OBJECTIVE: The current study examined predictors of, and reasons for, non-attendance at cardiac rehabilitation (CR) among coronary heart disease patients. METHODS: Measures of demographics, surgical procedures, cardiac risk factors, cardiac damage, and psychological variables (depression, trauma, anxiety and alexithymia) were obtained at baseline in 85 coronary heart disease patients, of whom 34 (40%) attended CR. Patients not attending CR reported reasons for their non-attendance. RESULTS: Men who had a sedentary lifestyle or were obese were significantly more likely to attend CR. Women were significantly more likely to attend CR if they had a partner. Patients reported numerous personal reasons for their non-attendance, some of which reflect a dislike of a group format. CONCLUSION: The results suggest the presence of obstacles to attendance and completion of CR that may differ for men and women. Innovative approaches are needed to encourage participation, including the development and evaluation of alternative formats of CR.
Dusseldorp E.,van Elderen T.,Maes S.,Meulman J.,Kraaij V..A meta-analysis of psycho educational programs for coronary heart disease patients.Health Psychol. 1999;18:506-519
2.
Oldridge N.B.,Guyatt G.H.,Fischer M.E.,Rimm A.A..Cardiac rehabilitation after myocardial infarction: Combined experience of randomized clinical trials.J Am Med Assoc. 1988;260:945-950
3.
Haskell W.L.,Alderman E.L.,Fair J.M.,Maron D.J.,Mackey S.F.,Superko H.R.,Williams P.T.,Johnstone I.M.,Champagne M.A.,Krauss R.M.,Farquhar J.W..Effects of intensive multiple risk factor reduction on coronary atherosclerosis and clinical cardiac events in men and women with coronary artery disease: The Stanford coronary risk intervention project (SCRIP).Circulation. 1994;89:975-990
4.
Herttzeanu H.L.,Shemesh J.,Aron L.A.,Aron A.L.,Peleg E.,Rosenthal T.,Motro M.,Kellermann J.J..Ventricular arrhythmias in rehabilitated and non rehabilitated post myocardial infarction patients with left ventricular dysfunction.Am J Cardiol. 1993;71:24-27
5.
Ketterer M.W..Secondary prevention of ischemic heart disease.Psychosomatics. 1993;34:478-484
6.
Lesperance F.,Frrasure-Smith N..Depression in patients with cardiac disease: a practical review.J Psychosom Res. 2000;48:379-391
Blackburn G.G.,Foody J.M.,Sprecher D.L.,Park E.,Apperson-Hansen C.,Pashkow F.J..Cardiac rehabilitation participation patterns in a large, tertiary care center: Evidence for selection bias.J Cardiopulm Rehabil. 2000;20:189-195
9.
Ades P.A.,Meacham C.P.,Handy M.A.,Nedde W.E.,Hanson J.S..The cardiac rehabilitation program of the University of Vermont Medical Center.J Cardiopulm Rehabil. 1986;6:265-277
10.
Hiatt A.M.,Zimmerman L.,Hoenshell-Nelson N..Factor's influencing patient entrance into a cardiac rehabilitation program.Cardiovasc Nurs. 1990;26:25-29
11.
Oldridge N.B.,Jones N.L..Improving patient compliance in cardiac exercise rehabilitation: effects of written agreement and self-monitoring.J Cardiac Rehabil. 1983;3:257-262
12.
Oldridge N.B.,Streiner D.L..The health belief model: Prediction of compliance and dropout in cardiac rehabilitation.Med Sci Sports Exerc. 1990;22:678-683
13.
[13]Dorn J, Naughton J, Imamura D, Trevisan M. Correlates of compliance in a randomized exercise trial in myocardial infarction patients. Med Sci Sports Exerc 2000;1081–9
14.
Lane D.,Carroll D.,Ring C.,Beevers D.G.,Lip G.Y.H..Predictors of attendance at cardiac rehabilitation after myocardial infarction.J Psychosom Res. 2001;51:497-501
15.
Harlan W.R.,Sandler S.A.,Lee K.L.,Choi Lam L.,Mark D.B..Importance of baseline functional and socioeconomic factors for participation in cardiac rehabilitation.Am J Cardiol. 1995;76:37-39
16.
