Participation in society in patients with coronary artery disease before and after cardiac rehabilitation

Nienke Ter Hoeve; Myrna E van Geffen; Marcel W Post; Henk J Stam; Madoka Sunamura; Ron T van Domburg; Rita J van den Berg-Emons

doi:10.1016/j.apmr.2015.01.019

Participation in society in patients with coronary artery disease before and after cardiac rehabilitation

Arch Phys Med Rehabil. 2015 Jun;96(6):1110-6. doi: 10.1016/j.apmr.2015.01.019. Epub 2015 Feb 7.

Authors

Nienke Ter Hoeve¹, Myrna E van Geffen², Marcel W Post³, Henk J Stam⁴, Madoka Sunamura⁵, Ron T van Domburg⁶, Rita J van den Berg-Emons⁴

Affiliations

¹ Capri Cardiac Rehabilitation Center, Rotterdam, The Netherlands; Department of Rehabilitation Medicine, Erasmus Medical Center, Rotterdam, The Netherlands. Electronic address: n.terhoeve@erasmusmc.nl.
² Capri Cardiac Rehabilitation Center, Rotterdam, The Netherlands; Department of Rehabilitation Medicine, Erasmus Medical Center, Rotterdam, The Netherlands.
³ Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands; Department of Rehabilitation, Center for Rehabilitation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
⁴ Department of Rehabilitation Medicine, Erasmus Medical Center, Rotterdam, The Netherlands.
⁵ Capri Cardiac Rehabilitation Center, Rotterdam, The Netherlands.
⁶ Department of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands.

PMID: 25662400
DOI: 10.1016/j.apmr.2015.01.019

Abstract

Objectives: To assess changes in participation in society (frequency, restrictions, satisfaction) during and after cardiac rehabilitation (CR) and to assess associations between participation and heath-related quality of life (HRQOL).

Design: Prospective cohort study.

Setting: Outpatient CR center.

Participants: Patients with coronary artery disease (N=121; mean age, 57y; 96 men [79%]).

Interventions: Multidisciplinary CR.

Main outcome measures: Participation in society was assessed with the Utrecht Scale for Evaluation of Rehabilitation-Participation and HRQOL with the MacNew Heart Disease health-related quality of life questionnaire. All measurements were performed pre-CR, post-CR, and 1 year after the start of CR.

Results: Frequency of participation did not change during and after CR. The proportion of patients experiencing restrictions in participation decreased from 69% pre-CR to 40% post-CR (P<.001) and 29% at 1 year (P<.001 vs post-CR). Pre-CR, 71% of patients were dissatisfied with their participation. This improved to 49% post-CR (P<.001) and 53% at 1 year (P<.001 vs pre-CR). Experienced restrictions explained 5% to 7% of the improvement in HRQOL during CR and satisfaction with participation explained 10% to 19%.

Conclusions: Participation in society improves in patients undergoing CR. Despite these improvements, the presence of coronary artery disease is associated with persistent restrictions and dissatisfaction with participation. Because experienced restrictions and dissatisfaction are related to changes in HRQOL it is important to address these aspects of participation during CR.

Keywords: Coronary artery disease; Rehabilitation; Social participation.

MeSH terms

Coronary Artery Disease / psychology*
Coronary Artery Disease / rehabilitation*
Depression / psychology
Female
Humans
Male
Middle Aged
Physical Fitness
Prospective Studies
Quality of Life
Social Participation*
Surveys and Questionnaires