PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Cardiac Rehabilitation”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 19 recordsLinked to original sources
PubMed1990

The challenge of cardiac rehabilitation.

Cardiac rehabilitation has emerged as an integral part of cardiovascular care and an important and exciting area of rehabilitation. Its future will depend on the maintenance of adequate funding sources and demonstration that quality of life or cost/benefit assessments justify the continuance of such programs. Physical activity will remain as the cornerstone of most programs, but it must be integrated with other risk factor modification programs. The practitioner of cardiac rehabilitation will need to recognize the appropriate application of risk factor modification.

Cardiac Rehabilitation↗
PubMedDate not supplied

The use of self-efficacy in cardiac rehabilitation.

Cardiac rehabilitation patients' perceptions of their ability to perform an exercise prescription can mediate how much effort they will expand toward exercise compliance. A review is made of self-efficacy theory and its application in research investigating the relationship between the self-efficacy and physical activity. This article explores how the nurse in cardiac rehabilitation can utilize the sources of efficacy information to assist the patient to modify the cardiovascular disease risk factor of sedentary lifestyle.

Adult↗
PubMed1992

Outcome assessment in cardiac rehabilitation.

Cardiac rehabilitation outcome assessment has reflected the isolated concerns of different professionals, each addressing different factors of the problems of patients. Physical, medical, psychosocial, and epidemiological approaches have been taken. Discrepancies in findings may relate more to problems with assessment than to the technology itself, and can undermine the usefulness of the intervention.

Adaptation, Psychological↗
PubMed1979

Community participation in cardiac rehabilitation.

Cardiac patients are not solely responsible for their own rehabilitation. The rehabilitative process is a prolonged one, and success lies in multidisciplinary management involving the patient, the immediate family and the community. The Health Act (Act No. 63 of 1977) has various implications for the future provision of rehabilitative services in South Africa. Each member of the health team and the community has a specific role to play, either within or outside the hospital setting, thus providing ongoing rehabilitative supervision of cardiac patients.

Aftercare↗
PubMed1991

The Johannesburg cardiac rehabilitation programme.

Cardiac rehabilitation has become a generally accepted mode of treatment for patients suffering from coronary artery disease. The Johannesburg cardiac rehabilitation programme was started in 1982 and has rapidly grown to become one of the largest programmes in southern Africa. This paper describes the 387 patients admitted to the unit between June 1986 and July 1988 and evaluates the effects of a combined exercise training and lifestyle modification programme. The mean age on admission was 55 years for males and 58 years for females. Most patients were from social classes I and II. Myocardial infarction, coronary artery bypass graft and a combination of both were the most common reasons for admission (35.4%, 23% and 21.2% respectively). On admission 72.9% of patients were smokers, 26.3% had hypertension and 34.3% had hypercholesterolaemia. A 50% drop-out rate within 12 months of starting the programme was noted. An increase in peak oxygen uptake, weight and skinfold thickness reduction, and improvement in the lipogram were seen after 6 months in patients who complied well with the programme. Cardiac rehabilitation is a secondary preventive strategy that can complement traditional medical and surgical therapies.

Adult↗
PubMed1991

Cardiac rehabilitation programs.

Cardiac rehabilitation programs are safe and effective in improving the functional activities of patients with cardiac disease, but they may be hazardous to those patients whose life might be in jeopardy if subjected to exercise. It is clear that not all cardiac patients require supervised rehabilitation programs to return to normal pre-cardiac-event activities. Many patients who have suffered cardiac events recover from the events without much functional debilitation, usually because they were normally active prior to the cardiac event. Patients who have had heart transplants, percutaneous transluminal coronary angioplasty, or heart valve surgery have no unique characteristics that differentiate them from cardiac patients who have had a myocardial infarction or coronary artery bypass graft or who have stable angina in terms of the necessity for participating in supervised rehabilitation programs. Therefore, patients who have had these surgical procedures might be selected for enrollment in cardiac rehabilitation programs on the basis of their physical and psychological conditions. Those patients who benefit from rehabilitation programs usually accomplish their goals within the 12-week sessions of the usual programs. Patients with stable cardiac conditions who are at high risk and have minimal functional capacities (3-5 METs) appear to benefit most, while patients who are of low risk and have functional capacities of 7-9 METs have minimal need for the program. High-risk patients have been described as including those who develop ventricular arrhythmias or marked ischemia with exercise. Low-risk patients have been described as including those who have functional capacities at 3 weeks postoperation of 8 METs or more, which allows them to resume most of their vocational and recreational activities. Patients with intermediate risk and functional capacities benefit from the programs, but they may not require the full 12 weeks of participation. The latter group may safely exit the programs when they attain the goals of the cardiac rehabilitation programs, e.g., the resumption of pre-cardiac-event activities and return to a relatively normal life. Accordingly, heart transplant patients and patients who have undergone percutaneous transluminal coronary angioplasty or heart valve surgery could benefit from prescribed cardiac rehabilitation programs if they have the need as described. The available information implies that many heart transplant, PTCA, or heart valve surgery patients are in excellent functional status after the surgical intervention and require minimal or no supervised exercise programs. However, a significant number of patients may lack confidence in their capabilities and may benefit from earlier exercise testing that would demonstrate to them their functional capabilities.(ABSTRACT TRUNCATED AT 400 WORDS)

Aftercare↗
PubMed1991

Nutrition information needs during cardiac rehabilitation: perceptions of the cardiac patient and spouse.

