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Comorbidities and Psychosocial Characteristics as Determinants of Dropout in Outpatient Cardiac Rehabilitation.
- Source :
-
The Journal of cardiovascular nursing [J Cardiovasc Nurs] 2017 Jan/Feb; Vol. 32 (1), pp. 14-21. - Publication Year :
- 2017
-
Abstract
- Background: Despite the clear benefits of cardiac rehabilitation (CR), a considerable number of patients drop out early.<br />Objective: Therefore, we wanted to evaluate dropout in CR with a special focus on comorbidities and psychosocial background.<br />Methods: Patients who attended CR after acute coronary syndrome, cardiac surgery, or heart failure (N = 489) were prospectively included. Dropout was defined as attending 50% of the training sessions or less (n = 96 [20%]). Demographic and clinical characteristics, exercise parameters, and psychosocial factors were analyzed according to dropout, and those with a trend toward a significant difference (P < .10) were entered in a multivariate logistic model.<br />Results: The presence of a cerebrovascular accident (4.18 [1.39-12.52]) involved a higher risk of dropout, and a comparable trend was seen for the presence of chronic obstructive pulmonary disease (2.55 [0.99-6.54]). Attending the training program only twice per week also implicated a higher risk of an early withdrawal (3.76 [2.23-6.35]). In contrast, patients on β-blockers were less likely to withdraw prematurely (0.47 [0.22-0.98]). Singles were more likely to drop out (2.89 [1.56-5.35]), as well as those patients who were dependent on others to get to CR (2.01 [1.16-3.47]). Finally, the reporting of severe problems on the anxiety/depression subscale of the EuroQOL-5D questionnaire involved a higher odds for dropout (7.17 [1.46-35.29]).<br />Conclusions: Neither demographic characteristics nor clinical status or exercise capacity could independently identify patients who were at risk of dropout. The presence of comorbidities and a vulnerable psychosocial background rather seem to play a key role in dropout.
- Subjects :
- Adult
Aged
Cardiac Rehabilitation psychology
Comorbidity
Exercise
Female
Follow-Up Studies
Humans
Male
Middle Aged
Outpatients statistics & numerical data
Patient Compliance psychology
Patient Dropouts psychology
Patient Satisfaction statistics & numerical data
Prospective Studies
Cardiac Rehabilitation statistics & numerical data
Patient Compliance statistics & numerical data
Patient Dropouts statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 1550-5049
- Volume :
- 32
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- The Journal of cardiovascular nursing
- Publication Type :
- Academic Journal
- Accession number :
- 26422639
- Full Text :
- https://doi.org/10.1097/JCN.0000000000000296