Barriers to cardiac rehabilitation and patient perceptions on the usage of technologies in cardiac rehabilitation: A cross‐sectional study

• Published in: Journal of clinical nursing Vol. 33; no. 3; pp. 1084 - 1093
• Main Authors: Chong, Mei Sin, Sit, Janet Wing Hung, Choi, Kai Chow, Suhaimi, Anwar, Chair, Sek Ying
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.03.2024
• Subjects: Cardiac Rehabilitation; Cardiovascular disease; Coronary Disease; Cross-Sectional Studies; Female; Health Behavior; Humans; Male; Middle Aged; Participation; Patients; perception; Perceptions; Rehabilitation; Social support; technology; participation; technology; cardiac rehabilitation; perception
• ISSN: 0962-1067; 1365-2702
• DOI: 10.1111/jocn.16919

Aims and Objectives The study aimed to identify factors associated with participation in Phase II cardiac rehabilitation and to assess patient perceptions towards the usage of technologies in cardiac rehabilitation. Background Despite efforts to promote utilisation of cardiac rehabilitation (CR), participation among patients remains unsatisfactory. Little is known of patient decision to participate Phase II CR in a multi‐ethnic country. Design A cross‐sectional study design. Methods A consecutive sampling of 240 patients with coronary heart disease completed Coronary Artery Disease Education Questionnaire (CADE‐Q) II, Hospital Anxiety and Depression Scale (HADS), Multidimensional Scale of Perceived Social Support (MSPSS) and Cardiac Rehabilitation Barriers Scale (CRBS). Results Seventy per cent of patients (mean age 60.5 [SD = 10.6] years, 80.8% male) participated in phase II cardiac rehabilitation. Self‐driving to cardiac rehabilitation centres, higher barriers in perceived need/health care and logistical factors were significantly associated with decreased odds of participation. Patients with more barriers from comorbidities/functional status, higher perceived social support from friends, and anxiety were more likely to participate. Chinese and Indians were less likely to participate when compared with Malays. More than 80% of patients used both home and mobile broadband internet, and 72.9% of them would accept the usage of technologies, especially educational videos, instant messenger, and video calls to partially replace the face‐to‐face, centre‐based cardiac rehabilitation approach. Conclusion Several barriers were associated with non‐participation in phase II cardiac rehabilitation. With the high perceived acceptance of technology usage in cardiac rehabilitation, home‐based and hybrid cardiac rehabilitation may represent potential solutions to improve participation. Relevance to clinical practice By addressing the barriers to cardiac rehabilitation, patients are more likely to be ready to adopt health behaviour changes and adhere to the cardiac rehabilitation programme. The high perceived acceptance of using technologies in cardiac rehabilitation may provide insights into new delivery models that can improve and overcome barriers to participation.