Barriers to participation in center-based cardiac rehabilitation programs and patients’ attitude toward home-based cardiac rehabilitation programs

Bakhshayeh, Samaneh; Sarbaz, Masoumeh; Kimiafar, Khalil; Vakilian, Farveh; Eslami, Saeid

doi:10.1080/09593985.2019.1620388

Cited by 54 publications

(42 citation statements)

References 29 publications

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“…The top barriers identified included not knowing about CR, cost, comorbidities, perceptions of sufficient independent exercise and capacity to self-manage their CVD (reflecting lack of knowledge of what CR entails and potentially denial), lack of perceived encouragement by referring providers, wait times, transportation and distance. We discovered that another group was simultaneously translating and validating a CRBS-P. 37 Similarly, they used best practices in translation, although the credentials of those who undertook the translation are not clear. Three different items were removed, and four items were added.…”

Section: Discussionmentioning

confidence: 99%

“…28 It is assumed that criterion validity will be upheld in the CRBS-P, as it has been established in other translations, 28 including the other Persian translation. 37 Discriminant validity has also been established in the English CRBS in terms of sex, age and socioeconomic differences, 23 25 26 but further exploration in an Iranian sample, including consideration of literacy would be useful. Exploration of interpretability of scores would also be important, but consideration of mean scores in enrollees and non-enrollees should be considered, as they are significantly higher in enrollees (as per criterion validity above), and it does appear that scores are higher in lower resource when compared with higher resource settings.…”

Section: Discussionmentioning

confidence: 99%

“…The findings from the other CRBS-P do support generalisability and that there was no response bias due to the method of administration, however there were some differences in some of the top barriers. 37 Fourth, we did not systematically document the characteristics of the patients called to provide input on the translation in terms of face, content and cross-cultural validity; therefore it is unknown whether they are representative of the average cardiac patient indicated for CR. Finally, there may be selection bias due to the fairly low response rate for the validation sample.…”

Section: Discussionmentioning

confidence: 99%

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Cross-cultural adaptation and psychometric validation of the Persian version of the Cardiac Rehabilitation Barriers Scale (CRBS-P)

et al. 2020

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ObjectivesThis study aimed to translate, cross-culturally adapt and psychometrically validate a Persian version of the Cardiac Rehabilitation Barriers Scale (CRBS-P) and to identify the main barriers in an Iranian setting.SettingAfshar cardiac rehabilitation (CR) centre, affiliated with the Yazd University of Medical Sciences, in the centre of Iran.DesignThis was a multimethod study, culminating in a cross-sectional survey.ParticipantsInpatient CR graduates who did not attend their initial outpatient CR appointment.MethodThe 21-item CRBS was translated and cross-culturally adapted in accordance with best practices; an expert panel considered the items and previous non-attending patients were interviewed via phone to refine the scale. Next, structural validity was assessed; participants were invited to complete the CRBS on the phone between March 2017 and February 2018. Using exploratory factor analysis (EFA) with principal component analysis extraction and oblique rotation. Second, confirmatory factor analysis (CFA) was used to verify the results; several goodness-of-fit indices were considered. The internal consistency and 3-week test–retest reliability of the scale (5% subsample) were evaluated using Cronbach’s α and intraclass correlation (ICC), respectively.ResultsFace, content and cross-cultural validity were established by the experts and patients (n=50). One thousand and one hundred (40.7%) of the 2700 patients completed the CRBS-P. Structural validity was established by EFA (Bartlett’s test p<0.001; =0.759) and confirmed by the CFA; a four-factor solution with 18 items accounting for 61.256% of variance had the best fit (χ2/df=3.206, root mean square error of approximation=0.061 and Comparative Fit Index=0.959). The internal consistency and test–retest reliability (n=42) of the scale were acceptable (ICC=0.743 95% CI (0.502 to 0.868); overall α=0.797). The top barriers were not knowing about CR, cost and lack of encouragement from physicians.ConclusionThe four-factor, 18-item CRBS-P had good psychometric properties, and hence can be reliably and validly used to measure CR barriers in Iran and other Persian-speaking populations.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Cross-cultural adaptation and psychometric validation of the Persian version of the Cardiac Rehabilitation Barriers Scale (CRBS-P)

et al. 2020

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“…When planning for CBCR, distance should be considered first. If the driving distance is more than 30 minutes, participation in cardiac rehabilitation decreases [ 33 ]. Furthermore, expansion of the CBCR program to other community resources such as sub-health centers should be considered.…”

