Published online Feb 26, 2022. doi: 10.4330/wjc.v14.i2.83
Peer-review started: September 23, 2021
First decision: December 2, 2021
Revised: December 15, 2021
Accepted: January 29, 2022
Article in press: January 29, 2022
Published online: February 26, 2022
Processing time: 146 Days and 17.2 Hours
Cardiovascular disease remains the largest cause of death globally and rates continue to rise. The exercise component of cardiac rehabilitation (CR) is regarded as an important element of such interventions. Recent statistics have demonstrated that attendance of CR programmes is low, despite continued calls for methods to increase attendance.
Such a study is warranted as low rates of uptake and completion of rehabilitation programmes are a concern. The barriers and facilitators towards CR are still somewhat unknown. Patients should continue to conduct regular exercise and physical activity after completing the rehabilitation programme. Thus, understanding patient perspectives on this area is also necessary. Exploring such topics should allow researchers and health care staff to target specific elements of service delivery to improve attendance in the future.
The aims of the present research study were to identify the barriers and facilitators to CR and physical activity. The study also aimed to explore cardiac patient views around service modification and ideas to increase attendance at such programmes.
The data analysed in this study was from a larger cross-sectional survey. Cardiac patients from the North of Scotland, who were referred for standard CR classes at a hospital were sampled. The current study qualitatively analysed the free-text responses to 5 open-ended questions included within a wider survey. A 6-step thematic analysis was used to analyse the data.
Patient responses were explored under two main topic areas: ”Cardiac rehabilitation experience” and “physical activity”. Patients described barriers to CR including time of day, location, a lack of communication and group dynamics. Patient generated ideas to increase the uptake of such programmes included more available classes, a greater variety of intensities and types of exercise and a change to the location of classes. Patients highlighted various benefits to both mental and physical health as a result of conducting the classes and physical activity.
It appears based on the findings of the current study that CR increases patients’ self-efficacy through a number of mechanisms. Key barriers to attending CR in this cohort included age and physical health, distance to the classes and the cost of attendance. With regards to these barriers, participants highlighted a range of methods to overcome these including provision of more classes held out with working hours, classes conducted in different locations and the need for a greater variety of exercise classes.
The study provides several ideas which future research can implement or examine. Future studies should attempt to develop, test, and evaluate methods to increase the uptake and attendance of CR based on the current low statistics of eligible patients’ attendance.