A qualitative study investigating patients' beliefs about cardiac rehabilitation

Background: The opportunity to attend a cardiac rehabilitation course is usually offered to patients who have suffered a myocardial infarction. However, despite referral, many patients fail to attend. Objective: To elicit patients' beliefs about the role of the cardiac rehabilitation course following myocardial infarction. Design: Qualitative study using in-depth semi-structured interviews. Setting: London Teaching Hospital. Subjects: Thirteen patients were interviewed after discharge from hospital following myocardial infarction, but prior to attendance at cardiac rehabilitation. Main outcome measures: Patients' beliefs about cardiac rehabilitation that may act as barriers to attendance. Results: Themes identified included: the content of cardiac rehabilitation, perceptions of exercise, benefits of cardiac rehabilitation, explicit barriers to attendance and cardiac knowledge. Whilst some patients viewed cardiac rehabilitation as an important and necessary part of recovery others expressed doubt that it was appropriate for them. Some patients were uncertain of the course content and misunderstood the role of exercise and its perceived effects. Misconceptions with regard to cardiac knowledge were also apparent. The combination of erroneous beliefs about cardiac rehabilitation and cardiac misconceptions seemed to result in doubts regarding attendance. Conclusions: Prior to course attendance some patients hold erroneous beliefs about the course content, especially the exercise component. Co-existent cardiac misconceptions are also apparent. Further research is needed to clarify the extent to which these beliefs may contribute to the decision not to attend cardiac rehabilitation.