title: Re-engineering cardiac rehabilitation programmes: considering the patient's point of view.
abstract: OBJECTIVE
  The aim of this paper is to report a study to describe how cardiac patients experience the first 3 months following a cardiac event requiring hospitalization, identify differences between the needs expressed by patients and the support they received during their recuperation and produce a preliminary model for the development of cardiac rehabilitation programmes, taking into account the patient perspective.
  
  
  BACKGROUND
  Although cardiac rehabilitation should be standard care for patients with cardiovascular disease, less than 20% begin and maintain a rehabilitation programme. Cited barriers include inadequate rehabilitation services, sub-optimal referral, low participation rates of women and older adults and travel considerations. The literature suggests that programmes better adjusted to patient needs could increase attendance, but little research has considered this perspective.
  
  
  METHODS
  Focus groups were conducted with a purposefully selected sample of 20 men and women who had been hospitalized for myocardial infarction, angina or percutaneous angioplasty. Data were analysed using qualitative content analysis.
  
  
  RESULTS
  A gap exists between what traditional rehabilitation programmes offer and patients' expressed needs during the recuperating process after hospitalization for a cardiac event. In our study, participants focused on stress management rather than on modifying health habits. Support groups were viewed as beneficial and, according to patients, accepting their condition, knowing their limits and better continuity of care would also help reduce stress. Based on the findings, we devised a model as the basis for developing cardiac rehabilitation programmes.
  
  
  CONCLUSIONS
  Cardiac rehabilitation programmes need to shift their focus of attention from promoting healthier behaviours to responding to participants' perceived needs, alongside risk factor reduction.
authors.affiliation: Clinical Research Centre, Université de Sherbrooke, Sherbrooke, Québec, Canada. mariane.paquet@usherbrooke.ca
authors.forename: Mariane
authors.initials: M
authors.lastname: Pâquet
authors.forename: Nicole
authors.initials: N
authors.lastname: Bolduc
authors.forename: Marianne
authors.initials: M
authors.lastname: Xhignesse
authors.forename: Alain
authors.initials: A
authors.lastname: Vanasse
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000787:Angina Pectoris / Q000523:psychology / Q000534:rehabilitation; D015906:Angioplasty, Balloon, Coronary; D003266:Continuity of Patient Care; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006331:Heart Diseases / Q000523:psychology / Q000534:rehabilitation*; D006760:Hospitalization; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000523:psychology / Q000534:rehabilitation; D009723:Nurse-Patient Relations; D017060:Patient Satisfaction; D011788:Quality of Life; D012907:Smoking; D012931:Social Environment