Cardiac rehabilitation and secondary prevention can promote recovery, reduce coronary events and improve quality of life in many people with heart disease. Traditionally provided for people with coronary heart disease, there is scope to have provision for a range of people, both young and old, and including those with heart failure, valve disease or with an internal cardiac defibrillator. At its best, cardiac rehabilitation spans the whole pathway of care, beginning before admission to hospital and continuing long after, with ongoing management of lifestyle changes. Guidelines are available based on best evidence, and programmes focus on the whole person and address physical, psychological and social well-being. They incorporate health education, risk factor modification, social support and exercise. Programmes can be run in the community, home or hospital. To ensure effective cardiac rehabilitation for each patient, members of the multi-disciplinary team are challenged to work together to meet the individual needs of patients and their family. The standard of care should be monitored through audit so that improvements can be made.
ACPICR (2003) Standards for the Exercise Component of Phase III Cardiac Rehabilitation.London : CSP .
2.
Aggarwal A Ades PA (2001) Exercise rehabilitation in elderly patients with cardiac disease . Cardiol Clin19: 525 – 536 .
3.
Asbury EA Collins P (2005) Cardiac syndrome X . Int J Clin Pract59: 1063 – 1069 .
4.
Asbury EA Slattery C Grant A Evans L Barbir M Collins P (2008) Cardiac rehabilitation for the treatment of women with chest pain and normal coronary arteries . Menopause15: 454 – 460 .
5.
Austin J Williams R Ross L Moseley L Hutchison S (2005) Randomised controlled trial of cardiac rehabilitation in elderly patients with heart failure . Eur J Heart Fail7: 411 – 417 .
6.
Banner N Guz A Heaton R Innes JA Murphy K Yacoub M (1988) Ventilatory and circulatory responses at the onset of exercise in man following heart or heart-lung transplantation . J Physiol399: 437 – 449 .
7.
Banner NR Lloyd MH Hamilton RD Innes JA Guz A Yacoub MH (1989) Cardiopulmonary response to dynamic exercise after heart and combined heart-lung transplantation . Br Heart J61: 215 – 223 .
8.
9.
Birks Y Sloper P Lewin R Parsons J (2006) Exploring health-related experiences of children and young people with congenital heart disease . Health Expect10: 16 – 29 .
10.
Blay N Donoghue J (2005) The effect of pre-admission education on domicilary recovery following laparoscopic cholecystectomy . Aust J Adv Nurs22: 14 – 19 .
11.
12.
Borg G (1998) Borg's Perceived Exertion and Pain Scales.Leeds : Human Kinetics .
13.
British Association of Cardiac Rehabilitation (2007) Standards and Core Components for Cardiac Rehabilitation.London : British Cardiac Society .
14.
British Heart Foundation (2003) Coronary Heart Disease Statistics British Heart Foundation Database.London : BHF .
15.
British Heart Foundation (2004) Coronary Heart Disease Statistics British Heart Foundation Database.London : BHF .
16.
British Heart Foundation (2006) Coronary Heart Disease Statistics British Heart Foundation Database.London : BHF .
17.
British Heart Foundation (2008) The National Audit of Cardiac Rehabilitation Annual Statistical Report 2008.London : BHF .
18.
Britt E Hudson SM Blampied NM (2004) Motivational interviewing in health settings: a review . Patient Educ Couns53: 147 – 155 .
19.
Chartered Society of Physiotherapy (1999) Standards for the Exercise Component of Phase III Cardiac Rehabilitation.London : Chartered Society of Physiotherapy .
20.
21.
Cupples ME McKnight A (1999) Five year follow up of patients at high cardiovascular risk who took part in a randomised controlled trial on health promotion . BMJ319: 687 – 688 .
22.
Dalal HM Evans PH (2003) Achieving national service framework standards for cardiac rehabilitation and secondary prevention . BMJ326: 481 – 484 .
23.
Department of Health (2000) National Service Framework for Coronary Heart Disease.London : HMSO .
24.
