Adherence to phase I cardiac rehabilitation in post-PCI patients: a latent class analysis
Zhuo Chai1, Yuxuan Fan2, Xue Gong1
1Department of Nursing, Harbin Medical University, Daqing, Heilongjiang, China.
Insights
Adherence to phase I cardiac rehabilitation after percutaneous coronary intervention (PCI) varies significantly among patients in China. Identifying these adherence patterns and influencing factors like social support and kinesiophobia is crucial for improving patient outcomes.
Area of Science:
- Cardiology
- Public Health
- Rehabilitation Medicine
Background:
- Coronary heart disease (CHD) is a major global health concern.
- Percutaneous coronary intervention (PCI) improves outcomes, but cardiac rehabilitation (CR) offers additional benefits.
- Adherence to phase I CR post-PCI is suboptimal, with unclear variations in China.
Purpose of the Study:
- To identify heterogeneity in adherence to phase I CR among post-PCI patients in China.
- To determine factors influencing different adherence patterns.
- To inform individualized interventions for improved CR adherence.
Main Methods:
- Latent class analysis (LCA) was used to categorize adherence patterns.
- Logistic regression identified factors associated with each adherence class.
- 212 post-PCI patients from Daqing Oilfield General Hospital were surveyed.
Main Results:
- Three adherence groups were identified: Good Adherence (31.2%), Poor Nutritional and Psychological Management (32.0%), and Lack of Exercise (36.8%).
- Factors influencing adherence included limited social support, poor chronic disease resource utilization, low education, alcohol history, and kinesiophobia.
- These factors significantly impacted subgroup adherence (P < 0.05).
Conclusions:
- Significant heterogeneity exists in phase I CR adherence among post-PCI patients.
- Targeted interventions based on identified adherence profiles are recommended.
- Improving adherence is key to enhancing patient quality of life and clinical outcomes.
Background:
Coronary heart disease seriously jeopardizes human health and has become a principal public health problem of global concern. While percutaneous coronary intervention (PCI) repairs narrowed arteries and extends patients' lives, cardiac rehabilitation offers additional benefits post-PCI. Numerous previous studies have shown that cardiac rehabilitation can inhibit the progression of atherosclerotic plaques in patients after coronary intervention, effectively controlling patients' clinical symptoms and improving their quality of life. However, the current status of adherence to phase I cardiac rehabilitation is poor, and the variation in adherence to phase I cardiac rehabilitation among post-PCI patients in China are not well understood. This study aimed to identify the heterogeneity of adherence to phase I cardiac rehabilitation and its influencing factors in post-PCI patients through latent class analysis (LCA) to support individualized interventions.
Methods:
PCI patients (N = 212) admitted to the Cardiac Rehabilitation Center of Daqing Oilfield General Hospital in Heilongjiang Province were selected to complete the General Demographic Information Questionnaire, Cardiac Rehabilitation Adherence Scale for Coronary Heart Disease Patients, Cardiac Rehabilitation Knowledge Questionnaire, Patient Health Questionnaire-9 (PHQ-9), Social Support Rating Scale, Tampa Scale for Kinesiophobia-Swedish Version (TSK-SV), and Chronic Disease Resource Survey Questionnaire at the end of phase I cardiac rehabilitation. Latent class analysis identified potential categories of adherence to phase I cardiac rehabilitation in post-PCI patients. Logistic regression analyzed the factors influencing the different categories.
Results:
Adherence to phase I cardiac rehabilitation in post-PCI patients was classified into three groups: Good Adherence (31.2%), Poor Nutritional and Psychological Management (32.0%), and Lack of Exercise (36.8%). Limited social support, poor utilization of chronic disease resources, low education level, a history of alcohol consumption, and kinesiophobia are factors influencing the different latent subgroups (P < 0.05).
Conclusion:
Heterogeneity exists in the adherence to phase I cardiac rehabilitation of post-PCI patients. Healthcare professionals should implement targeted interventions based on the characteristics of each category to improve adherence.
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