Health  Vol.6 No.19 , November 2014
Lifestyle after Cardiac Rehabilitation: Did the Message Come across, and Was It Feasible? An Analysis of Patients’ Narratives
ABSTRACT
Life following heart disease is considered important to prevent and reduce cardiovascular risk factors. Thus, cardiac rehabilitation is focused on potential life changes. Further insight into patients’ perspective on life after cardiac rehabilitation is needed as changing habits following heart disease is a complex matter. The objective of this study was to explore the characteristics of life after cardiac rehabilitation. A phenomenological-hermeneutic approach with qualitative interviews was performed in 20 patients six months after completing a hospital-based cardiac rehabilitation programme in 2012 at Aarhus University Hospital, Denmark. The patients were diagnosed with ischemic heart disease, heart failure or left heart valve disease. The interviews were analysed using the interpretation theory by Ricoeur. The variation in reactions to cardiac rehabilitation were: 1) considering prior life to be appropriate, maybe with minor adjustments; 2) acknowledging the need for incorporating life changes; and 3) reconciling or feeling guilt when being unable to manage changes. Participation in the cardiac rehabilitation programme was a positive experience, but it had minor influence on long-term adherence to recommended life . The important thing in establishing new routines was whether they aroused interest, and whether the experience of changes was perceived as necessary and manageable. In future cardiac rehabilitation, focusing on patients’ interests and supporting them in incorporating recommendations into their everyday life might be essential following heart disease, also after ending cardiac rehabilitation.

Cite this paper
Knudsen, M. , Laustsen, S. , Petersen, A. and Angel, S. (2014) Lifestyle after Cardiac Rehabilitation: Did the Message Come across, and Was It Feasible? An Analysis of Patients’ Narratives. Health, 6, 2641-2650. doi: 10.4236/health.2014.619303.
References
[1]   Piepoli, M.F., Corrà, U., Benzer, W., et al. (2010) Secondary Prevention through Cardiac Rehabilitation: From Knowledge to Implementation. A Position Paper from the Cardiac Rehabilitation Section of the European Association of Cardiovascular Prevention and Rehabilitation. European Journal of Preventive Cardiology, 17, 1-17.
http://dx.doi.org/10.1097/HJR.0b013e3283313592

[2]   Corrà, U., Piepoli, M.F., Carré, F., et al. (2010) Secondary Prevention through Cardiac Rehabilitation: Physical Activity Counselling and Exercise Training: Key Components of the Position Paper from the Cardiac Rehabilitation Section of the European Association of Cardiovascular Prevention and Rehabilitation. European Heart Journal, 31, 1967-1974.

[3]   Leventhal, H., Weinman, J., Leventhal, E.A., et al. (2008) Health Psychology: The Search for Pathways between Behavior and Health. Annual Review of Psychology, 59, 477-505.
http://dx.doi.org/10.1146/annurev.psych.59.103006.093643

[4]   Murray, J., Honey, S., Hill, K., et al. (2012) Individual Influences on Lifestyle Change to Reduce Vascular Risk: A Qualitative Literature Review. British Journal of General Practice.
http://dx.doi.org/10.3399/bjgp12X649089

[5]   Fletcher, S.M., Burley, M.B., Thomas, K.E., et al. (2014) Feeling Supported and Abandoned: Mixed Messages from Attendance at a Rural Community Cardiac Rehabilitation Program in Australia. Journal of Cardiopulmonary Rehabilitation & Prevention, 24, 29-33.
http://dx.doi.org/10.1097/HCR.0b013e3182a52734

[6]   Pryor, T., Page, K., Patsamanis, H., et al. (2014) Investigating Support Needs for People Living with Heart Disease. Journal of Clinical Nursing.
http://dx.doi.org/10.1111/jocn.12165

[7]   White, S., Bissell, P. and Anderson, C. (2010) Patients’ Perspectives on Cardiac Rehabilitation, Lifestyle Change and Taking Medicines: Implications for Service Development. Journal of Health Services Research & Policy, 15, 47-53.
http://dx.doi.org/10.1258/jhsrp.2009.009103