Department of Health (2004) National Service Framework for Coronary Heart Disease Winning the War on Heart Disease: Progress Report 2004.London : HMSO .
25.
Fitchet A Doherty PJ Bundy C Bell W Fitzpatrick AP Garratt CJ (2003) Comprehensive cardiac rehabilitation programme for implantable cardioverter-defibrillator patients: a randomised controlled trial . Heart89: 155 – 160 .
26.
Fleming H Goodman H Geraghty A West W Lancaster L (2001) A survey of patients’ education and needs while waiting for cardiac surgery . Clin Eff Nurs5: 143 – 151 .
27.
Flynn F Cafarelli M Petrakos K Christopherson P (2007) Improving outcomes for acute coronary syndrome patients in the hospital setting: successful implementation of the American Heart Association ‘Get With The Guidelines’ programme by Phase I cardiac rehabilitation nurses . J Cardiovasc Nurs22: 166 – 176 .
28.
Franklin BA Bonzheim K Gordon K Timmis GC (1998) Safety of medically supervised outpatient cardiac rehabilitation exercise therapy: a 16-year follow-up . Chest114: 902 – 906 .
29.
Frantz AK (2004) Breaking down the barriers to heart failure patient self care . Home Healthc Nurse22: 109 – 115 .
30.
Frizelle DJ Lewin RJP Kaye G (2004) Provision of rehabilitation services to patients with implanted cardioverter defibrillators: a survey of UK implantation centres . Br J Cardiol11: 302 – 305 .
31.
Fowler S Singh S Revill S (2005) Reproducibility and validity of the incremental shuttle walking test in patients following coronary artery bypass surgery . Physiotherapy91: 22 – 27 .
32.
Hall R; Moore R; Camm J; Swanton H; Gray H; Flint J; (2002) Fifth report on the provision of services for patients with heart disease. Heart 88(Suppl. 3): iii 1–iii 59.
33.
Halligan A Donaldson L (2001) Implementing clinical governance: turning vision into reality . BMJ322: 1413 – 1417 .
34.
35.
Jolliffe JA Rees K Taylor RS Thompson D Oldridge N Ebrahim S (2001) Exercise-based rehabilitation for coronary heart disease . Cochrane Database Syst Rev1: CD001800.
36.
Jolly K Taylor RS Lip GYH Stevens A (2004) Home-based cardiac rehabilitation compared with centre-based rehabilitation and usual care: a systematic review and meta-analysis: exercise-based rehabilitation for patients with coronary heart disease: systematic review and meta-analysis of randomized controlled trial . Am J Med116: 682 – 692 .
37.
Jones D West R (1995) Cardiac Rehabilitation, First ed.London : BMJ Publishing Group .
38.
Karim K Gormley J (2007) Quality of life post myocardial infarction – is the heart manual effective . Eur J Cardiovasc Nurs6: 47 – 48 .
39.
Kaski JC (2004) Pathophysiology and management of patients with chest pain and normal coronary arteriograms (cardiac syndrome X) . Circulation109: 568 – 572 .
40.
Kavanagh T (1996) Physical training in heart transplant recipients . J Cardiovasc Risk3: 154 – 159 .
41.
Lavie CJ Milani RV (1995) Effects of cardiac rehabilitation and exercise training on exercise capacity, coronary risk factors, behavioral characteristics, and quality of life in women . Am J Cardiol75: 340 – 343 .
42.
Lewin B (2007) A National Campaign for Cardiac Rehabilitation. The 7th York Cardiac Care & Rehabilitative Conference, University of York, York.
43.
Lugon M Secker-Walker J (2001) Advancing clinical governance . Qual Health Care10: 197 – 198 .
44.
Mitchell M (2000) Psychological preperations for patients undergoing day surgery . Ambul Surg8: 19 – 29 .
45.
McHugh F Hankey C Belcher PR (2000) The management of patients on the waiting lists for coronary artery bypass grafting: a case study . Coron Health Care4: 146 – 151 .
46.
