Abstract
Physical activity post-myocardial infarction has numerous health benefits, yet uptake through cardiac rehabilitation is poor. Whilst family support can facilitate patients' recovery, little is known about the role family may play in supporting physical activity for post-myocardial infarction patients. This qualitative study used semistructured interviews with 14 cardiac rehabilitation practitioners to explore their perceptions about the role of the family in supporting post-myocardial infarction patients' physical activity. Data were transcribed verbatim and analyzed thematically. Three familial roles were identified: "family as a second pair of ears," "family as physical activity regulators," and "family as social support." A fourth theme, "factors that influence family support," described how family health beliefs and perceptions could influence the physical activity support provided. Practitioner perceptions suggest families play an important role in post-myocardial infarction patients' physical activity, which is enhanced when families personally value physical activity. Integrating the family into cardiac rehabilitation may help facilitate physical activity-related interactions and promote positive engagement for patients.
Highlights
Coronary heart disease is a leading cause of death worldwide [World HealthOrganisation, 2019] and occurs when there is a build-up of plaque in the coronary arteries which, if the plaque erodes or ruptures can result in thrombus formation and myocardial infarction [MI]
A fourth theme, ‘factors that influence family support’ was identified, and comprised factors that influenced the level and type of PA support provided by families
Our findings suggest family support may help enhance PA engagement in the early stages of recovery, it is plausible that involving families in phases 2 and 3 of CR may help improve uptake of phase 4
Summary
Coronary heart disease is a leading cause of death worldwide [World HealthOrganisation, 2019] and occurs when there is a build-up of plaque in the coronary arteries which, if the plaque erodes or ruptures can result in thrombus formation and myocardial infarction [MI]. CR pathways vary worldwide in intensity and duration [Dalal et al, 2015] they follow the same progression from hospitalisation through to recovery and long-term maintenance [Price et al, 2016]. They typically comprises four phases: Phase 1 - the period in hospital following the patient’s acute event, where information on the patient’s condition and recovery is provided; Phase 2 – an outpatient visit to review that patient’s progress and agree their steps for recovery; Phase 3 structured and supervised exercise training, together with continued education and psychological support in an outpatient setting; and Phase 4 - the facilitation of longterm maintenance of lifestyle changes, occurring in community settings. Uptake to CR programmes is below 50% [Piepoli et al, 2015] and few who attend maintain PA following programme completion [Karmali et al, 2014]
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