Journal of psychosomatic research · 2026
A quantitative and qualitative analysis of non-participation in cardiac rehabilitation: The role of psychological burden and experienced barriers.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Douma Emma R, van den Houdt Sophie C M, Kop Willem J, Kupper Nina
Аннотация
BACKGROUND: Participation in cardiac rehabilitation (CR) remains low. The cumulative role of psychological factors in non-participation is insufficiently understood. Conceptual and mechanistic overlap suggests an accumulation of dysregulated psychobiological domains, which may result in an exposure-response relation with CR non-participation. The current study investigated the presence of such relationship between psychological burden and CR non-participation. Patient-reported reasons for non-participation were also investigated.
METHODS: Data from 1600 participants (Mage = 64.9 ± 9.6 years, 21.1% women) with coronary heart disease were used. A Psychological burden index was created as a count of depression, anxiety, work-related stress, social stress, Type D personality, and hostility. Logistic regression models examined whether an exposure-response association was present. Patient-reported reasons for non-participation were analyzed using inductive coding, and the role of psychological burden was explored.
RESULTS: The Psychological burden index was associated with increased CR participation (OR = 0.89, 95%CI: 0.82-0.97). Sensitivity analyses revealed that higher psychological burden was associated with enrollment in the psychosocial support module, explaining the increased CR participation. Analysis of patient-reported reasons showed that higher psychological burden was associated with non-participation due to medical reasons (OR = 1.15, 95% CI: 0.97-1.36, p < .10). Lower psychological burden was associated with reasons relating to patients' exercise capacity, motivation level, and deemed necessity.
CONCLUSION: Higher psychological burden was associated with increased participation in CR, which was partly explained by participation in the psychosocial support module. Patient-reported reasons for non-participation included medical reasons when psychological burden was high. Reducing implicit biases and individualizing the CR program could help improve CR participation.
METHODS: Data from 1600 participants (Mage = 64.9 ± 9.6 years, 21.1% women) with coronary heart disease were used. A Psychological burden index was created as a count of depression, anxiety, work-related stress, social stress, Type D personality, and hostility. Logistic regression models examined whether an exposure-response association was present. Patient-reported reasons for non-participation were analyzed using inductive coding, and the role of psychological burden was explored.
RESULTS: The Psychological burden index was associated with increased CR participation (OR = 0.89, 95%CI: 0.82-0.97). Sensitivity analyses revealed that higher psychological burden was associated with enrollment in the psychosocial support module, explaining the increased CR participation. Analysis of patient-reported reasons showed that higher psychological burden was associated with non-participation due to medical reasons (OR = 1.15, 95% CI: 0.97-1.36, p < .10). Lower psychological burden was associated with reasons relating to patients' exercise capacity, motivation level, and deemed necessity.
CONCLUSION: Higher psychological burden was associated with increased participation in CR, which was partly explained by participation in the psychosocial support module. Patient-reported reasons for non-participation included medical reasons when psychological burden was high. Reducing implicit biases and individualizing the CR program could help improve CR participation.