Paper
Wednesday, 19 July 2006
This presentation is part of : Health Promotion for Cardiac Patients
Effects of Health Beliefs on Cardiac Rehabilitation Initiation
Linda Creadon Shanks, ND, PhD, RN, Nursing, The University of Akron, Akron, OH, USA
Learning Objective #1: Identify the effects of various health beliefs on cardiac rehabilitation.
Learning Objective #2: Identify possible interventions that will increase the liklihood of a patient starting cardiac rehabilitation.
Cardiac rehabilitation has been shown to improve exercise tolerance and peripheral functional capacity, improve skeletal muscle strength and endurance, decrease symptoms of heart failure, decrease mortality, improve quality of life, and reduce risk factors. These benefits clearly indicate the importance of starting cardiac rehabilitation, but the majority of patients do not start. The purpose of this study was to examine the effects of health beliefs on cardiac rehabilitation initiation. Prior to discharge from the hospital, 97 patients completed questionnaires about perceived severity, perceived susceptibility, perceived cardiac threat, depression, and social support. Left ventricular ejection fraction and comorbid conditions were obtained from the medical record. These patients were contacted by telephone four months after discharge to determine whether or not they started a cardiac rehabilitation program and how strongly their physician recommended cardiac rehabilitation. Logistic regression was used for the analysis, and findings indicated a significant relationship between strength of physician recommendation, gender, disease severity and cardiac rehabilitation initiation. For every unit increase in strength of physician recommendation there was a 98% increase in the likelihood of starting cardiac rehabilitation. Men were 4.6 times more likely to participate than women, and patients with less severe disease were more likely to start. No significant relationships were found between perceived severity, perceived susceptibility, perceived threat and cardiac rehabilitation initiation. The findings confirm our understanding of the importance of strength of physician recommendation on cardiac rehabilitation initiation. This information can be used to increase the number of patients starting cardiac rehabilitation through programs designed to increase physician awareness of the importance of their recommendation. The influence of gender on cardiac rehabilitation initiation highlights the continuing need to refer women to cardiac rehabilitation programs and to design programs that meet the needs of women.

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