Patient Commitment to Cardiac Rehabilitation: A Qualitative Study

Neda Sanaie, Ali Darvishpoor Kakhki, Fazlollah Ahmadi

Abstract


Background: Commitment to Cardiac Rehabilitation (CR) is one of the essential strategies to reduce the long‑term complications of cardiovascular disease. The attributes of patients’ commitment have not been defined distinctly. Thus, the present study aimed to describe the attributes of commitment to CR from the participants’ perspective.

Materials and Methods: This qualitative study was carried out in Tehran from 2018 to 2019. Data were collected using semi‑structured interviews with 30 participants, including 13 CR specialists, 13 patients, and four caregivers, through purposeful sampling. The analysis was performed through the conventional content analysis using the Elo and Kyngäs approach.

Results: Commitment to CR has one theme titled the attitudinal‑motivational aspect that consists of four categories including attitudinal‑cognitive, attitudinal‑behavioral, attitudinal‑emotional, and motivational as the core features. The commitment to CR is devotion, internal desire, and voluntary obligation to initiate and continue CR cooperatively, all of which are accompanied by the purposeful initiation of the treatment plan.

 Conclusions: The patient’s commitment to CR is an intrinsic interest in achieving health that stems from the acceptance of the disease and the need for treatment. Besides, the rehabilitation team facilitates purposeful interpersonal relationships between the patient and the treatment group. It provides the basis for the patient’s active efforts to meet the challenges of the treatment process.



Keywords


Acceptance and commitment therapy, cardiac rehabilitation, Iran, qualitative research

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References


Roth GA, Abate D, Abate KH, Abay SM, Abbafati C, Abbasi N, et al. Global, regional, and national age sex specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: A systematic analysis for the Global Burden of Disease Study 2017. Lancet 2018;392:1736 88.

Benjamin EJ, Blaha MJ, Chiuve SE, Cushman M, Das SR, Deo R, et al. Heart disease and stroke statistics—2017 update: A report from the American Heart Association. Circulation 2017;135:e146 603.

Sarrafzadegan N, Mohammmadifard N. Cardiovascular disease in Iran in the last 40 years: Prevalence, mortality, morbidity, challenges and strategies for cardiovascular prevention. Arch Iran Med 2019;22:204 10.

Hermann M, Witassek F, Erne P, Rickli H, Radovanovic D. Impact of cardiac rehabilitation referral on one year outcome after discharge of patients with acute myocardial infarction. Eur J Prev Cardiol 2019;26:138 44.

Mehra VM, Gaalema DE, Pakosh M, Grace SL. Systematic review of cardiac rehabilitation guidelines: Quality and scope. Eur J Prev Cardiol 2020;27:912 28.

Sage S. Cardiac rehabilitation: Motivation and commitment. Br J Card Nurs 2013;8:237 40.

de Araújo Pio CS, Chaves GS, Davies P, Taylor RS, Grace SL. Interventions to promote patient utilization of cardiac rehabilitation. Cochrane Database Syst Rev 2019;2:CD007131.

Stensrud B, Høyer G, Beston G, Granerud A, Landheim AS. “Care or control?”: A qualitative study of staff experiences with outpatient commitment orders. Soc Psychiatry Psychiatr Epidemiol 2016;51:747 55.

Yuan S, Murphy J. Partnership in nursing care: A concept analysis. TMR Integr Nurs 2019;3:21 6.

Perreira TA, Berta W. The object of your affection: How commitment, leadership and justice influence workplace behaviours in health care. J Nurs Manag 2016;24:E146 54.

Takura T, Ebata Kogure N, Goto Y, Kohzuki M, Nagayama M, Oikawa K, et al. Cost effectiveness of cardiac rehabilitation in patients with coronary artery disease: A meta analysis. Cardiol Res Pract 2019;2019:1840894.

