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A National Health Service Hospital's cardiac rehabilitation programme: a qualitative analysis of provision.
J Clin Nurs 2007; 16(10):1908-18JC

Abstract

AIM

This paper reports a study examining the effectiveness of a London National Health Service Trust Hospital's cardiac rehabilitation programme, from the perspectives of healthcare professionals and patients.

BACKGROUND

Cardiovascular disease is the world's leading cause of death and disability. Substantial research has reported that, following a cardiac event, cardiac rehabilitation can promote recovery, improve exercise capacity and patient health, reduce various coronary artery disease risk factors and subsequently reduce hospitalization costs. Despite these findings and the introduction of the National Service Framework for Coronary Heart Disease, there is wide variation in the practice, management and organization of cardiac rehabilitation services.

METHODS

A purposeful sample of three postmyocardial infarction patients registered on the selected hospital's cardiac rehabilitation programme, coupled with 11 healthcare professionals were selected. The patients acted as individual case studies. The authors followed all three patients through phase III of their cardiac rehabilitation programme. The research attempted to explore the roles and procedures of a London hospital's cardiac rehabilitation programme through an interpretative framework involving qualitative research methods. Participant observation and in-depth semi-structured interviews were the instruments used to collect data.

FINDINGS

Whilst the healthcare professionals were enthusiastic about coronary heart disease prevention, the London NHS trust hospital's cardiac rehabilitation programme had several barriers, which reduced the programme's success and prevented it from achieving National Service Framework targets. The barriers were complex and mainly included service-related factors, such as lack of professional training, weak communication between primary and secondary care and confused roles and identities.

CONCLUSION

Although the study has immediate relevance for the local area, it highlighted issues of more general relevance to cardiac rehabilitation and secondary prevention programme development, such as communication and role and identity perceptions in a multi-professional working environment and the need to develop a formal training programme for cardiac rehabilitation healthcare professionals.

RELEVANCE TO CLINICAL PRACTICE

The results of this study highlight the need for increased investment, improved planning and the introduction of a comprehensive training programme for healthcare practitioners in cardiac rehabilitation. Implementation of these actions may reduce many of the service limitations and barriers that currently surround cardiac rehabilitation programmes.

Authors+Show Affiliations

School of Sport and Education, Brunel University, Middlesex, and Health and Exercise Sciences Group, Thames Valley University, Berkshire, UK. jamie.o'driscoll@tvu.ac.ukNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17880480

Citation

O'Driscoll, Jamie M., et al. "A National Health Service Hospital's Cardiac Rehabilitation Programme: a Qualitative Analysis of Provision." Journal of Clinical Nursing, vol. 16, no. 10, 2007, pp. 1908-18.
O'Driscoll JM, Shave R, Cushion CJ. A National Health Service Hospital's cardiac rehabilitation programme: a qualitative analysis of provision. J Clin Nurs. 2007;16(10):1908-18.
O'Driscoll, J. M., Shave, R., & Cushion, C. J. (2007). A National Health Service Hospital's cardiac rehabilitation programme: a qualitative analysis of provision. Journal of Clinical Nursing, 16(10), pp. 1908-18.
O'Driscoll JM, Shave R, Cushion CJ. A National Health Service Hospital's Cardiac Rehabilitation Programme: a Qualitative Analysis of Provision. J Clin Nurs. 2007;16(10):1908-18. PubMed PMID: 17880480.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A National Health Service Hospital's cardiac rehabilitation programme: a qualitative analysis of provision. AU - O'Driscoll,Jamie M, AU - Shave,Robert, AU - Cushion,Christopher J, PY - 2007/9/21/pubmed PY - 2007/12/6/medline PY - 2007/9/21/entrez SP - 1908 EP - 18 JF - Journal of clinical nursing JO - J Clin Nurs VL - 16 IS - 10 N2 - AIM: This paper reports a study examining the effectiveness of a London National Health Service Trust Hospital's cardiac rehabilitation programme, from the perspectives of healthcare professionals and patients. BACKGROUND: Cardiovascular disease is the world's leading cause of death and disability. Substantial research has reported that, following a cardiac event, cardiac rehabilitation can promote recovery, improve exercise capacity and patient health, reduce various coronary artery disease risk factors and subsequently reduce hospitalization costs. Despite these findings and the introduction of the National Service Framework for Coronary Heart Disease, there is wide variation in the practice, management and organization of cardiac rehabilitation services. METHODS: A purposeful sample of three postmyocardial infarction patients registered on the selected hospital's cardiac rehabilitation programme, coupled with 11 healthcare professionals were selected. The patients acted as individual case studies. The authors followed all three patients through phase III of their cardiac rehabilitation programme. The research attempted to explore the roles and procedures of a London hospital's cardiac rehabilitation programme through an interpretative framework involving qualitative research methods. Participant observation and in-depth semi-structured interviews were the instruments used to collect data. FINDINGS: Whilst the healthcare professionals were enthusiastic about coronary heart disease prevention, the London NHS trust hospital's cardiac rehabilitation programme had several barriers, which reduced the programme's success and prevented it from achieving National Service Framework targets. The barriers were complex and mainly included service-related factors, such as lack of professional training, weak communication between primary and secondary care and confused roles and identities. CONCLUSION: Although the study has immediate relevance for the local area, it highlighted issues of more general relevance to cardiac rehabilitation and secondary prevention programme development, such as communication and role and identity perceptions in a multi-professional working environment and the need to develop a formal training programme for cardiac rehabilitation healthcare professionals. RELEVANCE TO CLINICAL PRACTICE: The results of this study highlight the need for increased investment, improved planning and the introduction of a comprehensive training programme for healthcare practitioners in cardiac rehabilitation. Implementation of these actions may reduce many of the service limitations and barriers that currently surround cardiac rehabilitation programmes. SN - 0962-1067 UR - https://www.unboundmedicine.com/medline/citation/17880480/A_National_Health_Service_Hospital's_cardiac_rehabilitation_programme:_a_qualitative_analysis_of_provision_ L2 - https://doi.org/10.1111/j.1365-2702.2007.01815.x DB - PRIME DP - Unbound Medicine ER -