title: The experiences of patients undertaking a 'virtual' cardiac rehabilitation program.
abstract: Cardiac rehabilitation programs (CRP) are medically supervised, multidisciplinary programs that provide secondary prevention aimed at addressing risk factors and improving lifestyle behaviours for patients following an acute cardiac event. CRPs have been demonstrated to be a cost-effective and evidence-based mechanism to improve patient outcomes, but despite the known benefits of these programs, uptake remains poor. Poor attendance has been linked to many factors, but geographical accessibility is a key concern, since many CRPs are limited to hospitals in urban areas. The widespread availability of the Internet has made it possible to provide virtual health services to populations that may have previously been hard to access. This paper examines the qualitative findings from a 16-month mixed methods randomized controlled trial examining the impact of a virtual CRP (vCRP). The vCRP was revealed to be an accessible, appropriate, convenient and effective way to deliver cardiac rehabilitation services, with patients experiencing both clinical improvements and a high level of satisfaction. To understand the experience of patients undertaking the vCRP, semi-structured interviews were undertaken with a purposive sample of 22 participants. An analysis of the qualitative interviews revealed that the vCRP improved participants' access to healthcare professionals, supported them to make healthy choices, and enhanced feelings of accountability due to greater surveillance. Barriers to participation, such as computer literacy, and general perceptions of a vCRP were also examined. Further investigation into the use and long-term effectiveness of virtual programs across a broader range of healthcare settings is warranted, particularly in those with multiple chronic diseases and those located in rural and remote communities.
authors.affiliation: School of Nursing, University of Northern British Columbia.
authors.forename: Davina
authors.initials: D
authors.lastname: Banner
authors.affiliation: Faculty of Health Sciences, Simon Fraser University.
authors.forename: Scott
authors.initials: S
authors.lastname: Lear
authors.affiliation: School of Nursing, University of Northern British Columbia.
authors.forename: Daman
authors.initials: D
authors.lastname: Kandola
authors.affiliation: Centre for Health Evaluation and Outcome Sciences, Providence Health Care.
authors.forename: Joel
authors.initials: J
authors.lastname: Singer
authors.affiliation: School of Nursing, University of Northern British Columbia.
authors.forename: Dan
authors.initials: D
authors.lastname: Horvat
authors.affiliation: Department of Family Medicine, Faculty of Practice, University of British Columbia.
authors.forename: Joanna
authors.initials: J
authors.lastname: Bates
authors.affiliation: Division of Cardiology, Providence Health Care c Division of Cardiology.
authors.forename: Andrew
authors.initials: A
authors.lastname: Ignaszewski
mesh_terms: D000368:Aged; D001955:British Columbia / Q000453:epidemiology; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006331:Heart Diseases / Q000453:epidemiology* / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010353:Patient Education as Topic / Q000706:statistics & numerical data*; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D019035:Rural Health Services / Q000706:statistics & numerical data; D017216:Telemedicine / Q000706:statistics & numerical data*; D013813:Therapy, Computer-Assisted / Q000706:statistics & numerical data*; D016896:Treatment Outcome; D014584:User-Computer Interface