Factors Influencing Outpatient Cardiac Rehabilitation Attendance

In the current health climate, the length of stay of cardiac patients in hospital has been decreasing, and this has significantly reduced the time nurses and colleagues have for providing inpatient cardiac rehabilitation (CR). The purpose of this research was to determine if inpatient CR has an influence on outpatient cardiac rehabilitation attendance for women, Māori, and older people.

An audit of patients discharged from hospital between November 2011 and July 2012 with a diagnosis of acute coronary syndrome were sent a postal questionnaire.

The survey was completed by 143 people: 46% female, 12% Māori, and 70% > 65 years. Only 38% attended outpatient CR on discharge. Reasons for not attending included lack of referral to CR, and 61% understood only some/none of the information given to them while in hospital. The Cardiac Rehabilitation Coordinator most consistently recommended attendance, but this invitation was extended after discharge from hospital.

Attendance at outpatient CR is low and may increase with an improved individualized plan of care including greater cultural considerations and attention to discharge planning. An automatic referral tool as well as following evidence-based guidelines for inpatient care may increase participation rates for CR.

Nursing staff have the majority of contact with patients and it appears that very few nurses are discussing CR programs with their patients. The information to attend CR should be offered by all of the health professionals patients meet during their stay in hospital.