Primary health care resources for rehabilitation and secondary prevention after myocardial infarction - a questionnaire survey.
BACKGROUND
During the first year after a cardiac event, many patients are offered participation in a cardiac rehabilitation programme, after which the patients are often not given the opportunity to continue to attend rehabilitation and secondary prevention programmes.


OBJECTIVE
This study describes the primary health care centres' (PHCC) resources regarding cardiac rehabilitation/secondary prevention programmes for coronary heart disease (CHD) patients in a southern Swedish region.


METHODS
A questionnaire containing 26 dichotomous or multiple choice questions was sent to the responsible manager of all 137 public and private PHCCs in Region Skåne. Questionnaires from 91 (66%) of the PHCCs were completed and returned.


RESULTS
Few nurses at the PHCCs had special training regarding CHD (10%), cardiac rehabilitation (8%) or heart failure (32%). Twenty-one per cent of the physicians had special training regarding CHD. One third of the PHCCs did not offer long-term secondary prevention programmes, and few (6%) had any routines for offering socio-economic support to CHD patients. Comparison of private and public PHCCs showed that the private centres could not offer a physiotherapist (61 vs. 84%) or dietician (32 vs. 73%; p = 0.03) to the same extension as the public ones. Furthermore, the majority (91%) of PHCCs had no cooperation with patient organizations.


CONCLUSIONS
The PHCCs need to improve the strategies and long-term rehabilitation programmes. Furthermore, they need to focus on education programme for the staff. The result revealed that the PHCCs lack resources, strategies and long-term care programmes for CHD patients.
Department of Cardiothoracic Surgery, Lund University and Skåne University Hospital/Lund, Lund, Sweden. annica.sjostrom-strand@med.lu.se
Annica
A
Sjöström-Strand
Bodil
B
Ivarsson
Trygve
T
Sjöberg
D006295:Health Resources; D006801:Humans; D009203:Myocardial Infarction / Q000517:prevention & control* / Q000534:rehabilitation*; D011320:Primary Health Care / Q000458:organization & administration*; D055502:Secondary Prevention; D011795:Surveys and Questionnaires; D013548:Sweden