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Facilitating or getting in the way? The effect of clinicians' knowledge, values and beliefs on referral and
Robyn Gallagher1, Lis Neubeck2, Huiyun Du3
1Sydney Nursing School, The University of Sydney, Australia Faculty of Health, University of Technology, Sydney, Australia robyn.gallagher@sydney.edu.au.
Insights
Clinician attitudes significantly impact cardiac rehabilitation (CR) referral and participation. Addressing clinician knowledge, beliefs, and systemic factors is crucial for improving patient access to CR programs.
Area of Science:
- Cardiology
- Healthcare Management
- Behavioral Science
Background:
- Cardiac rehabilitation (CR) offers significant benefits for patients, including risk factor modification, improved quality of life, and reduced mortality.
- Despite proven benefits, many eligible patients are not referred to or do not participate in CR programs.
- Factors influencing CR referral and participation are multifaceted, involving patients, referral systems, and clinicians.
Purpose of the Study:
- To review and examine the existing literature on clinicians' attitudes, values, and beliefs regarding cardiac rehabilitation (CR).
- To understand how clinician-related factors influence patient referral and attendance in CR programs.
Main Methods:
- A comprehensive literature review was conducted focusing on studies related to clinicians' perspectives on CR.
- Expert consensus methodology was employed to develop the concepts discussed in the review.
Main Results:
- Clinicians' knowledge and awareness of CR benefits can be limited, particularly among those without cardiac qualifications.
- Discrepancies exist among clinicians regarding which patients are most likely to benefit from CR.
- Factors such as clinicians' personal health beliefs, perceptions of local CR program quality, and administrative referral processes can impede patient referrals.
Conclusions:
- Clinician-related factors play a critical role in CR referral and participation rates.
- Enhancing clinician education on CR, facilitating discussions about local CR services, and establishing efficient administrative systems are essential for improving CR uptake.
Background:
Despite the compelling evidence of the benefits of cardiac rehabilitation (CR) on risk factor modification, quality of life and mortality reduction, a significant proportion of eligible patients are not referred or do not participate. Factors influencing CR referral and participation are complex and are likely patient, referral system and clinician-related. Little is known about clinician-related factors, which include attitudes, values and beliefs towards CR, or how these factors affect patient referral and attendance. This review examines the current evidence in the literature in relation to clinicians' attitudes, values and beliefs about CR.
Methods:
A review of the literature was conducted on studies in relation to clinicians' attitudes, values and beliefs toward CR. An expert consensus methodology was used to develop the concepts presented in this paper.
Results:
Besides guidelines, a range of other factors influence clinicians' view about CR. This review suggests that clinicians lacking cardiac qualifications may have limited knowledge and awareness of CR and its benefits. Low agreement among clinicians on who is more likely to benefit from CR was also identified. Clinicians' personal lifestyle and health belief, the availability and quality of local the CR programme, and the lack of a standard administrative process of referral can also hinder the referral of patients to CR.
Conclusions:
Clinician-related factors are important to consider in relation to CR referral and participation. Education for clinicians, discussion of local services and the support of an efficacious system at programme and organisation levels are essential.
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