A survey instrument, which was developed from personal interviews with participants in a cardiac rehabilitation program, was administered at two hospital-based Phase II cardiac rehabilitation programs. Thirty-five patients (28 men, 7 women) and 29 spouses (5 men, 24 women) responded to survey items designed to investigate how subjects perceived themselves dealing with the cardiac diet, what questions they were asking, and how answers to those questions would help them. Subjects in the patient group (which was 80% male) most frequently asked questions dealing with compliance and the diet's benefits. Subjects in the spouse group (which was 83% female) most frequently asked questions relating to food selection. Participants indicated that having their questions answered would help them make decisions, be motivated, feel in control, and plan. Participants' overall attitude toward the diet was positive because patients were willing to make changes in their diet; however, more than half the sample thought food labels were difficult to understand and grocery shopping was difficult. We conclude that nutrition education programs that address individual needs and uses for nutrition information could enhance the learning process in group settings such as cardiac rehabilitation programs.

Adult↗
PubMed1977

Implementation of clinical pharmacy services in a cardiac rehabilitation unit.

The implementation of a comprehensive program for the rehabilitation of cardiac patients is discussed with primary emphasis on the clinical pharmacy services provided and the method of reimbursement for these clinical services. The three basic clinical pharmacy service objectives in the cardiac rehabilitation unit (CRU) are: (1) to provide drug information to the patient, his family and health-care team members; (2) to intensively monitor the drug therapy of all CRU patients, and (3) to evaluate the impact of pharmacy services being provided upon the quality of patient care and subsequent avoidable drug-related morbidity and mortality. The pharmacist is reimbursed for his clinical services from a percentage of the revenues gained from the higher room rate rather than from traditional dispensing functions and drug fees. It is concluded that the pharmacist is recognized as a necessary drug information source and an important member of the CRU team.

Cardiac Care Facilities↗
PubMed1992

Psychosocial aspects of cardiac rehabilitation in Europe.

While the present objectives of cardiac rehabilitation include recovery or restoration of everyday behaviour and secondary prevention, the effects of the traditional exercise-based, cardiac rehabilitation programmes are quite modest. It is argued that psychological interventions may affect these targets more easily, since there is evidence from controlled studies that psychological interventions may have beneficial effects on psychosocial recovery, compliance with medical advice and cardiovascular morbidity and mortality. As a consequence one may expect that psychologists would be at least part-time members of most cardiac rehabilitation teams in European countries. In order to get an impression of the position of psychologists and the share of psychosocial care in cardiac rehabilitation in Europe, a questionnaire was sent out to two or three individuals in each European country. Health care professionals from 16 European countries returned their completed questionnaires on time. Among other things, the results show that in general social workers and psychologists, who may be considered the main potential agents for psychosocial care, are largely underrepresented in cardiac rehabilitation teams. As far as psychologists are concerned, the number involved in cardiac rehabilitation varies significantly from country to country. Three groups of countries could be distinguished: a group consisting of The Netherlands, Austria, and Italy, where psychologists are fairly well represented; a second one consisting of Norway, Finland and Belgium, where small numbers of psychologists are involved in cardiac rehabilitation; and a third group (the largest) consisting of Switzerland, Poland, Czechoslovakia, Denmark, Ireland, Sweden, the UK, Greece, Portugal and Turkey, where the number of psychologists is negligible.

Cardiac Care Facilities↗
PubMed1992

Cardiac rehabilitation 1992.

The goal of cardiac rehabilitation is to optimize function through attention to the patient's medical needs, risk factors for recurrent events, physical reconditioning, and psycho-social needs. Medical needs include beta-adrenergic blocking agents and aspirin unless contraindicated, angiotensin converting inhibitors for left ventricular dysfunction, and relief of residual ischemia. Smoking, lipid abnormalities, physical inactivity, and hypertension remain important predictors of reinfarction and death and must be controlled. Obesity must be addressed because it exacerbates these problems. Therefore, the principles of behavior change should be applied to help patients control their risk factors and adopt healthy lifestyles. Smoking cessation and appropriate dietary behaviors can be adopted by the patient while in the hospital. Physical reconditioning can also begin with twice-daily exercises. After discharge from hospital and after an initial submaximal exercise evaluation, the patient will benefit from three sessions per week of outpatient cardiac rehabilitation for six to eight weeks. These sessions should last about an hour and raise the patient's heart rate as much as 30 beats per minute. Along with physical reconditioning, the cardiac rehabilitation program provides an opportunity to address risk factor modification, return to work, return to sexual activity, management of depression and anxiety, and the presence of risk factors in the patient's family. The patient should attend reinforcing sessions every three months for the first year and as necessary after that to control risk factors and reinforce the necessity for physical fitness.

