Engagement in cardiac rehabilitation after a first myocardial infarction: a qualitative evidence synthesis of patient experiences.

PURPOSE: To synthesize qualitative evidence on factors influencing patients' participation in cardiac rehabilitation after a first acute myocardial infarction.

METHODS

A search of eight databases was conducted from inception to May 2026. Included studies were quality assessed using JBI criteria, and findings were synthesized using a hybrid approach that combined meta-aggregation for data extraction with thematic synthesis for interpretive analysis.

RESULTS

The synthesis of 9 qualitative studies yielded 33 synthesized findings. These findings were organized into three key themes: (1) the complex process of identity transformation following a first acute myocardial infarction (2) the dynamic interaction between motivators and barriers affecting participation in cardiac rehabilitation and (3) the fundamental importance of support systems in shaping patient experiences.

CONCLUSION

Participation in cardiac rehabilitation among patients experiencing their first acute myocardial infarction is influenced by multiple factors. To enhance engagement, clinical healthcare providers should address identity disruption, strengthen intrinsic motivation, and facilitate peer and family support through tailored, multidisciplinary, and psychosocially integrated strategies.