Patient Needs Regarding Cardiac Rehabilitation: A Systematic Review and Meta-Ethnographic Synthesis

To improve uptake and completion of cardiac rehabilitation, it is important to identify needs and tailor cardiac rehabilitation accordingly. Therefore, the aim of this study was to synthesize the needs of patients with coronary heart disease, heart failure, or thoracic aortic dissection regarding cardiac rehabilitation.

We performed a systematic review and meta-ethnographic synthesis of qualitative studies. We synthesized lines of argument and assessed the confidence of evidence using the Grading of Recommendations Assessment, Development and Evaluation Confidence in Evidence From Reviews of Qualitative Research approach. Ultimately, we integrated our findings into a conceptual model with recommendations for cardiac rehabilitation professionals.

Ninety-four studies were included and provided data from 1731 patients, 185 significant others (eg, partners or family members), and 105 cardiac rehabilitation professionals. We have synthesized 5 lines of argument that explained the needs of patients: (1) Patients need safety but not overprotection (high confidence); (2) patients need significant others to be involved (high confidence); (3) patients need support from people with whom they can identify (moderate confidence); (4) patients need personalized care (moderate confidence); and (5) patients need help to redesign a meaningful future (high confidence).

There is a need for innovation of current cardiac rehabilitation programs. Overprotection of significant others must be addressed within a safe environment and by thorough involvement of significant others. Cardiac rehabilitation professionals can begin adapting cardiac rehabilitation by organizing peer support, providing personalized care, and helping to redesign a meaningful future. Meeting patients' needs may improve uptake and completion of cardiac rehabilitation.