Adherence to outpatient cardiac rehabilitation and related factors in STEMI after PCI in China: a sequential
Wenjie Zhang1, Hongjin Wang1, Peiru Li1
1Health Management Center, Affiliated Hospital of Jiangsu University, Zhenjiang, China.
Insights
This study investigates adherence to outpatient cardiac rehabilitation for ST-elevation myocardial infarction patients post-PCI in China. Findings will inform strategies to improve patient engagement in cardiac recovery programs.
Area of Science:
- Cardiology
- Public Health
- Health Behavior
Background:
- Acute myocardial infarction (AMI) is a leading cause of death globally.
- Cardiac rehabilitation is crucial for ST-elevation myocardial infarction (STEMI) patients, especially post-percutaneous coronary intervention (PCI).
- Suboptimal adherence to outpatient cardiac rehabilitation (OCR) in China necessitates further investigation into influencing factors.
Purpose of the Study:
- To assess adherence to OCR in STEMI patients after PCI in China.
- To identify factors influencing OCR adherence using the Health Belief Model.
- To develop targeted strategies for improving OCR adherence.
Main Methods:
- An explanatory sequential mixed-methods design combining quantitative and qualitative approaches.
- Quantitative phase: Cross-sectional survey of 198 STEMI patients post-PCI.
- Qualitative phase: Semi-structured interviews to explore facilitators and barriers; data integration for strategy development.
Main Results:
- Quantitative assessment of OCR adherence levels and related factors.
- Qualitative exploration of patient-perceived facilitators and barriers to OCR.
- Integration of findings to inform a targeted adherence improvement strategy.
Conclusions:
- Understanding adherence factors is key to improving OCR for STEMI patients post-PCI.
- A tailored strategy will be developed based on mixed-methods findings.
- This research aims to enhance long-term cardiac recovery and reduce mortality.
Background:
Acute myocardial infarction remains a major contributor to global morbidity and mortality. Cardiac rehabilitation is widely recognized as an essential component of the comprehensive medical management for patients with ST-elevation myocardial infarction, especially among those who have undergone percutaneous coronary intervention. Adherence to cardiac rehabilitation encompasses patient collaboration with a healthcare provider, active involvement in the treatment regimen, and persistence in practice, characterized by self-efficacy and relapse prevention. Outpatient cardiac rehabilitation constitutes the second phase of the continuum of care, bridging the inpatient and long-term maintenance stages. However, adherence to outpatient cardiac rehabilitation programs in China remains suboptimal. The factors influencing outpatient cardiac rehabilitation in patients with ST-elevation myocardial infarction after percutaneous coronary intervention have not yet been fully elucidated.
Aims:
To investigate the status and influencing factors of adherence to outpatient cardiac rehabilitation in patients with ST-elevation myocardial infarction after percutaneous coronary intervention one month after discharge in China and gain a deeper understanding of this phenomenon of interest.
Methods:
An explanatory sequential mixed-methods design will be employed to conduct this study with three phases. The first phase is a quantitative study with a cross-sectional design to assess the level of adherence to outpatient cardiac rehabilitation and related influences based on the Health Belief Model among 198 patients with ST-elevation myocardial infarction after percutaneous coronary intervention in two tertiary hospitals in Zhenjiang, Jiangsu Province, China. The second phase is followed by a qualitative study to explore the patients' perceived facilitators and barriers to adherence to outpatient cardiac rehabilitation. Purposive sampling, semi-structured interviews, and conventional content analysis approaches will be used to collect and analyze the data. The final phase links to integrating the data and developing a targeted strategy to improve adherence to outpatient cardiac rehabilitation among patients with ST-elevation myocardial infarction after percutaneous coronary intervention. The nominal group technique and "weaving techniques" will be implemented in accordance with the results of the preceding two phases.
Discussion:
A targeted strategy to improve outpatient cardiac rehabilitation adherence would be designed considering the factors affecting adherence to outpatient cardiac rehabilitation in patients with ST-elevation myocardial infarction after percutaneous coronary intervention.
Clinical Trial Registration:
This study has been registered in the Chinese Clinical Trial Registry: ChiCTR2400080035.
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