Psychosocial components of cardiac recovery and rehabilitation attendance

Abstract

Objective-To examine the relations between demographic factors, specific psychosocial factors, and cardiac rehabilitation attendance. Design-Cohort, repeated measures design. Setting-A large tertiary care centre in western Canada Patients-304 consecutive consenting patients discharged following acute myocardial infarction and/or coronary artery bypass graft surgery. Main outcome measures-The Jenkins self-eYcacy expectation scales and activity checklists of behaviour performance for maintaining health and role resumption, modified version of the selfmotivation inventory, and the shortened social support scale. Results-Those who had higher role resumption behaviour performance scores at two weeks after discharge were significantly less likely to attend cardiac rehabilitation programmes. At six months after discharge, those who attended cardiac rehabilitation demonstrated higher health maintenance self-eYcacy expectation and behaviour performance scores. Health maintenance self-eYcacy expectation and behaviour performance improved over time. Women reported less social support but showed greater improvement in health maintenance self-eYcacy expectation. Changes in self-eYcacy scores were unrelated to-but changes in health maintenance behaviour performance scores were strongly associated with-cardiac rehabilitation attendance. Conclusions-Cardiac patients and practitioners may have misconceptions about the mandate and potential benefits of rehabilitation programmes. Patients who resumed role related activities early and more completely apparently did not see the need to "rehabilitate" while those who attended cardiac rehabilitation programmes enhanced their secondary prevention behaviours. (Heart 2001;85:290-294)

Cardiac rehabilitation programmes: predictors of non-attendance and drop-out

“…Indeed, while CR programmes were originally developed for AMI patients, eligibility has since been extended to other patient groups. In this time we have seen higher uptake amongst CABGS patients and lower uptake amongst PCI patients relative to AMI patients, both in Australia and elsewhere [13,24]. The attendance rates of 66, 51 and 25% respectively for CABGS, AMI and PCI patients in our study directly reflect this pattern.…”

Cardiac Rehabilitation Barriers and Opportunities Among Women With Cardiovascular Disease

“…44 Others have attempted to measure social support using a 1-item question asking patients to rate support of family and friends 31 or tools specifically devised to measure social support. 32,39,59,81,84 After adjusting for important covariates, none of these studies found an association between social support and cardiac rehabilitation attendance.…”

“…On the other extreme, patients post-AMI or CABG who resumed their usual roles within 2 weeks after discharge were significantly less likely to enroll. 84 Based on results of many other studies, 3,32,34,44,74 it is very likely that these patients presumed that they did not need cardiac rehabilitation or they were too busy with other conflicting demands to attend. 34 Clinicians can use these results to identify patients at high risk for nonattendance, assess their perceptions of cardiac rehabilitation, and intervene to minimize these activity-related barriers to cardiac rehabilitation.…”

Direct to Consumer Advertising of Robotic Heart Bypass Surgery: Effectiveness, Patient Satisfaction and Clinical Outcomes

“…The DTCA group found out about rCABG from the ad and had to "self-refer", which may have created a bias in this group for patients with more self-efficacy, greater health literacy and potentially an economic motivation for faster recovery (Mackert andLove 2011, Junewicz 2014). A variety of studies have shown that these characteristics predict improved recovery in the setting of cardiovascular disease (King, Humen et al 2001, Jackson, Leclerc et al 2005. At the same time, they can set the stage for a disturbed patient-physician relationship.…”