Barriers for Nonparticipation and Dropout of Women in Cardiac Rehabilitation Programs: A Systematic Review

Resurrección, Davinia M.; Motrico, Emma; Rigabert, Alina; Rubio-Valera, María; Conejo-Cerón, Sonia; Pastor, Luis; Moreno-Peral, Patrícia

doi:10.1089/jwh.2016.6249

Cited by 91 publications

(98 citation statements)

References 55 publications

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“…Two reviews found that CR completion was associated with individual and contextual factors such as the perceptions of CR programs, being male, younger than 65 and having transport [ 15 , 16 ]. Specifically in women, recent systematic reviews found that CR dropout is influenced by multilevel barriers such as intrapersonal barriers, interpersonal barriers, logistical barriers, health system barriers, or CR program barriers [ 17 – 19 ]. However, the only qualitative studies included in these reviews were related to experiences or reasons for women’s participation into CR [ 20 – 22 ], and there were no specific qualitative studies focused on women’s reasons for dropping out from CR.…”

Section: Introductionmentioning

confidence: 99%

Reasons for dropout from cardiac rehabilitation programs in women: A qualitative study

et al. 2018

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BackgroundEmpirical evidence has shown that cardiac rehabilitation programs are effective in reducing morbidity and mortality, improving quality of life in patients with cardiovascular disease. Despite the benefits, women have a high cardiac rehabilitation dropout rate. Our aim was to explore women’s perceptions about the reasons they faced for dropout from these programs.MethodsSemi-structured interviews were conducted with women (n = 10) after dropping out from three different cardiac rehabilitation centers in Spain. In addition, a focus group and a semi-structured interview with cardiovascular professionals were conducted. From a grounded theory perspective, thematic analysis was used to derive themes from interview transcripts.ResultsThe women were between 41 and 70 years. We identified five general themes that illustrated reasons for cardiac rehabilitation dropout: intrapersonal reasons (self-reported health, self-reported mental health, health beliefs); interpersonal reasons (family caregiver role, work conflicts); logistical reasons (transport, distance); cardiac rehabilitation program characteristics (perception of the objective of cardiac rehabilitation, exercise component, inconvenient timing, cardiac rehabilitation equipment); and health system reasons (financial assistance for transport, long waiting list). The cardiovascular professionals found barriers to cardiac rehabilitation completion similar to those found by the women.ConclusionsIn order to prevent cardiac rehabilitation dropout in women, modular and flexible programs are needed. In addition, the inclusion of primary care centers or community resources could improve cardiac rehabilitation completion in women. Psychological assessment and counseling during cardiac rehabilitation should be included as an essential part of the programs and recommended for those women with depressive symptoms. Finally, improved financial assistance for transport from the health system is essential.

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Section: Introductionmentioning

confidence: 99%

Reasons for dropout from cardiac rehabilitation programs in women: A qualitative study

et al. 2018

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“…Despite the existing evidence, there is little development of hospital CR units in primary care environments (phase II of CR). [13][14][15][16][17][18][19]. For this reason, most patients are sent back home without a start-up program that advises them on their illnesses and the changes in habits that are fundamental for their recovery.…”

Section: Introductionmentioning

confidence: 99%

“…This phase has the peculiarity that the person may have already returned to his/her routine activities and/or to the workplace, and this phase extends in time for the rest of the patient's life cycle. [19,20].…”

Section: Introductionmentioning

confidence: 99%

Cardiac Rehabilitation in Primary Care. Impact of an Intervention on Perceived Self-Efficacy

Madueño-Caro

Mellado-Fernández

Pardos-Lafarga

et al. 2019

JFMK

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Cardiac rehabilitation is cost-effective and should be considered a part of the care system provided to patients who have suffered a myocardial infarction or another heart disease. The main variable to study was the scoring, prior to and after the intervention in the General Scale of Self-Efficacy by Baessler & Schwarzer. A clinical community trial that was open controlled and randomised was used. All adult subjects of both sexes who had completed a cardiac rehabilitation program for 12 months at the reference hospital were selected and offered to participate. The psychometric variables registered were the Salamanca screening questionnaire, the Hamilton Anxiety Rating Scale, and the Beck Depression Inventory. Eighty-nine subjects accepted to participate in the study (93.89% response rate), with an average age of 63.01 years (SD 8.75). Once the study was concluded, the main outcome was a difference in means of 6.09 points in the General Scale of Self-Efficacy (p < 0.0053, 96% confidence interval—4.1950–10.29), showing that the group exposed to the intervention reached a higher score in the above-mentioned scale. However, there were no significant differences (t-student 0.1211; p = 0.943) after the estimation and contrast of population means for score differences between the groups regarding the Hamilton scale. Similarly, there were no significant differences between the groups regarding the means obtained in the variable score difference in the Beck Depression Inventory (t-student −0.1281; p = 0.8987). The results showed an increase in those scores related to general self-efficacy among the population that completed the intervention program, as compared to the control group.

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“…9 Women in this age group often have conflicting work or family responsibilities, making it difficult to schedule health care visits. 10 Therefore, a need exists for developing innovative educational strategies for women seeking menopause health information. 11 As defined by the Office of the National Coordinator for Health Information Technology, patient portals are secure online websites that give patients convenient 24-hour access to personal health information from anywhere with an Internet connection.…”

Section: Introductionmentioning

confidence: 99%

A Patient Portal Intervention for Menopause Knowledge and Shared Decision-Making

Dang

Thavalathil

Ruiz

et al. 2019

Journal of Women's Health

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Background: Menopause is a time often fraught with changes and symptoms, which may require difficult choices and decision-making. During this period, women would benefit from a better understanding and indepth discussions with providers regarding menopause, associated conditions, and appropriate therapy. Patient portals offer a potential means to improve knowledge and shared decision-making (SDM) about menopause. Materials and Methods: This protocol article explores the feasibility of using the secure messaging (SM) function of the Veterans Affairs (VA) Patient Portal, ''My HealtheVet'' to implement an educational intervention and measure its impact on knowledge and SDM in the management of menopause. Results: This is a quality improvement pilot study in which women veterans of menopausal age in the Miami VA are offered an educational intervention via a patient portal, while women veterans in two neighboring VA facilities are not. Intervention participants receive weekly SMs with information on menopause symptoms, and treatment. After 6-months, all participants are surveyed on menopause knowledge, SDM, and satisfaction with the program. Conclusion: This study is among the first to assess the impact of an innovative patient portal intervention to improve knowledge and SDM between patients and providers regarding menopause. If successful, our program will add to the ''meaningful use'' of patient portals and offer a scalable and timely resource for SDM about menopause.

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Barriers for Nonparticipation and Dropout of Women in Cardiac Rehabilitation Programs: A Systematic Review

Cited by 91 publications

References 55 publications

Reasons for dropout from cardiac rehabilitation programs in women: A qualitative study

Reasons for dropout from cardiac rehabilitation programs in women: A qualitative study

Cardiac Rehabilitation in Primary Care. Impact of an Intervention on Perceived Self-Efficacy

A Patient Portal Intervention for Menopause Knowledge and Shared Decision-Making

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