[Factors influencing the participation of post coronary artery bypass patients in cardiac rehabilitation exercise]

Studies have shown that cardiovascular rehabilitation exercise improves quality of life in post-coronary-bypass-surgery patients. However, the rate of participation in this exercise by this patient group in Taiwan has increased only 8.2% during the past 13 years (from 61.9% in 1996 to 70.1% in 2009). Little is known about the factors that influence patient motivation to participate in cardiovascular rehabilitation exercise.This study explores the factors that influence patient participation in rehabilitation exercise following coronary bypass surgery.This cross-sectional, correlational study recruited a convenience sample of 253 patients who had undergone coronary bypass surgery at a medical center in southern Taiwan. Structured questionnaires, including a patient rehabilitation exercise experience questionnaire, Short Form-36 Health Survey-Taiwan Form, and cardiac rehabilitation exercise design factors questionnaire were used for data collection. SPSS19.0 was used to analyze data.The variables "healthcare provider recommendation of rehabilitation exercise", "exercise program accessibility", "physical health status", and "patient post-surgical exercise patterns" each had a significant influence on participant participation in post-surgical rehabilitation exercise. Binary logistic regression analyses identified "receiving information on rehabilitation exercise", "level of patient-perceived importance of rehabilitation exercise", and "having post-surgical exercise patterns" as important predictors of participation in a rehabilitation exercise program, with OR ratios of 112, 7.86, and 3.23 times respectively. These 3 factors accounted for 90.1% of the total variance.Patient education on coronary bypass post-surgical rehabilitation exercise programs should be emphasized during pre-surgical consultation and care in order to facilitate the recovery of normal life functions following coronary bypass surgery.影響冠狀動脈繞道術後病患參與復健運動之因素探討心臟復健運動可改善冠狀動脈繞道術後病人生活品質。台灣復健參與率於13年間（1996年61.9%至2009年70.1%）卻僅上升8.2%；相關的影響因素缺乏本土實證資料，對有效提升參與率形成限制，因此，亟需深入探討。探討影響冠狀動脈繞道術後個案參與復健運動之相關因素。本研究為橫斷性、相關性研究，選取南部某醫學中心接受冠狀動脈繞道手術之253位個案為研究對象，主要研究工具為「個案復健運動經驗問卷」、「台灣版SF-36健康評估量表」與「影響參與復健運動方案因素調查表」，並以SPSS 19.0 for Windows進行統計分析。病患參與術後復健運動與否，和醫護人員提供復健運動相關資訊、就醫方便性、生理健康狀態、術後有無復健運動習慣等呈顯著性差異。再以二元邏輯迴歸分析發現有接受復健運動相關訊息、覺得復健運動是重要的、術後有運動習慣和是否參與復健運動等因素，於參與術後復健運動可能性分別是沒有參與者的112倍、7.86倍及3.23倍，且整體正確預測率為90.1%。應強化醫護人員對術後復健運動訊息提供之重視，於病人術前早期介入，以有效協助個案早日回復術後的生活功能。