Patient preference and adherence · 2026
Facilitators and Barriers to Adherence to Home-Based Cardiac Rehabilitation Exercise in Patients with Chronic Heart Failure: A Qualitative Study.
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Su Pingping, Tang Qingfeng, Li Yulin, Chang Feifei, Feng Xiaoyu, Wu Xiaobing
Аннотация
BACKGROUND: Chronic heart failure (CHF) is a major global health burden. Home-based cardiac rehabilitation (HBCR) is an effective alternative to center-based programs but suffers from low patient adherence, with influencing factors within the Chinese context being underexplored.
OBJECTIVE: To explore perceived facilitators and barriers to HBCR exercise adherence among Chinese patients with CHF using the Information-Motivation-Behavioral Skills (IMB) model.
METHODS: A descriptive phenomenological qualitative study was conducted at a tertiary hospital in Guangzhou, China. Semi-structured interviews were performed with 22 CHF patients (NYHA I-III). Data were analyzed using Colaizzi's seven-step method, and themes were mapped onto the IMB model.
FINDINGS: Three IMB dimensions emerged: Information (lack of exercise knowledge; rehabilitation misconceptions); Motivation (perceived benefits, need for professional guidance, social support, poor physical perception, inertia, habit-driven motivation); Behavioral skills (active planning, self-regulation, symptom monitoring). Notably, family support - particularly from adult children - was a culturally specific facilitator, while equating daily labor with structured exercise was a unique barrier.
CONCLUSION: Adherence to HBCR is shaped by interlinked information, motivational, and behavioral skill deficits. Clinically, providers should (a) correct culturally rooted misconceptions using plain-language education, (b) involve family members as active supporters, (c) provide post-discharge cues to action via digital platforms, and (d) teach concrete self-regulation skills. These actionable strategies can improve long-term adherence in Chinese CHF patients.
OBJECTIVE: To explore perceived facilitators and barriers to HBCR exercise adherence among Chinese patients with CHF using the Information-Motivation-Behavioral Skills (IMB) model.
METHODS: A descriptive phenomenological qualitative study was conducted at a tertiary hospital in Guangzhou, China. Semi-structured interviews were performed with 22 CHF patients (NYHA I-III). Data were analyzed using Colaizzi's seven-step method, and themes were mapped onto the IMB model.
FINDINGS: Three IMB dimensions emerged: Information (lack of exercise knowledge; rehabilitation misconceptions); Motivation (perceived benefits, need for professional guidance, social support, poor physical perception, inertia, habit-driven motivation); Behavioral skills (active planning, self-regulation, symptom monitoring). Notably, family support - particularly from adult children - was a culturally specific facilitator, while equating daily labor with structured exercise was a unique barrier.
CONCLUSION: Adherence to HBCR is shaped by interlinked information, motivational, and behavioral skill deficits. Clinically, providers should (a) correct culturally rooted misconceptions using plain-language education, (b) involve family members as active supporters, (c) provide post-discharge cues to action via digital platforms, and (d) teach concrete self-regulation skills. These actionable strategies can improve long-term adherence in Chinese CHF patients.