'Just not for me' – contributing factors to nonattendance/noncompletion at phase III cardiac rehabilitation in acute coronary syndrome patients: a qualitative enquiry

Oliver Rudolf Herber (Lead / Corresponding author), Karen Smith, Myra White, Martyn C. Jones

Research output: Contribution to journalArticle

3 Citations (Scopus)
177 Downloads (Pure)

Abstract

Aims and objectives: To explore what reasons do non-attenders and non-completers give for their patterns of participation or non-participation in cardiac rehabilitation programmes and how future uptake could be enhanced.

Background: Cardiac rehabilitation is a cost effective clinical intervention designed for adults with acute coronary syndrome. Despite evidence from meta-analyses demonstrating that cardiac rehabilitation programmes facilitate physical and psychological recovery from acute coronary syndrome, only 20 to 50% of eligible patients attend Phase III outpatient programmes.

Design: A qualitative study using thematic analysis.

Method: Within the context of a larger mixed-method study, acute coronary syndrome patients were recruited between 2012 and 2014 from three hospitals in Scotland. Out of 214 patients who consented to enrol in the main study, a purposive sub-sample of 25 participants was recruited. Semi-structured interviews were conducted and analysed using thematic analysis.

Results: Three major influences of participation were identified: (1) personal factors, (2) programme factors, (3) practical factors. In addition valuable suggestions for future programme modifications were provided. A significant barrier to attending cardiac rehabilitation programmes is that participants perceived themselves to be unsuitable for the programme alongside a lack of knowledge and/or misconceptions regarding cardiac rehabilitation.

Conclusion: The responses of non-attenders and non-completers revealed misconceptions related to programme suitability, the intensity of exercise required and the purpose of a cardiac rehabilitation programme. As long as these misconceptions continue to persist in coronary syndrome patients this will impact upon attendance. The lack of perceived need for cardiac rehabilitation stems from a poor understanding of the programme, especially among non-attenders and non-completers and subsequently an inability to comprehend possible benefits.

Relevance to clinical practice: The knowledge of common misconceptions puts clinical nurses in a better position to identify and pro-actively address these erroneous assumptions in their patients in order to improve participation in cardiac rehabilitation.

Original languageEnglish
Pages (from-to)3529-3542
Number of pages14
JournalJournal of Clinical Nursing
Volume26
Issue number21-22
Early online date2 Jan 2017
DOIs
Publication statusPublished - Nov 2017

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Acute Coronary Syndrome
Cardiac Rehabilitation
Scotland
Meta-Analysis
Outpatients
Nurses
Interviews
Exercise
Psychology
Costs and Cost Analysis

Keywords

  • Cardiac rehabilitation programme;
  • Acute coronary syndrome;
  • Barriers
  • Facilitators
  • Qualitative research
  • Non-attendance
  • Non-completion
  • Cardiovascular disease
  • Patient participation
  • Face-to-face interviews

Cite this

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title = "'Just not for me' – contributing factors to nonattendance/noncompletion at phase III cardiac rehabilitation in acute coronary syndrome patients: a qualitative enquiry",
abstract = "Aims and objectives: To explore what reasons do non-attenders and non-completers give for their patterns of participation or non-participation in cardiac rehabilitation programmes and how future uptake could be enhanced.Background: Cardiac rehabilitation is a cost effective clinical intervention designed for adults with acute coronary syndrome. Despite evidence from meta-analyses demonstrating that cardiac rehabilitation programmes facilitate physical and psychological recovery from acute coronary syndrome, only 20 to 50{\%} of eligible patients attend Phase III outpatient programmes.Design: A qualitative study using thematic analysis.Method: Within the context of a larger mixed-method study, acute coronary syndrome patients were recruited between 2012 and 2014 from three hospitals in Scotland. Out of 214 patients who consented to enrol in the main study, a purposive sub-sample of 25 participants was recruited. Semi-structured interviews were conducted and analysed using thematic analysis.Results: Three major influences of participation were identified: (1) personal factors, (2) programme factors, (3) practical factors. In addition valuable suggestions for future programme modifications were provided. A significant barrier to attending cardiac rehabilitation programmes is that participants perceived themselves to be unsuitable for the programme alongside a lack of knowledge and/or misconceptions regarding cardiac rehabilitation.Conclusion: The responses of non-attenders and non-completers revealed misconceptions related to programme suitability, the intensity of exercise required and the purpose of a cardiac rehabilitation programme. As long as these misconceptions continue to persist in coronary syndrome patients this will impact upon attendance. The lack of perceived need for cardiac rehabilitation stems from a poor understanding of the programme, especially among non-attenders and non-completers and subsequently an inability to comprehend possible benefits.Relevance to clinical practice: The knowledge of common misconceptions puts clinical nurses in a better position to identify and pro-actively address these erroneous assumptions in their patients in order to improve participation in cardiac rehabilitation.",
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author = "Herber, {Oliver Rudolf} and Karen Smith and Myra White and Jones, {Martyn C.}",
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'Just not for me' – contributing factors to nonattendance/noncompletion at phase III cardiac rehabilitation in acute coronary syndrome patients : a qualitative enquiry. / Herber, Oliver Rudolf (Lead / Corresponding author); Smith, Karen; White, Myra; Jones, Martyn C.

