Listening to patients: Choice in cardiac rehabilitation

Abstract

Background: The benefits of cardiac rehabilitation (CR) after myocardial infarction (MI) are increasingly recognised and is recommended in national guidelines. Aims: To explore patients' experience of MI and to identify the factors which influence the choice patients make given the option of hospital or home-based CR after MI. Method: Qualitative study using semi-structured interviews and interpretive phenomenological analysis (IPA). This study was embedded within a randomised trial with preference arms. Results: Seventeen participants were interviewed before their rehabilitation programme. Ten expressed a preference for home-based and seven for hospital-based rehabilitation. Common to both groups was shock and disbelief, which led to a loss of confidence. They expressed a strong desire to make lifestyle changes and looked for specific advice, guidance and support from knowledgeable experts. The hospital-based group had an emphasis on supervision during exercise, needed the camaraderie of a group, were willing to make travel arrangements and believed they lacked self-discipline. The home-based group believed that their CR should fit in with their lives rather than their lives fitting in with the rehabilitation programme and were self-disciplined. They disliked groups and expressed practical concerns. Conclusions: Understanding the factors that influence patient's choices may help professionals guide them to the most appropriate CR method and hence improve uptake. © 2006 European Society of Cardiology.