Moher M Yudkin P Wright L Turner R Fuller A Schofield T (2001) Cluster randomised controlled trial to compare three methods of promoting secondary prevention of coronary heart disease in primary care . BMJ322: 1338 – 1342 .
47.
Murphy CM George MV Driscoll A (2008) Concordance with phase I cardiac rehabilitation giudlines in the inpatient setting . Aust J Adv Nurs25: 31 – 37 .
48.
49.
50.
Paquet M Bolduc N Xhignesse M Vanasse A (2005) Re-engineering cardiac rehabilitation programmes: considering the patients’ point of view . J Adv Nurs51: 567 – 576 .
51.
Pell J (1997) Cardiac rehabilitation: a review of its effectiveness . Coron Health Care1: 8 – 7 .
52.
Pollock M Franklin B Balady G Chaitman B Fleg J Fletcher B (2000) Resistance exercise in individuals with and without cardiovascular disease. Benefits, rationale, safety, and prescriptionAn advisory from the committee on exercise, rehabilitation, and prevention, council on clinical cardiology, American Heart Association . Circulation101: 828 – 833 .
53.
Rees K Taylor RS Singh S Coats AJS Ebrahim S (2004) Exercise based rehabilitation for heart failure . Cochrane Database Syst Rev (3): CD003331 10.1002/14651858.CD003331.pub2.
54.
Rutledge DN; Donaldson NE; Pravikoff DS; (2001) Patient education in disease and symptom management: congestive heart failure. www.nurseweb.ucsf.edu (accessed 03.03.08).
55.
Scot A Ignaszewski A (2001) Cardiac rehabilitation: a comprehensive review . Curr Control Trials Cardiovasc Med2: 221 – 232 .
Snaith RP (2003) The hospital and anxiety scale . Health Qual Life Outcomes1: 29 .
60.
Stewart KJ Badenhop D Brubaker PH Keteyian PH King M (2003) Cardiac rehabilitation following percutaneous revascularization, heart transplant, heart valve surgery, and for chronic heart failure . Chest123: 2104 – 2111 .
61.
Swedberg K Cleland J Dargie H Drexler H Follath F Komajda M (2005) Guidelines for the diagnosis and treatment of chronic heart failure: executive summary (update 2005): the task force for the diagnosis and treatment of chronic heart failure of the European Society of Cardiology . Eur Heart J26: 1115 – 1140 .
62.
Taylor R (1997) Cardiac rehabilitation: do exercise programmes make a difference . Coron Health Care1: 193 – 199 .
63.
Taylor R Brown A Ebrahim S Jolliffe J Noorani H Rees K (2004) Exercise-based rehabilitation for patients with coronary heart disease: systematic review and meta-analysis of randomized controlled trials . Am J Med116: 682 – 692 .
64.
Thompson DR Franklin BA (2004) From case report to meta analysis – additional evidence for the benefits of exercise training in cardiac patients . Am J Med116: 714 – 716 .
65.
Turnball J (1998) Evaluating health care, using goal attainment scaling . Nurs Stand12: 35 – 38 .
66.
Vanhees L Schepers D Heidbuchel H Defoor J Fagard R (2001) Exercise performance and training in patients with implantable cardioverter-defibrillators and coronary heart disease . Am J Cardiol87: 712 – 715 .
67.
Whaley MH Brubacker PH Kaminsky LA Miller CR (1997) Validity of rating of perceived exertion during graded exercise testing in apparently healthy adults and cardiac patients . J Cardiopulm Rehabil17: 261 – 267 .
68.
WHO (1993) Needs and Action Priorities in Cardiac Rehabilitation and Secondary Prevention.Geneva : WHO Regional Office for Europe .
69.
Wren C O'Sullivan JJ (2001) Survival with congenital heart disease and need for follow up in adult life . Heart85: 438 – 443 .
70.
Zigmond AS Snaith RP (1983) The Hospital Anxiety and Depression Scale . Acta Psychiatr Scand67: 361 – 370 .
