding CR delivery for patients with HF and the possible barriers and factors that potentially affect referral have not been explored. Therefore, this study seeks to evaluate nurses’ attitudes towards the delivery of CR programs and the possible barriers and factors that potentially influence the decision for a referral. Methods: An online survey with eight multiple-choice items was disseminated to all nurses between February and July 2022 in Saudi Arabia. The characteristics of the respondents were described using descriptive statistics. Percentages and frequencies were used to report categorical variables. Results: Overall, 1056 nurses completed the online survey, of which 395 (37.40%) were male. Out of 1056 nurses, 414 (39.20%) strongly agreed that CR would improve patients’ physical fitness, and 392 (37.10%) strongly agreed that CR would reduce breathlessness in patients with HF. In total, 381 nurses strongly agreed (36.10%) that CR would improve HF patients’ palpitation and fatigue. Out of 1056 nurses, 396 (37.50%) strongly agreed that CR would improve HF patients’ ability to perform daily activities, and 326 (30.90%) strongly agreed that CPR would reduce the rate of hospital readmission. The at-home program was the preferred mode of delivering CR programs among 607 (57.50%) nurses. Apart from the exercise component, symptom management was perceived by 704 (66.70%) nurses as the fundamental component of CR programs. The most common patient-related factor that strongly affected the decisions regarding referral was “mobility affected by breathlessness” (57%). A lack of CR centers (46%) was the most common barrier. Conclusion: Nurses perceived CR as an effective management strategy for HF patients. Although a home-based program, with symptom management being an essential component, in addition to the exercise component, was perceived as the preferred mode of delivery, CR centers are lacking, which represented a significant barrier to CR referral from the nurses’ perspective.

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Physiotherapists’ Attitudes, and Barriers of Delivering Cardiopulmonary Rehabilitation for Patients with Heart Failure in Saudi Arabia: A Cross-Sectional Study

Cited by 9 publications

References 42 publications

Barriers to Establishing Outpatient Cardiac Rehabilitation in the Western Region of Saudi Arabia: A Cross-Sectional Study

Barriers to Establishing Outpatient Cardiac Rehabilitation in the Western Region of Saudi Arabia: A Cross-Sectional Study

Healthcare providers’ attitudes, beliefs and barriers to pulmonary rehabilitation for patients with chronic obstructive pulmonary disease in Saudi Arabia: a cross-sectional study

Nurses’ Perception of, and Barriers to, Delivering Cardiopulmonary Rehabilitation for Heart Failure Patients: A National Survey in Saudi Arabia

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