Predicting and explaining cardiac rehabilitation attendance.
BACKGROUND
A variety of factors influence patients' health behaviour; these are patterns of practitioner practice, patient characteristics and availability of resources.


OBJECTIVE
To examine patient-related factors (demographic, health, psychosocial characteristics) that may influence patients' attendance at cardiac rehabilitation programs and their subsequent behaviour change.


METHODS
A prospective cohort design was used. Three hundred four acute myocardial infarction and/or coronary artery bypass graft surgery patients from a tertiary care centre in a Western Canadian city were enrolled to participate in telephone interviews at two weeks and again at approximately six months after their hospital discharge. Measures of self-efficacy and behaviour performance for cardiac health maintenance and role resumption, motivation and social support were used at both interview times. A survey focusing on factors influencing patients' choices to attend cardiac rehabilitation programs was also administered at the interview six months after discharge.


RESULTS
Attendance at cardiac rehabilitation programs is not associated with patients' risk factor status, and elderly and rural-living patients are at particular risk for nonattendance.


CONCLUSIONS
Systematic mechanisms to guide the appropriate referral of patients to this health care resource and administer secondary prevention initiatives to those with limited access to resources need to be a priority in cardiovascular health care.
Division of Cardiology, University of Alberta, Edmonton, Canada. kingk@ucalgary.ca
K M
KM
King
D P
DP
Humen
H L
HL
Smith
C L
CL
Phan
K K
KK
Teo
D000368:Aged; D002170:Canada; D003695:Delivery of Health Care / Q000379:methods / Q000592:standards; D005260:Female; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000523:psychology / Q000534:rehabilitation*; D010349:Patient Compliance / Q000523:psychology; D010817:Physician-Patient Relations; D011379:Prognosis; D011446:Prospective Studies; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012046:Rehabilitation / Q000592:standards* / Q000706:statistics & numerical data; D012424:Rural Population; D011795:Surveys and Questionnaires