Reasons for Refusal of Exercise Rehabilitation in Patients after Radiofrequency Ablation of Atrial Fibrillation in the Context Digital Medical Care: a Qualitative Research

Abstract

Background Telerehabilitation based on digital medical care can efficiently improve the health status of patients after radiofrequency ablation of atrial fibrillation. However, the current participation rate in telerehabilitation is low. Objective To analyse the reasons for refusal of exercise rehabilitation in patients after radiofrequency ablation of atrial fibrillation in the context digital medical care based on the theory of leisure constraints. Methods Patients after radiofrequency ablation of atrial fibrillation in the inpatient department or outpatient clinic of Department of Cardiology, at the First Affiliated Hospital of Nanjing Medical University from July to September 2022 were selected as the study subjects by using the purposive sampling method. The phenomenological approach was adopted to collect data from patients who refused exercise telerehabilitation after radiofrequency ablation through semi-structured interviews, and Colaizzi analysis was used to summarize the reasons. Results A total of 14 patients were finally included in this study. Three themes including self-limiting factors, interpersonal limiting factors, and structural limiting factors, and twelve sub-themes were extracted, namely, low level of digital literacy, negative illness perception, psychological distress caused by disease, digital medical trust crisis, deep-rooted personal exercise habits, alienation sense from rehabilitation team, insufficient social network establishment, economic burden related to equipment acquisition, harsh climate, low rehabilitation service capacity in primary care, constraints of available time by role pressure, and poor applicability of wearable devices. Conclusion The reasons for refusal to exercise telerehabilitation include lack of literacy and trust in digital medical care, high level of illness perception and psychological distress, poor exercise habits, rehabilitation team and peer alienation, economic burden, harsh climate, lack of capacity and personal time for rehabilitation service capacity in primary care, and inadequate applicability of existing wearable devices.

Keywords

• atrial fibrillation|exercise therapy|rehabilitation exercise|motivational interviewing|digital health|motivational interviewing