‘Getting back to normal’: patients’ expectations of cardiac rehabilitation

Objectives To identify cardiac patients’ perceptions of their own health and health problems, especially to establish patients’ understanding of the main aims of cardiac rehabilitation; to delineate patients’ perceptions of the role of exercise and diet in rehabilitation; to determine patients’ concerns regarding participation and to examine obstacles to patient involvement in cardiac rehabilitation.

Design A qualitative approach was undertaken using a prospective descriptive study design. Patients participated in semi-structured interviews of approximately 40minutes duration. Responses to questions were coded and answers grouped in clusters and main themes identified through a consensual process.

Setting A cardiac unit in an acute teaching hospital in North East Scotland.

Participants A convenience sample of 50 patients, 34 women and 16 men, were interviewed. The majority had undergone coronary artery bypass surgery.

Main outcome measures Responses to questions as part of an interview schedule developed specifically for the study.

Results Many respondents associated cardiac rehabilitation with recovery from surgery reflecting that patients had limited knowledge of cardiac disease. Patients described cardiac rehabilitation in terms of undertaking specific activities, especially exercise. Thirty-six interviewees referred directly to exercise/walking, while nine patients referred to relaxation/stress reduction and four to diet. Seventy percent of participants (35) reported receiving information on cardiac rehabilitation, while 30% (15) said that ‘nobody’ had spoken to them about it. Seventeen interviewees identified transport difficulties and responsibilities as a carer as barriers to attendance. Overall, some patients were ambivalent regarding the need to attend a cardiac rehabilitation programme.

Conclusions Study participants had a limited understanding of cardiac rehabilitation and is role in reducing the risk of future cardiac problems. The outlook of the patients interviewed may be far removed from that of health professionals.