S Greenfield

Dr S Greenfield, University of Birmingham, Birmingham, UK; s.m.greenfield@bham.ac.uk

QUESTION

Why do post-myocardial infarction (MI) or revascularisation patients not adhere to home-based or hospital-based cardiac rehabilitation programmes (CRPs)?

DESIGN

Semi-structured interviews.

SETTING

4 hospitals and participant’s homes in the UK.

PARTICIPANTS

Purposive sample of 49 patients (age range 34–87 y, 67% men) who had MI or revascularisation and did not adhere to home-based (n = 21) or hospital-based (n = 28) CRPs were identified from a randomised controlled trial. The home-based CRP included a copy of the Heart Manual (6-wk exercise and walking programme), information tapes, home visits, and telephone calls from nurses. The hospital-based CRP included group or individual exercise based on circuit training, and combined or separate sessions of education and relaxation.

METHODS

At 3–20 months after randomisation, participants were individually interviewed for 40–45 minutes about their cardiac event, expectations and experience in CRPs, and lifestyle changes. Interviews were tape recorded, transcribed, and analysed for themes and subthemes.

MAIN FINDINGS

In general, reasons for non-adherence to CRPs were multifactorial …