Psychosocial predictors for cardiac rehabilitation participation for patients with coronary artery disease

Abstract

Aims: Cardiac rehabilitation (CR) is a class Ia recommendation by international guidelines. However, the participation remains disappointingly low. Multiple barriers were already identified. Nevertheless, the relationship with psychosocial factors remains unsettled. The aim of this study is to analyse the role of psychosocial factors in CR participation.

Methods and results: A prospective study on 165 patients with a percutaneous coronary intervention. The main outcome was participation in a centre-based CR programme. The independent relationship between participation and optimism, type D personality or distressed personality, health literacy, depression, social support and self-efficacy. A total number of 165 patients were included in the study of which 81 (49.1%) participated in a centre-based CR programme. Participants were predominantly male. Solely, patients participating in CR were significantly younger (P = 0.005). Participants of CR had significantly higher levels of social support especially from their significant other (P = 0.020) and family (P = 0.050). Furthermore, the health literacy score was significantly higher in the participants group (P = 0.030). A multiple logistic regression demonstrated that higher age, higher social support, not working, being obese and being able to drive a car were significant statistical predictors for CR participation.

Conclusions: This study is one of the first to demonstrate the role of social support and health literacy in the participation of CR. Other well-known barriers for CR participation such as age, transport and scheduling issues were identified as barriers in this study.

Keywords: Cardiac rehabilitation; Cardiovascular disease; Health literacy; Optimism; Participation; Social factors.