title: Feeling supported and abandoned: mixed messages from attendance at a rural community cardiac rehabilitation program in Australia.
abstract: OBJECTIVE
  In 2010, the Healthy Heart (HH) community-based cardiac rehabilitation program was offered at Latrobe Community Health Service in rural Victoria, Australia. The 8-week program, based on National Heart Foundation guidelines, consisted of exercise sessions; health education on diet, stress, and smoking cessation; and behavioral change strategies. Participants were also informed about local community exercise opportunities. A program evaluation was conducted in 2011 to assess whether the content of the program was meeting the needs of participants and to identify what suggestions they had for improvement.
  
  
  METHODS
  Eighteen patients had completed the HH program in 2010. Eight of these participants, 7 men and 1 woman, volunteered to take part in a focus group. Conventional content analysis was used to identify and group the common themes that emerged from the focus group discussions.
  
  
  RESULTS
  Three themes were identified that reflected the participant experiences of attending the HH program. The first, "recovering confidence," described participant responses to the content of the sessions. The second, "putting it into practice," referred to their comments about taking responsibility for making lifestyle changes. The third, "feeling abandoned," emerged from the reported difficulty participants expressed about maintaining motivation for change after program completion.
  
  
  CONCLUSIONS
  Participants rated the HH program as very successful by objective measures. However, they reported struggling to maintain self-management strategies postprogram. There is clearly a need to develop strategies that support cardiac rehabilitation participants over the longer-term.
authors.affiliation: Department of Social Work (Dr Fletcher), Department of Rural and Indigenous Health (Ms Burley and Dr Mitchell), Monash University, Moe, Victoria, Australia; Latrobe Community Health Service, Gippsland, Victoria, Australia (Dr Fletcher and Mss Burley and Thomas); and East Gippsland Regional Clinical School, School of Rural Health, Monash University, Bairnsdale, Victoria, Australia (Dr Mitchell).
authors.forename: Susan M
authors.initials: SM
authors.lastname: Fletcher
authors.forename: Mollie B
authors.initials: MB
authors.lastname: Burley
authors.forename: Karen E
authors.initials: KE
authors.lastname: Thomas
authors.forename: Eleanor K L
authors.initials: EK
authors.lastname: Mitchell
mesh_terms: D000368:Aged; D001315:Australia; D003153:Community Health Services / Q000379:methods / Q000592:standards; D004644:Emotions; D005260:Female; D006331:Heart Diseases / Q000523:psychology / Q000534:rehabilitation; D006801:Humans; D008019:Life Style; D008297:Male; D009042:Motivation; D020380:Needs Assessment; D010358:Patient Participation; D057240:Patient Preference / Q000523:psychology; D015397:Program Evaluation; D012046:Rehabilitation / Q000379:methods / Q000458:organization & administration / Q000523:psychology; D012424:Rural Population; D011795:Surveys and Questionnaires