Reframing the dilemma of poor attendance at cardiac rehabilitation: an exploration of ambivalence and the decisional balance

Everett, Bronwyn; Salamonson, Yenna; Zecchin, R; Davidson, Patricia M.

doi:10.1111/j.1365-2702.2008.02612.x

Cited by 12 publications

(8 citation statements)

References 58 publications

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“…43,44 once a patient is referred to Cr, liaison discussions could positively influence patient motivation, Cr knowledge, and attitudes, and could also reduce ambivalence and noncompliance. 71 the incorporation of patient liaison into automatic referral strategies is supported by the preliminary results of the CrCare study, 15,55 which demonstrates through a multicenter, controlled, observational design that automatic referral in combination with patient liaison can result in Cr enrollment rates of up to 72%. 15 this combined approach to Cr referral resulted in a Cr referral rate 11 times higher than for 'standard' referral methods, after adjustment for the effect of recruitment center.…”

Section: Improving Practice In Cr Referralmentioning

confidence: 97%

Effects of cardiac rehabilitation referral strategies on referral and enrollment rates

et al. 2009

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| Despite recommendations in clinical practice guidelines, evidence suggests that utilization of cardiac rehabilitation (CR) following indicated cardiac events is low. Referral strategies, such as automatic referral, have been advocated to improve CR utilization. In this Review, we evaluate the effects of referral strategies on rates of CR referral and enrollment. Referral strategies are categorized as 'automatic' (the use of electronic health records or systematic discharge order sets), as 'liaison' (discussions with allied healthcare providers), or as 'other' (for example, the use of motivational letter to patients). The highest rates of CR referral have been achieved in studies implementing automatic referral orders, whereas the highest rates of CR enrollment have resulted from a combination of automatic and liaison methods. Overall, innovative referral strategies significantly increase CR utilization. While further investigation is needed, institutions should evaluate their CR referral practice in light of these findings.

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Section: Improving Practice In Cr Referralmentioning

confidence: 97%

Effects of cardiac rehabilitation referral strategies on referral and enrollment rates

et al. 2009

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“…Patient ambivalence, that is simultaneously wanting to and yet not wanting to attend CR, has also been discussed in explaining poor attendance (Everett et al . ). Whatever the reason may be, the consequences of nonattendance or noncompletion of CR are far‐reaching and detrimental.…”

Section: Introductionmentioning

confidence: 97%

“…Nonattendance or noncompletion of CR is influenced by socio-demographic factors such as age and gender (Shanks et al 2007), psychological or cognitive variables like anxiety and depression (McGrady et al 2009), illness and treatment perceptions (Yohannes et al 2007), infrastructure-related issues such as accessibility or referral , and lack of motivation (Hagan et al 2007) or co-morbidities (Yohannes et al 2007). Patient ambivalence, that is simultaneously wanting to and yet not wanting to attend CR, has also been discussed in explaining poor attendance (Everett et al 2009). Whatever the reason may be, the consequences of nonattendance or noncompletion of CR are far-reaching and detrimental.…”

Section: Introductionmentioning

confidence: 99%

‘Just not for me’ – contributing factors to nonattendance/noncompletion at phase III cardiac rehabilitation in acute coronary syndrome patients: a qualitative enquiry

Herber

Smith

White

et al. 2017

Journal of Clinical Nursing

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Aims and objectives To explore what reasons do nonattenders and noncompleters give for their patterns of participation or nonparticipation in cardiac rehabilitation programmes and how future uptake could be enhanced. Background Cardiac rehabilitation is a cost‐effective clinical intervention designed for adults with acute coronary syndrome. Despite evidence from meta‐analyses demonstrating that cardiac rehabilitation programmes facilitate physical and psychological recovery from acute coronary syndrome, only 20–50% of eligible patients attend Phase III outpatient programmes. Design A qualitative study using thematic analysis. Method Within the context of a larger mixed‐method study, acute coronary syndrome patients were recruited between 2012–2014 from three hospitals in Scotland. Of 214 patients who consented to enrol in the main study, a purposive subsample of 25 participants was recruited. Semi‐structured interviews were conducted and analysed using thematic analysis. Results Three major influences of participation were identified: (1) personal factors, (2) programme factors and (3) practical factors. In addition, valuable suggestions for future programme modifications were provided. A significant barrier to attending cardiac rehabilitation programmes is that participants perceived themselves to be unsuitable for the programme alongside a lack of knowledge and/or misconceptions regarding cardiac rehabilitation. Conclusion The responses of nonattenders and noncompleters revealed misconceptions related to programme suitability, the intensity of exercise required and the purpose of a cardiac rehabilitation programme. As long as these misconceptions continue to persist in coronary syndrome patients, this will impact upon attendance. The lack of perceived need for cardiac rehabilitation stems from a poor understanding of the programme, especially among nonattenders and noncompleters and subsequently an inability to comprehend possible benefits. Relevance to clinical practice The knowledge of common misconceptions puts clinical nurses in a better position to identify and pro‐actively address these erroneous assumptions in their patients in order to improve participation in cardiac rehabilitation.

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“…Zhong Yan et al, Jones, Aiwu Jia and Zhifeng Zhang established the English Learning Self-Efficacy Questionnaire from different dimensions respectively (Grusec, 1992). In 1986, American psychologist Horwitz, EK proposed the concept of English learning anxiety (Everett, Salamonson, & Davidson, 2009). Then, Macinty, Gardner and Arnold et.…”

Section: Introductionmentioning

confidence: 99%

Correlation Analysis Between Self-Efficacy and Psychological Anxiety of College English Learners Based on Triadic Reciprocal Determinism

Zeng¹,

Wang²,

Zhang³

2020

RACP

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Many college students in China face great difficulties in English learning. Their learning psychology is directly affected by the self-efficacy. This paper introduces the triadic reciprocal determinism (TRD) to identify the correlations between self-efficacy and psychological anxiety of college English learners. A questionnaire survey was conducted to in a university of Shaanxi, China, to measure the self-efficacy and psychological anxiety of college students in English learning. Based on the survey data, the correlations between the two factors were discussed through regression analysis, using the General English Self-Efficacy Scale and the Foreign Language Classroom Anxiety Scale. The results show that the self-efficacy of college students in English learning belongs to the general level; the psychological anxiety in English learning is very prominent; for college English learners, their self-efficacy has a significant negative correlation with psychological anxiety. The research results enrich the theories on self-efficacy and psychological anxiety, and promote the reform of college English teaching.

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Reframing the dilemma of poor attendance at cardiac rehabilitation: an exploration of ambivalence and the decisional balance

Abstract: Understanding the dynamics of ambivalence provides an alternative to thinking of patients as lacking motivation, being non-compliant, or even resistant. Helping patients to explore and resolve their ambivalence may be all that is needed to help them make a decision and move forward.

Cited by 12 publications

References 58 publications

Effects of cardiac rehabilitation referral strategies on referral and enrollment rates

Effects of cardiac rehabilitation referral strategies on referral and enrollment rates

‘Just not for me’ – contributing factors to nonattendance/noncompletion at phase III cardiac rehabilitation in acute coronary syndrome patients: a qualitative enquiry

Correlation Analysis Between Self-Efficacy and Psychological Anxiety of College English Learners Based on Triadic Reciprocal Determinism

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