Investigation and related factor analysis of barriers to outpatient cardiac rehabilitation in patients with coronary heart disease.

[Abstract] Objective·To evaluate the current status of barriers to outpatient cardiac rehabilitation (CR) in patients with coronary heart disease (CHD) and analyze related factors. Methods·From October to December 2017, the inpatients or outpatients with CHD from seven tertiary general hospitals in Yangpu District, Hongkou District, Baoshan District and Songjiang District of Shanghai were selected as the research objects by convenient sampling method. The general information questionnaire, the Cardiac Rehabilitation Information Awareness Questionnaire (CRIAQ) and the Chinese/Mandarin Cardiac Rehabilitation Barriers Scale (CRBS-C/M) were used to investigate the awareness of CR information, the barriers to CR and related factors in the patients with CHD. Results·A total of 390 questionnaires were distributed, and 342 valid questionnaires were recovered, with an effective recovery rate of 87.7%. The average age of the CHD patients was (67.03±10.83) years old. Among them, 42 patients (12.3%) had heard of CR. The overall median score of CRBS-C/M was 3.10 (2.71, 3.43) points, and the median scores of five dimensions ranged from 3.00 to 3.50 points. The median score of external logistical factors was the highest, which was 3.50 (3.00, 4.00) points. The top three barriers were "distance" "severe weather" and "I did not know about cardiac rehabilitation", with 75.4% (258/342), 69.3% (237/ 342) and 67.8% (232/342) of the patients agreeing or strongly agreeing, respectively. The average score of CRIAQ was (46.48± 12.54) points. Multiple linear regression analysis showed that CRIAQ score (β=-0.242, P=0.000), whether diagnosed as unstable angina or not (β =0.194, P=0.000), gender (β =0.154, P=0.002) and whether participating in outpatient CR programs or not (β = -0.128, P=0.016) were the related factors of CR barriers in the patients with CHD (F=8.909, P=0.000), which explained 25.9% of the total variation. Conclusion·The CR barrier of the patients with CHD is in the upper middle level, and the biggest barrier factor is the external logistical factor. The top three reasons that patients think hindering their participation in CR are long distance, severe weather and not knowing about CR. The patients with high awareness of CR information, or participating in outpatient CR programs have a low level of CR barriers, while the patients with unstable angina pectoris or the female patients have a high level. [ABSTRACT FROM AUTHOR]