Listening to patients: choice in cardiac rehabilitation.
BACKGROUND
The benefits of cardiac rehabilitation (CR) after myocardial infarction (MI) are increasingly recognised and is recommended in national guidelines.


OBJECTIVE
To explore patients' experience of MI and to identify the factors which influence the choice patients make given the option of hospital or home-based CR after MI.


METHODS
Qualitative study using semi-structured interviews and interpretive phenomenological analysis (IPA). This study was embedded within a randomised trial with preference arms.


RESULTS
Seventeen participants were interviewed before their rehabilitation programme. Ten expressed a preference for home-based and seven for hospital-based rehabilitation. Common to both groups was shock and disbelief, which led to a loss of confidence. They expressed a strong desire to make lifestyle changes and looked for specific advice, guidance and support from knowledgeable experts. The hospital-based group had an emphasis on supervision during exercise, needed the camaraderie of a group, were willing to make travel arrangements and believed they lacked self-discipline. The home-based group believed that their CR should fit in with their lives rather than their lives fitting in with the rehabilitation programme and were self-disciplined. They disliked groups and expressed practical concerns.


CONCLUSIONS
Understanding the factors that influence patient's choices may help professionals guide them to the most appropriate CR method and hence improve uptake.
Wingham
Jenny
J
Knowledge Spa, Royal Cornwall Hospital Trust, Truro, TR1 3HD, UK. Jenny.Wingham@rcht.cornwall.nhs.uk
Dalal
Hasnain M
HM
Sweeney
Kieran G
KG
Evans
Philip H
PH
D000368:Aged; D000369:Aged, 80 and over; D002755:Choice Behavior; D003142:Communication; D005081:Exercise Therapy; D005260:Female; D006126:Group Processes; D007722:Health Knowledge, Attitudes, Practice; D006301:Health Services Needs and Demand; D006699:Home Care Services; D006801:Humans; D007398:Interpersonal Relations; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009203:Myocardial Infarction / Q000523:psychology / Q000534:rehabilitation; D015404:Nursing Methodology Research; D010044:Outpatient Clinics, Hospital; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D010353:Patient Education as Topic; D036301:Qualitative Research; D020377:Self Efficacy; D012944:Social Support; D011795:Surveys and Questionnaires; D014195:Travel