British journal of nursing (Mark Allen Publishing) · 2025
Exploring ways to improve completion of cardiac rehabilitation in areas of high deprivation.
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Steward Anna, Collet Katharine
Аннотация
BACKGROUND: Cardiac rehabilitation (CR) completion rates are higher in patients living in areas of low deprivation than in those living in areas of high deprivation, widening the health inequality gap.
AIM: A service evaluation was undertaken in the Coventry CR Service to explore the barriers to and facilitators of service completion among patients living in high-deprivation areas, to understand the most important factors to consider when undertaking service improvements.
DESIGN: A process map was completed of the current service. Patients' postcodes were matched with the Index of Multiple Deprivation and used to categorise a high-deprivation area. Purposive recruitment of patients took place during CR clinic appointments. Service users were then interviewed using a semi-structured questionnaire on discharge from the service, and enrolment was stopped at data saturation. Thematic analysis was used. The service was evaluated using the World Health Organization Building Blocks Framework and themes reviewed in terms of service delivery, health workforce, information, technology, and financing.
PARTICIPANTS: Twelve patients who took part in CR between May and August 2022 were interviewed. Facilitators of completion included: personalised CR programmes, work flexibility, social aspects, relating to others, enjoyment, staff and patient education. Barriers included: family commitments, work, not relating to others, parking, the gym environment and poor communication.
CONCLUSION: The two main ways the service could be improved to increase completion is to enhance programme flexibility and patient education in the home-based programme. Investment in technology may mean that facilitators of the gym-based programme, such as monitoring, two-way communication and exercise progression, can be replicated at home.
AIM: A service evaluation was undertaken in the Coventry CR Service to explore the barriers to and facilitators of service completion among patients living in high-deprivation areas, to understand the most important factors to consider when undertaking service improvements.
DESIGN: A process map was completed of the current service. Patients' postcodes were matched with the Index of Multiple Deprivation and used to categorise a high-deprivation area. Purposive recruitment of patients took place during CR clinic appointments. Service users were then interviewed using a semi-structured questionnaire on discharge from the service, and enrolment was stopped at data saturation. Thematic analysis was used. The service was evaluated using the World Health Organization Building Blocks Framework and themes reviewed in terms of service delivery, health workforce, information, technology, and financing.
PARTICIPANTS: Twelve patients who took part in CR between May and August 2022 were interviewed. Facilitators of completion included: personalised CR programmes, work flexibility, social aspects, relating to others, enjoyment, staff and patient education. Barriers included: family commitments, work, not relating to others, parking, the gym environment and poor communication.
CONCLUSION: The two main ways the service could be improved to increase completion is to enhance programme flexibility and patient education in the home-based programme. Investment in technology may mean that facilitators of the gym-based programme, such as monitoring, two-way communication and exercise progression, can be replicated at home.