Cardiac rehabilitation programs and the problem of patient dropout.

As one of the leading causes of death in the United States, coronary atherosclerotic heart disease (CAHD) has been shown to have a reduced incidence if the principles of primary prevention are instituted to reduce cardiac risk factors. In people who already suffer from CAHD, employing secondary prevention such as controlling hypertension, reducing serum lipid levels, eliminating nicotine intake, reducing stress, losing weight, and increasing exercise habits can decrease recurrence of problems related to CAHD. Cardiac rehabilitation programs are a way to help CAHD patients restore optimal medical, physiological, psychological, social, and vocational performance following an acute cardiac event. A major problem in cardiac rehabilitation programs is patient dropout. For any cardiac rehabilitation program to be a success, the CAHD patient must become invested in the maintenance of health and, therefore, committed to participation in the program. The author reviews the current literature, including discussions of the history of cardiac rehabilitation, current trends in cardiac rehabilitation programs, factors that influence patients' investment in these programs, and ways in which the cardiac rehabilitation nurse might intervene to make an impact on patients' participation.