International Journal of Physiotherapy and Research

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Type of Article : Original Research

Year: 2016 | Volume 4 | Issue 3 | Page No. 1489-1497

Date of Publication: 11-06-2016

DOI: 10.16965/ijpr.2016.114

PHASE II CARDIAC REHABILITATION PROGRAM- BARRIERS TO FOLLOW UP AND PARTICIPATION: A CROSS-SECTIONAL STUDY

Renu B. Pattanshetty *1, Radhika Chintamani 2, Saviola Ribeiro 2.
 
*1 Department of Cardio-Pulmonary Physiotherapy, KLEU Institute Of Physiotherapy, JN Medical College Campus, Belagavi, Karnataka, India.
2 Intern, KLEU Institute Of Physiotherapy, JN Medical College Campus, Belagavi, Karnataka, India.

Corresponding author: Dr. Renu B. Pattanshetty Mpt; Ph.D, Dept. Of Cardio-Pulmonary Physiotherapy, KLEU Institute Of Physiotherapy, JN Medical College Campus, Belagavi-590010, Karnataka, India. Mob no: +919448482564
E-Mail: renu_kori@rediffmail.com

Abstract:

Background and objective: Cardiac Rehabilitation is an effective tool for the care of patients with heart disease. The objective of the present study was to identify the barriers to follow up and participation in phase 2 cardiac rehabilitation in post CABG subjects.
Material and methodology: A total of two eighty eight (288) subjects both male and female were included the study. The demographic data of each subject was recorded and they were administered with Zung Self Rating Depression Scale, Exercise Benefit Barrier Scale, Cardiac Depression Scale, Herth Hope Index, Life Orientation Scale, Perceived Stress Scale, Enrichd Social Support Scale.
Results:  The result of the present study was analyzed for rate of referral, gender, distance, socio-economic status, education, smoking history, age, body mass index, six minute walk test, and hemodynamic changes like systolic blood pressure, diastolic blood pressure, heart rate reserve, resting heart rate. Raw data was subjected to statistical analysis using Likelihood analyses x2 analyses and t-tests, gender difference in the variable of interest were tested. The results were compared dividing the subjects to attending & non attending group. Comparison of attending and non-attending patients with different characteristics, percentage of non-attending showed significant difference in transportation, inconvenient location (p=0.0001), expense (p=0.0030), illiteracy (p=0.0021) no one recommended it and age(p=0.0236) . There was no significant difference in gender.
Conclusion: Depression, distance, socio-economic status, education, and age were the major barriers for not attending the cardiac rehabilitation phase II program. In addition, perception of individual concerning benefits and barriers to participate in exercise, dislike towards the exercise, poor life orientation and quality of life in the subject were also factors for not attending the cardiac rehabilitation phase II program.
Key Words: Phase II Cardiac rehabilitation, coronary artery bypass grafting, Exercise benefit/barrier scale, Perceived stress scale, Enriched social support instrument, Revised life orientation scale, Zungself rating depression scale, Herth hope index, Cardiac depression scale.

