Impact of general health on the outcomes of center-based cardiac rehabilitation

Abstract

Background: Cardiovascular disease is the number one cause of death, and cardiac rehabilitation (CR) is effective in reducing the risks of disease progression and mortality by improving physical functioning and quality of life. Despite the significant impact of CR, the completion of CR is low. Factors influencing CR completion have been widely studied, but little is known about the impact of general health on CR completion self-care behaviors, and physical functioning associated with CR completion. Therefore, the purpose of the study was to explore relationships between health beliefs, general health, CR completion, physical function, and self-care behavior. The conceptual framework shows how health belief perceptions, support systems, sociodemographic factors, and general health influence CR completion, physical function, and self-care behavior. Methods: This was a retrospective cohort study using a sample of participants completing the outpatient CR center at a large medical center in the southeastern United States. Multiple linear regression was used to determine the predictors of CR completion, the improvement of physical function, and self-care behavior. Results: HbA1C predicted CR completion, and there was no significant relationship between CR completion and general health. Gender and general health (sitting time, fatigue, anxiety, and depression) predicted the improvement of physical functioning. Age and general health (sitting time, self-care complexity, and disease burden) predicted self-care behaviors. There was no relationship between health beliefs and CR completion. Conclusion: CR completion was predicted by glycemic control, while physical functioning improvement and self-care behavior were predicted by general health indicators. Additional research is needed to validate the findings and develop a sensitive screening tool to identify high-risk patients who are likely to drop out from a CR program. Further research to develop strategies to prevent CR incompletion and poor outcomes prior to patients’ participation is warranted.