Factors influencing outpatient cardiac rehabilitation attendance

BACKGROUND Cardiac rehabilitation (CR) is an evidence-based, secondary prevention treatment programme that assists and guides patients in developing healthier lifestyles after a cardiac event. CR has been shown to prevent future coronary events and is an effective way of reducing disability and prolonging survival in patients with coronary heart disease. Less than half of eligible people with heart disease attend CR programmes. This may be due to non-referral of eligible patients or non-attendance of patients after referral. In New Zealand some groups of people are significantly less likely to attend CR. These groups include people who are older, have less education, and are female, Māori or Pacific people AIM This study discusses whether the delivery and content of inpatient CR meets patient expectations and if inpatient CR has an influence on attending an outpatient CR programme. The study will focus on information given to patients and their perceptions of heart health during their hospital stay. Clarity will be offered on which health professional is most successful in recommending attendance at CR. METHODOLOGY A quantitative, descriptive and non-experimental study was conducted, starting with a hospital audit of information of patients with a discharge diagnosis of acute coronary syndrome. The sample group was patients discharged from hospital between November 2011 and July 2012. Information from the hospital system included discharge diagnosis, length of stay, readmissions to hospital, discharge ward and basic demographics such as age, ethnicity, and home address. A questionnaire was sent to 418 patients meeting the inclusion requirements. Questions focused on what sort of information was provided during inpatient CR while in hospital and how patients perceived their illness. Information was also sought on attendance to outpatient CR programmes. The data was analysed using Excel™. RESULTS There were 181 people who completed the survey; 37% of respondents were 37% female, 9% were Māori, and 70% of respondents were over 65 years old. Key findings were 50% of people felt their heart event was a shock and felt they would have liked more information in hospital. Only 37% of people attended outpatient CR on discharge from hospital which is about the same as international figures. Some of the reasons given for not attending were not knowing about CR (27%) and 61% of people understood only some/none of the information given while in hospital. The health professional who consistently recommended CR was the CR nurse and the invitation was given after discharge from hospital. Some themes from the comments for not attending were the distance to travel was too far (especially from one of the rural districts), the time of the programme conflicted with work commitments and some felt CR was not necessary. The people who did attend said they went to learn about heart disease and felt it would be beneficial to their health. CONCLUSION These findings suggest an automatic referral tool would increase referral rates, and following evidence based guidelines for inpatient care could increase participation rates for CR. Employing a coordinator for inpatient CR would increase nursing knowledge of CR and promote outpatient CR.

Name thesis:degree_name

Master of Nursing

Level thesis:degree_level

Masters

Grantor

Eastern Institute of Technology

Year dc:date.issued

2012

Author dc:creator

• Hutchinson, Pip

• Hawke's Bay (N.Z.)
• New Zealand
• patients
• Māori patients
• coronary heart disease
• cardiac rehabilitation
• attendance
• patient information
• heart health
• perceptions
• surveys

Statement dc:rights

• All rights reserved

Language dc:language.iso

en

Handle dc:identifier.uri

https://hdl.handle.net/10652/6534

OAI identifier oai:identifier

oai:null:10652/6534