References

  1. World Health Organization. The top 10 causes of death [serial online] 20 June 2013 [cited Jan 2016] Available from: URL: http://www.who.int/mediacentre/factsheets/fs317/en/
  2. O’Sullivan SB, Schmitz TJ. In “Heart Disease”-pg 589. In Textbook of Physical Rehabilitation. New Delhi: Jaypee Brothers Medical Publishers LTD; 5th edition. 2009.
  3. Pagidipati NJ and Gaziano TA. Estimating deaths from cardiovascular disease: a review of global methodologies of mortality measurement. Circulation 2013; 127(6):749-56.
  4. Leeder S, Raymond S, Greenberg H. A Race against Time: The challenge of Cardiovascular Disease in Developing Economies. 2004. Columbia University, New York City New York.
  5.  Mehta PJ,  Golwalla A. Cardiovascular System. Dr. Shilpa Pradip Mehta Mumbai.20th ed. Practical Medicine; 2013.
  6.  Libby P, Theroux P, MD. Pathophysiology of Coronary Artery Disease. Basic Sciences for Clinicians. Circulation: 2005; 111. pp 3481-3488.
  7. Tripathi KD. Cardiovascular Drugs. Jaypee Brothers Medical Publishers Ltd. 6th ed. Essentials of Medical Pharmacology; 2006.
  8. Sherman DL, Ryan TJ. Coronary angioplasty versus bypass grafting cost benefits consideration. Med Clin North Am; 1995 Sept; 79(5):1085-95
  9. Ellen A, Hillegss &William Temes; Therapeutic Interventions in Cardiac Rehabilitation and prevention; Essentials of cardiopulmonary physical therapy 2nd ed. p.677,682.
  10.  Brannon F, Foley M,  Starr J, Saul L. Overview of Cardiac Rehabilitation.3rd ed. Cardiopulmonary Rehabilitation: Basic theory and application. p.1
  11. O’Connor GT, Buring JE, Yusef S, et al. An overview of randomized trials of rehabilitation with exercise after myocardial infarction. Circulation 1989; 80:234–44.
  12. Oldridge NB, Guyatt G, Fischer M, et al. Cardiac rehabilitation after myocardial infarction: combined experience of randomized clinical trials. JAMA 1988; 260:945–50.
  13. Ades PA, Green NM, Coello CE. Effects of exercise and cardiac rehabilitation on cardiovascular outcomes. Cardiol Clin 2003; 21:435 - 48.
  14. Daly J, Sindone AP, Thompson DR, et al. Barriers to participation in and adherence to cardiac rehabilitation programs: a critical literature review. Prog Cardiovasc Nurs 2002; 17:8 - 17.
  15.  Scott IA, Lindsay KA, Harden HE. Utilization of outpatient cardiac rehabilitation in Queensland. Med J Aust 2003; 179:431- 5.
  16. Cardiac Care Network of Ontario [Home page on the Internet]. The Ontario cardiac rehabilitation pilot project-report and recommendations. September 2002; [cited 2016 Jan 8]. Available from http://www.ccn.on.ca/rehabpublic/ocrppresources.html.
  17. Grace S, Abbey S,  Shnek Z, Jane Irvine, Franche R, Donna E. Stewart. Cardiac rehabilitation II: referral and participation. Hosp Psychiatry 2002; 24:127 - 34.
  18. Missik E. Women and cardiac rehabilitation: accessibility issues and policy recommendations. Rehabil Nurs 2001; 26:141 -7.
  19. Plach SK. Women and cardiac rehabilitation after heart surgery: patterns of referral and adherence. Rehabil Nurs 2002; 27:104- 9.
  20.  Scott LA, Ben Or K, Allen JK. Why are women missing from outpatient cardiac rehabilitation programs? A review of multilevel factors affecting referral, enrollment, and completion. J Womens Health 2002;11:773 - 91.
  21. Wenger N, Froelicher E, Smith L. Cardiac Rehabilitation as secondary prevention. Clinical Practice Guideline 96-0673 1995; Rockville: US, Department of Health and Human Services, Public Health Service, Agency for Health Care Policy and Research and National Heart, Lung and blood institute.
  22. YMW Mak, WK Chan, CSS Yue. Barriers to participation in phase II cardiac rehabilitation program. Hong Kong Med J 2005;11:472-5
  23.  Green P, McNamara M, Oser C, Vella C. Factors Associated with Non-Completion of Cardiac Rehabilitation-Men Vs. Women. Journal of Cardiopulmonary Rehabilitation and Prevention. 2014; 34:284.
  24. Richardson LA, Buckenmeyer PJ, Bauman BD, et al. Contemporary cardiac rehabilitation: patient characteristics and temporal trends over the past decade. J Cardiopulm Rehabil 2000; 20:57–64.
  25. King KM, Humen DP, Smith HL, et al. Psychosocial components of cardiac recovery and rehabilitation attendance. Heart 2001; 85:290–8.
  26. Evenson KR, Rosamond WD, Luepker RV. Predictors of outpatient cardiac rehabilitation utilization: the Minnesota heart survey registry. J Cardiopulm Rehabil 1998;18:192–8.
  27. Halm M, Penque S, Doll N, et al. Women and cardiac rehabilitation: referral and compliance patterns. J Cardiovasc Nurs 1999; 13:83–92.
  28. L Jackson, J Leclerc, Y Erskine, W Linden. Getting the most out of cardiac rehabilitation: a review of referral and adherence predictors. Vancouver BC, Canada; Heart 2005; 91:10-14.
