"To move or not to move"exercise adherence in home-based cardiac rehabilitation after coronary artery bypass graft surgery: A qualitative study.

BACKGROUND

Exercise-based cardiac rehabilitation (CR) is a core component of secondary prevention after coronary artery bypass grafting (CABG) and is proven to reduce mortality and improve long-term functional recovery. However, adherence to home-based CR remains consistently low, posing a significant and still under-addressed challenge in long-term secondary prevention.

OBJECTIVE

To explore and gain an in-depth understanding of exercise adherence among post-CABG patients during home-based cardiac rehabilitation.

METHODS

This qualitative study adopted a hermeneutic phenomenological approach, guided by the Health Belief Model. Between March and April 2025, semi-structured interviews were conducted with 18 post-discharge CABG patients, purposively sampled to reflect varying levels of exercise adherence. Data were coded using NVivo software and analyzed through interpretive phenomenological analysis.

RESULTS

Five main themes emerged: (1) Family support as a double-edged sword; (2) Barriers rooted in traditional beliefs; (3) Physical barriers to exercise; (4) Multidimensional sources of exercise confidence; and (5) Evolving perceptions across rehabilitation phases.

CONCLUSIONS

Exercise adherence after CABG is influenced by evolving health beliefs shaped by family dynamics, cultural values, physical recovery, and sources of exercise confidence, with these beliefs and perceptions shifting across rehabilitation phases. When designing home-based cardiac rehabilitation interventions, it is essential to consider patients' cultural and educational backgrounds, monitor their progress with timely feedback, involve family members, and tailor strategies to different stages of recovery.