Section: Discussionmentioning

confidence: 99%

Community-Based Cardiac Rehabilitation Conducted in a Public Health Center in South Korea: A Preliminary Study

Baek

Mok

et al. 2020

Ann Rehabil Med

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Objective To evaluate the safety and effectiveness of the community-based cardiac rehabilitation (CBCR) program that we had developed.Methods Individuals aged >40 years with cardiovascular disease or its risk factors who were residing in a rural area were recruited as study subjects. The CBCR program, which consisted of 10 education sessions and 20 weeks of customized exercises (twice a week), was conducted in a public health center for 22 weeks. Comprehensive outcomes including body weight, blood glucose level, and 6-minute walk distance (6MWD) were measured at baseline, 11th week, and completion. Furthermore, the outcomes of young-old (65–74 years) and old-old (≥75 years) female subjects were compared.Results Of 31 subjects, 21 completed the program (completion rate, 67.7%). No adverse events were observed, and none of the subjects discontinued the exercise program because of chest pain, dyspnea, and increased blood pressure. Body weight and blood glucose level were significantly decreased, and 6MWD was significantly increased following program implementation (p<0.05). Both young-old and old-old women exhibited an improvement in blood glucose level and 6MWD test (p<0.05).Conclusion We reported the results of the first attempted CBCR in South Korea that was implemented without adverse events during the entire program. Improved aerobic exercise ability and reduced risk factors in all participants were observed. These improvements were also achieved by older adults aged ≥75 years.

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“…[ 5 6 ] In the past, CR focused on implementing center-based rehabilitation programs; today, with increased home-based programs and electronic telerehabilitation, efforts are being made to make CR available to all patients. [ 7 8 ] Commitment to CR plays a key role in achieving the therapeutic goals of patients with CVD. [ 9 ]…”

Section: Introductionmentioning

confidence: 99%

Exploring the consequences of patient commitment to cardiac rehabilitation program: A qualitative study

Sanaie

Kakhki

Ahmadi

2021

J Edu Health Promot

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BACKGROUND: Commitment to implementing cardiac rehabilitation (CR) plays an important role in managing the problems caused by heart diseases. Commitment to the treatment plan implementation is accompanied by numerous positive consequences. This study was carried out to explain the consequences of commitment to CR. MATERIALS AND METHODS: Data were collected through semi-structured individual interviews with 26 participants (13 CR specialists and 13 patients), using purposeful sampling. Interview questions focused on the factors influencing the formation of commitment to the CR and its consequences. Conventional content analysis with Graneheim and Lundman's approach was used to analyze the data. To obtain data trustworthiness, Lincoln and Guba's criteria were used. RESULTS: The findings were classified in three categories: purposeful of a purposeful behavior structure (sense of controlling and managing the condition, sense of responsibility, sense of security), formation of active performance structure (interaction between the patient-family-treatment team, stabilization of behavior and prevention of intermittent behavior, no cessation of the treatment plan and adherence to it, directing behaviors and adaptation to conditions) and achieving dynamic and effective care (active follow-up of the treatment plan, sense of satisfaction, reduced readmission, reduced costs, improved quality of life, reduced anxiety and concerns about treatment failure, increased self-care ability). CONCLUSION: The results show that the patient's commitment to CR is accompanied by optimal consequences. The results of this study can help design the training plan for the CR staff and develop the clinical practice guidelines to provide educational-care approaches to patients to reinforce their commitment.

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Barriers to participation in center-based cardiac rehabilitation programs and patients’ attitude toward home-based cardiac rehabilitation programs

Cited by 54 publications

References 29 publications

Cross-cultural adaptation and psychometric validation of the Persian version of the Cardiac Rehabilitation Barriers Scale (CRBS-P)

Cross-cultural adaptation and psychometric validation of the Persian version of the Cardiac Rehabilitation Barriers Scale (CRBS-P)

Community-Based Cardiac Rehabilitation Conducted in a Public Health Center in South Korea: A Preliminary Study

Exploring the consequences of patient commitment to cardiac rehabilitation program: A qualitative study

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