  29. Grace SL, Susan E. Abbey, Zachary M. Shnek, Jane Irvine, Renee-Louise Franche, Donna E. Stewart. Cardiac rehabilitation II: referral and participation. Hosp Psychiatry 2002;24:127 – 34
  30. Harlan WR, Sandler SA, Lee KL, et al. Importance of baseline functional and socioeconomic factors for participation in cardiac rehabilitation. Am J Cardiol 1995; 76:36–9.
  31. Johnson JE, Weinert C, Richardson JK. Rural residents use of cardiac rehabilitation programmes. Public Health Nurs 2001; 15(4):288–96.
  32. Ades PA, Walmann ML, Polk DM, et al. Referral patterns and exercise response in the rehabilitation of female coronary patients aged >62 years. Am J Cardiol 1992; 69:1422–5
  33. Sacker A,Firth D, Fitzpatrick R, Lynch KL, Bartley M. Comparing health inequality in men and women: prospective study of mortality 1986-96. British Medical Journal 2000;320(7245):1303-10
  34. Blackburn GG, Foody JM, Sprecher DL, et al. Cardiac rehabilitation participation patterns in a large, tertiary care center: evidence for selection bias. J Cardiopulm Rehabil 2000;20: 189- 95.
  35.  Barber K, Stommel M, Kroll J, et al. Cardiac rehabilitation for community-based patients with myocardial infarction: factors predicting discharge recommendation and participation. J Clin Epidemiol 2001; 54:1025 - 30.
  36. Spenser FA, Salami B, Yarzebski J, et al, Temporal trends and associated factors of inpatient cardiac rehabilitation in patients with acute myocardial infarction: a community-wide prespective. J Cardiopulm Rehabil 2001;m21:377-84.
  37. Grace SL, Evindar A, Kung T, et al. Increasing access to cardiac rehabilitation: automatic referral to the program nearest home. J Cardiopulm Rehabil 2004; 24:171 -4.
  38. Sanderson BK, Bittner V. Women in cardiac rehabilitation: outcomes and identifying risk for dropout. Am Heart Journal. 2005; 150:1052-8.
  39. Joel H, Emily G, Mary A, Richard A, Melissa D. Depression and cardiac rehabilitation attendance by Medicare beneficiaries after hospitalization for myocardial infaction. Journal of Cardiopulmonary Rehabilitation and Prevention.2014; 34:284.
  40. Casey E, Joel W. Hughes, Donna Waechter, Richard Josephson, James Rosneck. Depression predicts failure to complete phase II cardiac rehabilitation. J Behav Med (2008) 31:421-31
  41. Grace S, Gravely-Witte, Brual J, Monette G, Suskin N, Higginson L, Alter DA, Stewart DE. Contribution of patient and physician factors to cardiac rehabilitation enrollment: a prospective multilevel study. European Journal of Cardiovascular Prevention & Research. 2008 Oct 1; 15(5):548-56.
  42. Bernadine M. Pinto, Shira I.Dunsiger, Nancy Farrell, Bess H. Marcus and John F. Todaro. Psychosocial Outcomes of an Exercise Maintenance Intervention After Phase II Cardiac Rehabilitation. J Cardiopulm rehabil prev.2013 March; 33(2):91-98.
  43. Eaker E. Psychosocial risk factors for coronary artery disease in women. Cardiology Clinics 1998; 16(1):103-11
  44. Orth-Gomer. International epidemiological evidence for a relationship between social support and cardiovascular disease. In: Shumaker SA, Czajkowski SM, editors. Social support and cardiovascular disease. New York: Plenum Press, 1994. pp.97-17.
  45. Scheier, M.F., et al, Journal of Personality and Social Psychology. Distinguishing optimism from neurotism (and trait anxiety, self mastery and self esteem): a reevaluation of the Life Orientation Test. J Pers Soc Psychol. 1994; 67:1063-1078.
  46.  Oldridge N, Guyatt G, Jones N, et al. Effects on quality of life with comprehensive rehabilitation after acute myocardial infarction. Am J Cardiol 1991; 67:1084-89.
  47. Dugmore LD, Tipson RJ, Phillips MH, et al. Changes in cardio respiratory fitness, psychological wellbeing, quality of life, and vocational status following a 12 month cardiac exercise rehabilitation program. Heart 1999; 81:359-66.
  48. Stahle A, Mattsson E, Ryden L, Unden A, Nordlander R. Improved physical fitness and quality of life following training of elderly patients after acute coronary events. A 1 year follow-up randomized controlled study. Eur Heart J 1999; 20:1475-84.
  49. Yu C-M, Lau C-P, Chau J, McGhee S, Kong S-L, Cheung BM-Y, Li LS-W. A short course of cardiac rehabilitation program is highly cost effective in improving long-term quality of life in patients with recent myocardial infarction or percutaneous coronary intervention. Arch Phys Med Rehabil 2004; 85:1915-22.

 

Renu B. Pattanshetty, Radhika Chintamani, Saviola Ribeiro. PHASE II CARDIAC REHABILITATION PROGRAM- BARRIERS TO FOLLOW UP AND PARTICIPATION: A CROSS-SECTIONAL STUDY. Int J Physiother Res 2016;4(3):1489-1497. DOI: 10.16965/ijpr.2016.114

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