Vascular Health and Risk Management (Aug 2023)
Barriers to Participation in Cardiac Rehabilitation Among Patients with Coronary Heart Disease After Reperfusion Therapy: A Scoping Review
Abstract
Firman Sugiharto,1 Aan Nuraeni,2 Yanny Trisyani,2 Azalia Melati Putri,1 Nuraulia Aghnia Armansyah1 1Faculty of Nursing, Universitas Padjadjaran, Sumedang, Jawa Barat, Indonesia; 2Department of Critical Care and Emergency Nursing, Faculty of Nursing, Universitas Padjadjaran, Sumedang, Jawa Barat, IndonesiaCorrespondence: Firman Sugiharto, Faculty of Nursing, Universitas Padjadjaran, Jl. Raya Ir. Soekarno KM. 21, Hegarmanah, Jatinangor, Sumedang, West Java, 45363, Indonesia, Tel +6282218235600, Fax +6282287793411, Email [email protected]: Patients with coronary heart disease (CHD) experience many barriers to participate in cardiac rehabilitation (CR) programs. Several studies identify barriers that can affect participation in CR among patients with CHD after reperfusion therapy. However, there has yet to be a review specifically in this population. This review aims to identify the literature systematically that analyzes the barriers that affect the participation of CHD patients after reperfusion therapy in implementing the CR program. This study used the Preferred Reporting Item for PRISMA Extension for Scoping Reviews (PRISMA-ScR) with databases PubMed, ScienceDirect, EBSCO-hosted Academic Search Complete, Scopus, Taylor & Francis, and Sage Journals. The keywords used in English were “coronary artery disease OR myocardial infarction OR cardiovascular disease OR heart disease” AND “Barrier OR obstacle”, AND “percutaneous coronary intervention OR PCI OR angioplasty OR coronary artery bypass graft surgery OR CABG” AND “cardiac rehabilitation OR rehabilitation OR recovery”. The inclusion criteria in this review were full-text articles in English, articles with a descriptive, cross-sectional, and cohort design with a minimum of 100 participants that discussed barriers to participation in patients with CHD after undergoing reperfusion therapy, and the CR phases such as I, II, III, and IV have also been identified. Based on the initial search, there are 23 relevant studies out of 7400. The results of this study reported that most of the participants from the studies analyzed had a low level of participation in CR (≤ 50%). We classify the factors that affect the level of CR participation into five categories: individual factors, health history, environmental, logistical, and health system. The most reported barriers in each category were age, comorbidities, lack of support from friends, family and health workers, distance or travel time, and cost and economic status. Professional health workers, especially nurses, can identify various barriers that patients feel so that they can increase their participation in attending CR.Keywords: cardiac rehabilitation, coronary heart disease, patient participation, reperfusion
