Abstract
BackgroundEmpirical evidence has shown that cardiac rehabilitation programs are effective in reducing morbidity and mortality, improving quality of life in patients with cardiovascular disease. Despite the benefits, women have a high cardiac rehabilitation dropout rate. Our aim was to explore women’s perceptions about the reasons they faced for dropout from these programs.MethodsSemi-structured interviews were conducted with women (n = 10) after dropping out from three different cardiac rehabilitation centers in Spain. In addition, a focus group and a semi-structured interview with cardiovascular professionals were conducted. From a grounded theory perspective, thematic analysis was used to derive themes from interview transcripts.ResultsThe women were between 41 and 70 years. We identified five general themes that illustrated reasons for cardiac rehabilitation dropout: intrapersonal reasons (self-reported health, self-reported mental health, health beliefs); interpersonal reasons (family caregiver role, work conflicts); logistical reasons (transport, distance); cardiac rehabilitation program characteristics (perception of the objective of cardiac rehabilitation, exercise component, inconvenient timing, cardiac rehabilitation equipment); and health system reasons (financial assistance for transport, long waiting list). The cardiovascular professionals found barriers to cardiac rehabilitation completion similar to those found by the women.ConclusionsIn order to prevent cardiac rehabilitation dropout in women, modular and flexible programs are needed. In addition, the inclusion of primary care centers or community resources could improve cardiac rehabilitation completion in women. Psychological assessment and counseling during cardiac rehabilitation should be included as an essential part of the programs and recommended for those women with depressive symptoms. Finally, improved financial assistance for transport from the health system is essential.
Highlights
Cardiovascular disease (CVD) is the leading cause of death in women (51%) [1]
We identified five general themes that illustrated reasons for cardiac rehabilitation dropout: intrapersonal reasons; interpersonal reasons; logistical reasons; cardiac rehabilitation program characteristics; and health system reasons
The cardiovascular professionals found barriers to cardiac rehabilitation completion similar to those found by the women
Summary
Cardiovascular disease (CVD) is the leading cause of death in women (51%) [1]. CR is considered a Class IA recommendation in clinical practice guidelines for women [5,6]. Empirical evidence has shown that it is effective in reducing morbidity and mortality, improving quality of life in patients with CVD [7,8]. In Spain, less than 7% of eligible patients participated in CR and participation rates for women are lower than recommended in clinical guidelines [13,14]. Empirical evidence has shown that cardiac rehabilitation programs are effective in reducing morbidity and mortality, improving quality of life in patients with cardiovascular disease. Women have a high cardiac rehabilitation dropout rate. Our aim was to explore women’s perceptions about the reasons they faced for dropout from these programs
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