Factors influencing cardiovascular patients to complete phase II cardiac rehabilitation - a qualitative study

Cardiac rehabilitation (CR) is essential for improving health outcomes and quality of life in patients with cardiovascular disease. Despite its proven effectiveness, global adherence to CR remains low, particularly in China. This qualitative study aimed to explore the factors influencing sustained participation in Phase II CR among cardiovascular patients, including both motivators and barriers, with the aim of providing insights to enhance program design and patient engagement.

This qualitative, phenomenological study explored the feelings and experiences of 18 cardiovascular patients who completed at least 25 outpatient CR sessions at three tertiary hospitals in Shanghai. Participants were recruited through purposive sampling. Data were collected through face-to-face, semi-structured interviews conducted from July 2024 to February 2025. Transcripts were analyzed using Colaizzi's method, supported by NVivo 15 software.

Analysis revealed five primary themes encompassing 13 sub-themes: (1) Strong health belief, including desire for health recovery and belief in the value of CR; (2) Perceived benefits of CR, comprising improvements in physical endurance, psychological and emotional well-being, and health behavior changes; (3) Social support, from family, peers, and healthcare professionals; (4) Barriers to participation, involving financial costs, time and logistical constraints, and psychological concerns; (5) Opportunities for improvement in CR programs, highlighting the need for better accessibility, increased insurance reimbursement, and diversified and flexible program formats.

Sustained participation in Phase II CR was largely influenced by personal motivations driven by strong health beliefs and reinforced by perceived health benefits and robust social support. Addressing identified barriers-particularly financial constraints and limited accessibility-through targeted strategies like enhancing insurance coverage, raising awareness, and providing flexible, diversified CR formats is imperative. Such improvements could significantly increase adherence rates and optimize cardiovascular health outcomes during and immediately following Phase II CR.

not applicable.