Coronary Disease↗
PubMed1992

Cardiac rehabilitation. Current status and future directions.

Comprehensive cardiac rehabilitation is more than exercise training for patients with coronary artery disease and now includes all aspects of secondary prevention. Exercise training is individually prescribed based on clinical status and therapeutic goals. Smoking cessation and abstinence and the treatment of hypercholesterolemia are integral to the rehabilitation process. Education and counseling are important adjuncts to treatment, especially soon after a coronary event. Vocational rehabilitation can be included simply and effectively in the rehabilitation process. Efficient and cost-effective cardiac rehabilitation is tailored to a patient's medical condition, risk factor evaluation, and vocational status. The future of cardiac rehabilitation will be linked to the success of training nonphysician health professionals to provide preventive services.

Ambulatory Care↗
PubMed1992

Cardiac rehabilitation participation predicts lower rehospitalization costs.

The effect of participation in cardiac rehabilitation on medical costs was determined by measuring hospitalization charges for cardiac admissions over a 3-year period in 580 post-coronary event patients (58% after coronary bypass surgery, 42% after myocardial infarction), of whom 230 entered a cardiac rehabilitation program and 350 did not. Baseline left ventricular ejection fraction was similar in entrants and nonentrants (59.9% vs 59.5%). Over the 1 to 46-month follow-up period (mean 21 months), per capita hospitalization charges for participants in cardiac rehabilitation were $739 lower than charges for nonparticipants ($1197 +/- 3911 vs $1936 +/- 5459, p = 0.022). This was due to both a lower incidence of hospitalizations and lower charges per hospitalization. Inasmuch as groups differed with regard to age, sex, diagnostic category, and smoking status, data were adjusted for these baseline differences by means of analysis of covariance. Rehospitalization charges remained significantly higher in nonparticipants (p = 0.015). Because physician charges were not measured, the cost differential between groups is underestimated. Results of this study show an association between participation in comprehensive cardiac rehabilitation and lowered cardiac rehospitalization costs in the years after an acute coronary event.

Aged↗
PubMed1992

Multivariate models for compliance with phase 3 cardiac rehabilitation services in Johannesburg.

The efficacy of an exercise cardiac rehabilitation programme depends on an adequate compliance of its participants. A 50% dropout rate after 12 months has been reported by most rehabilitation programmes. Compliance with attendance and the exercise prescription are monitored daily at the Johannesburg Cardiac Rehabilitation Centre. This study evaluated the attendance of 711 patients admitted to the programme between June 1986 and March 1990 and looked at possible differences in attendance and intensity rates of compliers and dropouts prior to dropout. Multiple regression analyses were performed on all patients using different measures of exercise compliance as dependent variables and patient characteristics on admission as explanatory variables in order to establish possible associations which could identify potential dropouts at an early stage. We found that 36% of patients dropped out by 12 months and that 50% managed to complete our 18 month programme. Dropouts complied less than compliers in terms of attendance and intensity before dropping out. Significant associations were found between the measures of compliance and patient characteristics. Age, smoking, peak oxygen uptake and a measure of hostility were identified as predictive factors. With the exception of the energy expended per session the variation in the other measures of compliance was poorly explained by the explanatory variables suggesting that other factors could be related to compliance at the Johannesburg Cardiac Rehabilitation Centre and need to be further evaluated.

Cardiac Care Facilities↗
PubMed1991

Cardiac rehabilitation services: what are they and are they worth it?

The objectives of cardiac rehabilitation include lowering mortality but, more importantly, increasing functional capacity so reducing disability and potentially improving quality of life. The data suggest that cardiac rehabilitation services are worth the patient's costs and efforts and as such, they should be considered an integral component of comprehensive cardiovascular care by cardiologists and primary care physicians. While there is considerable agreement on the roles of exercise testing and training in the three position stands, there are also substantiated, and important, differences in their recommendations on other cardiac rehabilitation services, such as counseling and risk factor management. The challenge for the 1990's is not only to continue to better define the effectiveness of cardiac rehabilitation services, but more urgently, how to deliver effective services most efficiently. This will help physicians provide optimum care for their patients, will improve the patient's likelihood of regaining for themselves an active and productive life, and should generate a more equitable and accountable reimbursement system for quality health care.

Cardiac Rehabilitation↗