In: Journal of Clinical Nursing, Vol. 26, No. 21-22, 11.2017, p. 3529-3542.

Research output: Contribution to journalArticle

TY - JOUR

T1 - 'Just not for me' – contributing factors to nonattendance/noncompletion at phase III cardiac rehabilitation in acute coronary syndrome patients

T2 - a qualitative enquiry

AU - Herber, Oliver Rudolf

AU - Smith, Karen

AU - White, Myra

AU - Jones, Martyn C.

N1 - This study was funded by the Scottish Government Chief Scientist Office (CSO), grant number CZH/4/650.

PY - 2017/11

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N2 - Aims and objectives: To explore what reasons do non-attenders and non-completers give for their patterns of participation or non-participation in cardiac rehabilitation programmes and how future uptake could be enhanced.Background: Cardiac rehabilitation is a cost effective clinical intervention designed for adults with acute coronary syndrome. Despite evidence from meta-analyses demonstrating that cardiac rehabilitation programmes facilitate physical and psychological recovery from acute coronary syndrome, only 20 to 50% of eligible patients attend Phase III outpatient programmes.Design: A qualitative study using thematic analysis.Method: Within the context of a larger mixed-method study, acute coronary syndrome patients were recruited between 2012 and 2014 from three hospitals in Scotland. Out of 214 patients who consented to enrol in the main study, a purposive sub-sample of 25 participants was recruited. Semi-structured interviews were conducted and analysed using thematic analysis.Results: Three major influences of participation were identified: (1) personal factors, (2) programme factors, (3) practical factors. In addition valuable suggestions for future programme modifications were provided. A significant barrier to attending cardiac rehabilitation programmes is that participants perceived themselves to be unsuitable for the programme alongside a lack of knowledge and/or misconceptions regarding cardiac rehabilitation.Conclusion: The responses of non-attenders and non-completers revealed misconceptions related to programme suitability, the intensity of exercise required and the purpose of a cardiac rehabilitation programme. As long as these misconceptions continue to persist in coronary syndrome patients this will impact upon attendance. The lack of perceived need for cardiac rehabilitation stems from a poor understanding of the programme, especially among non-attenders and non-completers and subsequently an inability to comprehend possible benefits.Relevance to clinical practice: The knowledge of common misconceptions puts clinical nurses in a better position to identify and pro-actively address these erroneous assumptions in their patients in order to improve participation in cardiac rehabilitation.

AB - Aims and objectives: To explore what reasons do non-attenders and non-completers give for their patterns of participation or non-participation in cardiac rehabilitation programmes and how future uptake could be enhanced.Background: Cardiac rehabilitation is a cost effective clinical intervention designed for adults with acute coronary syndrome. Despite evidence from meta-analyses demonstrating that cardiac rehabilitation programmes facilitate physical and psychological recovery from acute coronary syndrome, only 20 to 50% of eligible patients attend Phase III outpatient programmes.Design: A qualitative study using thematic analysis.Method: Within the context of a larger mixed-method study, acute coronary syndrome patients were recruited between 2012 and 2014 from three hospitals in Scotland. Out of 214 patients who consented to enrol in the main study, a purposive sub-sample of 25 participants was recruited. Semi-structured interviews were conducted and analysed using thematic analysis.Results: Three major influences of participation were identified: (1) personal factors, (2) programme factors, (3) practical factors. In addition valuable suggestions for future programme modifications were provided. A significant barrier to attending cardiac rehabilitation programmes is that participants perceived themselves to be unsuitable for the programme alongside a lack of knowledge and/or misconceptions regarding cardiac rehabilitation.Conclusion: The responses of non-attenders and non-completers revealed misconceptions related to programme suitability, the intensity of exercise required and the purpose of a cardiac rehabilitation programme. As long as these misconceptions continue to persist in coronary syndrome patients this will impact upon attendance. The lack of perceived need for cardiac rehabilitation stems from a poor understanding of the programme, especially among non-attenders and non-completers and subsequently an inability to comprehend possible benefits.Relevance to clinical practice: The knowledge of common misconceptions puts clinical nurses in a better position to identify and pro-actively address these erroneous assumptions in their patients in order to improve participation in cardiac rehabilitation.

KW - Cardiac rehabilitation programme;

KW - Acute coronary syndrome;

KW - Barriers

KW - Facilitators

KW - Qualitative research

KW - Non-attendance

KW - Non-completion

KW - Cardiovascular disease

KW - Patient participation

KW - Face-to-face interviews

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DO - 10.1111/jocn.13722

M3 - Article

C2 - 28042887

VL - 26

SP - 3529

EP - 3542

JO - Journal of Clinical Nursing

JF - Journal of Clinical Nursing

SN - 0962-1067

IS - 21-22

ER -