[8]   Meillier, L.K., Nielsen, K.M., Larsen, F.B., et al. (2012) Socially Differentiated Cardiac Rehabilitation: Can We Improve Referral, Attendance and Adherence among Patients with First Myocardial Infarction? Scandinavian Journal of Public Health, 40, 286-293
http://dx.doi.org/10.1177/1403494812443600

[9]   Clark, A., King-Shier, K., Spalling, M., et al. (2013) Factors Influencing Participation in Cardiac Rehabilitation Programmes after Referral and Initial Attendance: Qualitative Systematic Review and Meta-Synthesis. Clinical Rehabilitation, 27, 948-950.
http://dx.doi.org/10.1177/0269215513481046

[10]   Condon, C. and McCarthy, G. (2006) Lifestyle Changes Following Acute Myocardial Infarction: Patients’ Perspectives. European Journal of Cardiovascular Nursing, 5, 37-44.
http://dx.doi.org/10.1016/j.ejcnurse.2005.06.005

[11]   Zwisler, A., Madsen, M. and Nissen, N.K. (2006) Cardiac Rehabilitation—A Health Technology Assessment. Evidence from the Literature and the DANREHAB Trial. Copenhagen.

[12]   Ricoeur, P. (1990) Time and Narrative. University of Chicago Press, Chicago.

[13]   Ricoeur, P. (1976) Interpretation Theory: Discourse and the Surplus of Meaning. Texas Christian University Press, Fort Worth.

[14]   Paterson, B.L. (2001) The Shifting Perspectives Model of Chronic Illness. Journal of Nursing Scholarship, 33, 21-26.
http://dx.doi.org/10.1111/j.1547-5069.2001.00021.x

[15]   Paquet, M., Bolduc, N., Xhignesse, M. and Vanasse, A. (2005) Re-Engineering Cardiac Rehabilitation Programmes: Considering the Patient’s Point of View. Journal of Advanced Nursing, 51, 567-576.
http://dx.doi.org/10.1111/j.1365-2648.2005.03544.x

[16]   Bergman, E. and Bertero, C. (2003) “Grasp Life Again”. A Qualitative Study of the Motive Power in Myocardial Infarction Patients. European Journal of Cardiovascular Nursing, 2, 303-310.
http://dx.doi.org/10.1016/S1474-5151(03)00098-7

[17]   Gregory, S., Bostock, Y. and Backett-Milburn, K. (2006) Recovering from a Heart Attack: A Qualitative Study into Lay Experiences and the Struggle to Make Lifestyle Changes. Family Practice, 23, 220-225.
http://dx.doi.org/10.1093/fampra/cmi089

[18]   Cooper, A.F., Jackson, G., Weinman, J. and Horne, R. (2005) A Qualitative Study Investigating Patients’ Beliefs about Cardiac Rehabilitation. Clinical Rehabilitation, 19, 87-96.
http://dx.doi.org/10.1191/0269215505cr818oa

[19]   Kristofferzon, M., Lofmark, R. and Carlsson, M. (2007) Striving for Balance in Daily Life: Experiences of Swedish Women and Men Shortly after a Myocardial Infarction. Journal of Clinical Nursing, 16, 391-401.
http://dx.doi.org/10.1111/j.1365-2702.2005.01518.x

[20]   Tully, N.E., Morgan, K.M., Burke, H.M. and McGee, H.M. (2010) Patient Experiences of Structured Heart Failure Programmes. Rehabilitation Research and Practice, 2010, Article ID: 157939.
http://dx.doi.org/10.1155/2010/157939

[21]   White, S., Bissell, P. and Anderson, C. (2011) A Qualitative Study of Cardiac Rehabilitation Patients’ Perspectives on Making Dietary Changes. Journal of Human Nutrition and Dietetics, 24, 122-127.
http://dx.doi.org/10.1111/j.1365-277X.2010.01136.x

 
 
Top