Attitudes to and Attendance at Cardiac Rehabilitation After Spontaneous Coronary Artery Dissection
Barbara M Murphy1, Michelle C Rogerson, Siiri E Iismaa
1Author Affiliations: Australian Centre for Heart Health, Melbourne, Victoria, Australia (Drs Murphy, Rogerson and Le Grande, and Prof Jackson); School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia (Drs Murphy and Le Grande, and Prof Jackson); Victor Chang Cardiac Research Institute, Sydney, New South Wales, Australia (Drs Iismaa and Hesselson, and Prof Graham); St Vincent's Hospital, Sydney, New South Wales, Australia (Dr Iismaa and Prof Graham); and Centre on Behavioral Health, University of Hong Kong, Pokfulam, Hong Kong (Prof Jackson).
Insights
Cardiac rehabilitation (CR) attendance is high after spontaneous coronary artery dissection (SCAD), but patients perceive traditional CR as irrelevant. Tailored SCAD-specific programs are needed to improve patient support and outcomes.
Area of Science:
- Cardiology
- Public Health
- Patient Support
Background:
- Cardiac rehabilitation (CR) is standard post-heart event care.
- Uptake and relevance of CR after spontaneous coronary artery dissection (SCAD) is understudied.
Purpose of the Study:
- Investigate attitudes toward CR in SCAD survivors.
- Determine CR attendance rates and correlates.
- Identify reasons for CR non-attendance post-SCAD.
Main Methods:
- Online focus groups (n=30) explored SCAD survivor attitudes toward CR.
- Thematic analysis of focus group data.
- Online survey (n=310) assessed CR attendance, correlates, and non-attendance reasons.
Main Results:
- Qualitative themes: perceived lack of CR relevance, attendee mismatch, health professional knowledge gaps, preference for SCAD-specific CR, and perceived benefits.
- CR attendance rate was 63% (73% among referred).
- Mid-level education and lifetime anxiety correlated with CR attendance.
Conclusions:
- Despite high attendance, SCAD survivors perceive traditional CR as unnecessary or irrelevant.
- Findings highlight the need for SCAD-specific CR programs and support.
- Addressing patient perceptions and tailoring CR is crucial for effective post-SCAD care.
Purpose:
Cardiac rehabilitation (CR) is standard care for patients after a heart event, including acute myocardial infarction. However, the uptake and relevance of traditional CR after acute myocardial infarction due to spontaneous coronary artery dissection (SCAD) has not been extensively investigated. The present study investigated attitudes toward CR, identified the rate and correlates of CR attendance, and examined the reasons for CR non-attendance after SCAD.
Methods:
Online focus groups (n = 30) explored attitudes toward and experiences of CR of survivors of SCAD, with data analyzed thematically according to recommended guidelines. An online survey (n = 310) then investigated rates of CR attendance and reasons for non-attendance. Correlates of CR attendance were identified using bivariate and multivariable analyses.
Results:
Thematic analysis revealed 5 themes in the perceptions of CR of survivors of SCAD: (1) lack of relevance of CR educational content; (2) lack of identification with typical CR attendees; (3) lack of CR health professional knowledge and skills; (4) preference for SCAD-specific CR; and (5) benefits of CR. The survey demonstrated a CR attendance rate of 63% (73% among those referred). The correlates of CR attendance were mid-level education and self-reported lifetime anxiety. Among attendees, the correlates of attending fewer sessions were having a more recent SCAD, not having lifetime anxiety, and not knowing other survivors of SCAD. Reported reasons for non-attendance mirrored qualitative themes identified.
Conclusion:
While the survey demonstrated high CR attendance, perceptions that CR was unnecessary and irrelevant after SCAD were evident, often based on health professional advice. The findings add to the growing literature highlighting a need for appropriate support for survivors of SCAD.