Mohammadi F, Taherian A, Hosseini MA, Rahgozar M. Effect of home based cardiac rehabilitation quality of life in the patients with myocardical infarction. J Rehab 2006;7:26 32.

Holloway I, Galvin K. Qualitative Research in Nursing and Healthcare. John Wiley and Sons; 2016.

Krippendorff K. Content Analysis: An Introduction to its Methodology. Sage Publications; 2018.

Elo S, Kyngäs H. The qualitative content analysis process. J Adv Nurs 2008;62:107 15.

Creswell JW, Creswell JD. Research Design: Qualitative, Quantitative, and Mixed Methods Approaches. Sage publications; 2017.

Higgins T, Larson E, Schnall R. Unraveling the meaning of patient engagement: A concept analysis Patient Educ Couns 2017;100:30 6.

Yao T, Qiu Q, Wei Y. Retaining hotel employees as internal customers: Effect of organizational commitment on attitudinal and behavioral loyalty of employees. Int J Hosp Manag 2019;76:1 8.

Meeker D, Goldberg J, Kim KK, Peneva D, Campos HDO, Maclean R, et al. Patient Commitment to Health (PACT Health) in the heart failure population: A focus group study of an active communication framework for patient centered health behavior change. J Med Internet Res 2019;21:e12483.

Ghahnaviyeh LA, Bagherian B, Feizi A, Afshari A, Darani FM. The effectiveness of acceptance and commitment therapy on quality of life in a patient with myocardial Infarction: A randomized control trial. Iran J Psychiatry 2020;15:1.

Galletta M, Portoghese I, Melis P, Gonzalez CIA, Finco G, D’Aloja E, et al. The role of collective affective commitment in the relationship between work–family conflict and emotional exhaustion among nurses: A multilevel modeling approach. BMC Nurs 2019;18:1 9.

Setyajidi B, Kambuaya B, Tuhumena R, Bharanti E. Influence of patient satisfaction through commitment to loyalty inpatient Hospitals Jayapura. Adv Soc Sci Res J 2018;5:370 8.

Hadden BW, Agnew CR, Tan K. Commitment readiness and relationship formation. Pers Soc Psychol Bull 2018;44:1242 57.

Falk A, Zimmermann F. Information processing and commitment. Econ J 2018;128:1983 2002.

Yıldız E. The effects of acceptance and commitment therapy on lifestyle and behavioral changes: A systematic review of randomized controlled trials. Perspect Psychiatr Care 2020;56:657 90.

Jaros SJ, Jermier JM, Koehler JW, Sincich T. Effects of continuance, affective, and moral commitment on the withdrawal process: An evaluation of eight structural equation models. Acad Manage J 1993;36:951 95.

Tan K, Agnew CR. Ease of retrieval effects on relationship commitment: The role of future plans. Pers Soc Psychol Bull 2016;42:161 71.

Zukauskiene R. Interpersonal Development. Routledge; 2017.

Weigel DJ, Etopio AL, Shrout MR, Evans WP. The everyday communication of commitment: Testing an integrated model of self construal, cognition, affect, motivation and communication. West J Commun 2020;84:499 520.

Ferdinand KC, Senatore FF, Clayton Jeter H, Cryer DR, Lewin JC, Nasser SA, et al. Improving medication adherence in cardiometabolic disease: Practical and regulatory implications. J Am Coll Cardiol 2017;69:437 51.

Ooi J, Francová A, Székely M, Michael J. The sense of commitment in individuals with borderline personality traits in a non clinical population. Front Psychiatry 2018;9:519.

Taouk Y, Spittal MJ, LaMontagne AD, Milner AJ. Psychosocial work stressors and risk of all cause and coronary heart disease mortality: A systematic review and meta analysis. Scand J Work Environ Health 2020;46:19 31.

Behnke M, Kaczmarek LD. Successful performance and cardiovascular markers of challenge and threat: A meta analysis. Int J Psychophysiol 2018;130:73 9.


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