Cooper A.,Lloyd G.,Weinman J.,Jackson G..Why patients do not attend cardiac rehabilitation: role of intentions and illness beliefs.Heart. 1999;82:234-236
Ades P.A.,Waldmann M.L.,McCann W.J.,Weaver S.O..Predictors of cardiac rehabilitation participation in older coronary patients.Arch Intern Med. 1992;152:1033-1035
20.
Ades P.A.,Waldman M.L.,Polk D.M.,Coflesky J.T..Referral patterns and exercise response in the rehabilitation of female coronary patients aged years.Am J Cardiol. 1992;69:1423-1425
21.
Blumenthal J.A.,Williams R.S.,Wallace A.G.,Williams R.B.,Needles T.L..Physiological and psychological variables predict compliance to prescribed exercise therapy in patients recovering from myocardial infarction.Psychosom Med. 1982;44:519-527
22.
Taylor D.K.,Barber K.R.,McIntosh B.A.,Khan M..The impact of post acute myocardial infarction (AMI) depression on patient compliance and risk factor modification.Psychol Health Med. 1998;3:439-442
23.
[23]Kojima M, Frasure-Smith N, Lesperance F. Alexithymia following myocardial infarction: Psychometric properties and correlates of the Toronto Alexithymia Scale. J Psychosomatic Med 2001;487-495
24.
Devins G.M.,Orme C.M.Test critiques. Kayserm K.J.Sweetland R.C., ed. Kansas City: Test Corporation of America Inc; 1986:133-160.
25.
Foa E.B.,Riggs D.S.,Dancu C.V.,Rothbaum B.O..Reliability and validity of a brief instrument for assessing posttraumatic stress disorder.J Traumatic Stress. 1993;6:459-473
26.
Derogatis L.R.Symptom Checklist 90 Revised. Minneapolis: National Computer Systems Inc; 1975:
Richardson J.,Barkan S.,Cohen M.,Back S.,Fitzgerald G.,Feldman J.,Young M.,Palacio H..Experience covariates of depressive symptoms among a cohort of HIV infected women.Social Work in Health Care. 2001;32:93-111
29.
Kou Z.,Shi Y..Clinical psychological study of cancer patients.Chinese J Clin Psychol. 1995;3:163-165
30.
Geisser M.E.,Roth R.S.,Robinson M.E..Assessing depression among persons with chronic pain using the Center for Epidemiological Studies Depression Scale and the Beck Depression Inventory: A comparative analysis.Clin J Pain. 1997;13:163-170
31.
Parikh R.,Eden D.T.,Price T.R.,Robinson R.G..The sensitivity and specificity of the Center for Epidemiological Studies Depression Scale in screening for post-stroke depression.Int J Psychiatry Med. 1988;18:169-181
32.
Fukunishi I.,Koyama I.,Tombimatsu H..Psychological acceptance and alexithymia in spinal cord injury patients.Psychol Reports. 1995;76:475-481
33.
Porcelli P.,Zaka S.,Leoci C.,Centonze S..Alexithymia in inflammatory bowel disease: A case-control study.Psychother Psychosom. 1995;64:49-53
34.
Taylor G.J.,Bagby M.,Ryan D.P.,Parker J.D.A.,Doody K.F.,Deefe P..Criterion Validity of the Toronto Alexithymia Scale.Psychosom Med. 1988;50:500-509
35.
Bunker S.,McBurney H.,Cox H.,Jelinek M..Identifying participation rates at outpatient cardiac rehabilitation programs in Victoria, Australia.J Cardiopulm Rehabil. 1999;19:334-338
36.
Radtke K.L..Exercise compliance in cardiac rehabilitation.Rehabil Nurs. 1989;14:182-186
37.
Carney R.M.,Freedland K.E.,Stein P.K.,Skala J.A.,Hoffman P.,Jaffe A.S..Change in heart rate and heart rate variability during treatment for depression in patients with coronary heart disease.Psychosom Med. 2000;62:639-647
38.
Cossette S.,Frasure-Smith N.,Lesperance F..Clinical implications of a reduction in psychological distress on cardiac prognosis in patients participating in a psychosocial intervention program.Psychosom Med. 2001;63:257-266
39.
Friedman D.B.,Williams A.N.,Levine B.D..Compliance and efficacy of cardiac rehabilitation and risk factor modification in the medically indigent.Am J Cardiol. 1997;79:281-285
