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Published online: 2019-09-24
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Barriers and facilitators to participating in cardiac rehabilitation and physical activity in a remote and rural population; a cross-sectional survey

Emma J. Foster, Sarah-Anne Munoz, Daniel Crabtree, Stephen J. Leslie, Trish Gorely
DOI: 10.5603/CJ.a2019.0091
·
Pubmed: 31565795

open access

Ahead of print
Original articles
Published online: 2019-09-24

Abstract

Background: Cardiac disease requires ongoing active management which may include attendance at formal cardiac rehabilitation (CR) and increased physical activity (PA). However, uptake rates are sub-optimal. This study aimed to identify factors associated with attendance at CR and PA in a rural Scottish population.

Methods: A cross-sectional postal survey assessing factors potentially associated with attending CR and participating in PA. Data were also collected from hospital electronic medical records. Binary logistic and ordinal regressions were used to identify barriers and facilitators to participation.

Results: The cohort consisted of 840 participants referred to the CR department of a regional Scottish hospital. After applying the inclusion/exclusion criteria, 567 patients were sent a questionnaire. The number of returned questionnaires was 295 (52.0%). Responders were predominantly male (75.9%), with a mean age of 68.7 years. At the multivariate level, the only factor associated with CR attendance was a lack of perceived need (odds ratio [OR] 0.02, 95% confidence interval [CI] 0.01–0.06). Analyses of PA associations identified self-efficacy as the only significant facilitator (OR 1.29, 95% CI 1.05–1.59), and a lack of willpower as the only barrier (OR 0.42, 95% CI 0.18–0.97). Other factors were linked to CR attendance and PA at a univariate level only.

Conclusions: This study characterised CR and PA participation, and explored demographic, medical, and psychological factors associated with both activities — with the most important being perceived need, self-efficacy and willpower. These findings may be beneficial in clinical practice by targeting these factors to increase CR attendance and PA levels.

Abstract

Background: Cardiac disease requires ongoing active management which may include attendance at formal cardiac rehabilitation (CR) and increased physical activity (PA). However, uptake rates are sub-optimal. This study aimed to identify factors associated with attendance at CR and PA in a rural Scottish population.

Methods: A cross-sectional postal survey assessing factors potentially associated with attending CR and participating in PA. Data were also collected from hospital electronic medical records. Binary logistic and ordinal regressions were used to identify barriers and facilitators to participation.

Results: The cohort consisted of 840 participants referred to the CR department of a regional Scottish hospital. After applying the inclusion/exclusion criteria, 567 patients were sent a questionnaire. The number of returned questionnaires was 295 (52.0%). Responders were predominantly male (75.9%), with a mean age of 68.7 years. At the multivariate level, the only factor associated with CR attendance was a lack of perceived need (odds ratio [OR] 0.02, 95% confidence interval [CI] 0.01–0.06). Analyses of PA associations identified self-efficacy as the only significant facilitator (OR 1.29, 95% CI 1.05–1.59), and a lack of willpower as the only barrier (OR 0.42, 95% CI 0.18–0.97). Other factors were linked to CR attendance and PA at a univariate level only.

Conclusions: This study characterised CR and PA participation, and explored demographic, medical, and psychological factors associated with both activities — with the most important being perceived need, self-efficacy and willpower. These findings may be beneficial in clinical practice by targeting these factors to increase CR attendance and PA levels.

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Keywords

cardiac rehabilitation, physical activity, barriers, facilitators, rural

About this article
Title

Barriers and facilitators to participating in cardiac rehabilitation and physical activity in a remote and rural population; a cross-sectional survey

Journal

Cardiology Journal

Issue

Ahead of print

Published online

2019-09-24

DOI

10.5603/CJ.a2019.0091

Pubmed

31565795

Keywords

cardiac rehabilitation
physical activity
barriers
facilitators
rural

Authors

Emma J. Foster
Sarah-Anne Munoz
Daniel Crabtree
Stephen J. Leslie
Trish Gorely

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