TY - JOUR
T1 - Participating in cardiac rehabilitation
T2 - A systematic review and meta-synthesis of qualitative data
AU - Neubeck, Lis
AU - Freedman, S. Ben
AU - Clark, Alexander M.
AU - Briffa, Tom
AU - Bauman, Adrian
AU - Redfern, Julie
N1 - Funding Information:
LN has a PhD Scholarship from the Heart Foundation of Australia. JR has a NHMRC-Heart Foundation Fellowship. AMC receives career awards from the Canadian Institutes for Health Research and Alberta Innovates: Health Care Solutions.
PY - 2012/6
Y1 - 2012/6
N2 - Background: Participation in cardiac rehabilitation (CR) benefits patients with coronary heart disease (CHD), yet worldwide only some 15-30% of those eligible attend. To improve understanding of the reasons for poor participation we undertook a systematic review and meta-synthesis of the qualitative literature.Methods: Qualitative studies identifying patient barriers and enablers to attendance at CR were identified by searching multiple electronic databases, reference lists, relevant conference lists, grey literature, and keyword searching of the internet (1990-2010). Studies were selected if they included patients with CHD and reviewed experience or understanding about CR. Meta-synthesis was used to review the papers and to synthesize the data.Results: From 1165 papers, 34 unique studies were included after screening. These included 1213 patients from eight countries. Study methodology included interviews (n = 25), focus groups (n = 5), and mixed-methods (n = 4). Key reasons for not attending CR were physical barriers, such as lack of transport, or financial cost, and personal barriers, such as embarrassment about participation, or misunderstanding the reasons for onset of CHD or the purpose of CR.Conclusions: There is a vast amount of qualitative research which investigates patients' reasons for non-attendance at CR. Key issues include system-level and patient-level barriers, which are potentially modifiable. Future research would best be directed at investigating strategies to overcome these barriers.
AB - Background: Participation in cardiac rehabilitation (CR) benefits patients with coronary heart disease (CHD), yet worldwide only some 15-30% of those eligible attend. To improve understanding of the reasons for poor participation we undertook a systematic review and meta-synthesis of the qualitative literature.Methods: Qualitative studies identifying patient barriers and enablers to attendance at CR were identified by searching multiple electronic databases, reference lists, relevant conference lists, grey literature, and keyword searching of the internet (1990-2010). Studies were selected if they included patients with CHD and reviewed experience or understanding about CR. Meta-synthesis was used to review the papers and to synthesize the data.Results: From 1165 papers, 34 unique studies were included after screening. These included 1213 patients from eight countries. Study methodology included interviews (n = 25), focus groups (n = 5), and mixed-methods (n = 4). Key reasons for not attending CR were physical barriers, such as lack of transport, or financial cost, and personal barriers, such as embarrassment about participation, or misunderstanding the reasons for onset of CHD or the purpose of CR.Conclusions: There is a vast amount of qualitative research which investigates patients' reasons for non-attendance at CR. Key issues include system-level and patient-level barriers, which are potentially modifiable. Future research would best be directed at investigating strategies to overcome these barriers.
KW - Attendance
KW - barriers and enablers
KW - cardiac rehabilitation
KW - patient experience
UR - http://www.scopus.com/inward/record.url?scp=84865559881&partnerID=8YFLogxK
U2 - 10.1177/1741826711409326
DO - 10.1177/1741826711409326
M3 - Review article
C2 - 22779092
AN - SCOPUS:84865559881
SN - 2047-4873
VL - 19
SP - 494
EP - 503
JO - European Journal of Preventive Cardiology
JF - European Journal of Preventive Cardiology
IS - 3
ER -