The content and characteristics of face-to-face interventions to encourage patients’ enrollment in cardiac rehabilitation; a scoping review

Abstract

Purpose To provide an overview of the content and characteristics of face-to-face interventions to encourage enrollment in exercise-based cardiac rehabilitation (CR). Methods Following a published protocol describing the methods, six databases were searched. The search was limited to studies published from January 2000 to December 2021. Two reviewers independently performed study selection and data extraction. Results 5583 studies were identified and 20 studies with a variety of study designs met the inclusion criteria. Eight studies specified important content in face-to-face interventions to be: Education, problem-solving, support of autonomy, exploring reasons for change, emotional and cognitive support while showing understanding. Studies targeting patients’ experiences used motivational interviewing and addressed worries and anticipated difficulties. Intention to attend, CR barriers, practical barriers, exercise self-efficacy, and patients asking questions supported enrollment. Reassurance could lead to nonattendance if patients had a high degree of worry and distress. Conclusion Face-to-face interventions are important to support patients’ enrollment in CR and should integrate a person-centered dialogue exploring reasons for change and providing support to overcome barriers. Focus on the patients’ perspectives, the mechanisms of change, and the evaluation of the intervention to inform implementation should be further explored. Implications for Rehabilitation In-hospital face-to-face interventions support enrollment in cardiac rehabilitation (CR) in patients with ischemic heart disease. This study suggests that individual worries and barriers toward CR should be jointly explored while considering patients’ capacity for making choices as well as their vulnerability. Patients should be encouraged to ask questions. A too strong focus on reassurance and problem-solving can impede enrollment.