4.4 Article

Are survivors of cardiac arrest provided with standard cardiac rehabilitation? - Results from a national survey of hospitals and municipalities in Denmark

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EUROPEAN JOURNAL OF CARDIOVASCULAR NURSING
卷 20, 期 2, 页码 115-123

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OXFORD UNIV PRESS
DOI: 10.1177/1474515120946313

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Cardiac arrest; cardiac rehabilitation; national health services; mapping

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The study aimed to assess the provision of cardiac rehabilitation to Danish survivors of cardiac arrest and found that, compared with patients after acute myocardial infarction, survivors of cardiac arrest received lower levels of certain core components in hospitals. Municipalities showed no difference in provision of core components. Overall, organizational factors did not appear to influence the provision of cardiac rehabilitation to survivors of cardiac arrest in Denmark, suggesting the need for further research to ensure equal access to all components of cardiac rehabilitation.
Aim: To quantify the provision of standard cardiac rehabilitation to Danish survivors of cardiac arrest at a programme level, and to analyse whether organizational factors influenced the provision. Method: We mapped the provision of cardiac rehabilitation core components to survivors of cardiac arrest and compared this with a reference group of patients after acute myocardial infarction using data from a cross-sectional programme-level survey among all hospitals (n=34) and municipalities (n= 98) in Denmark. Organizational factors of potential importance to service provision were considered: health care region, size of catchment area/population, type of department/municipality and socioeconomic index. Results: Response rates for the provision of each core component of cardiac rehabilitation ranged from 64% to 98%. All hospitals and municipalities provided some aspect of cardiac rehabilitation to survivors of cardiac arrest. Across hospitals, provision of four core components of cardiac rehabilitation to survivors of cardiac arrest was lower compared with post acute myocardial infarction patients: patient education (relative risk (RR) =0.45 (95% confidence interval (CI) 0.27 to 0.75)), exercise training (RR=0.69 (95% CI 0.49 to 0.98)), screening for anxiety and depression (RR=0.64 (95% CI 0.46 to 0.90) and nutritional counselling RR=0.76 (95% CI 0.62 to 0.93)). No difference was found in the provision of core components across municipalities. Overall, the provision of cardiac rehabilitation to survivors of cardiac arrest was not affected by organizational factors Conclusion: This study indicates a need for future research to inform the development, adoption and implementation of equal access to all components of cardiac rehabilitation for survivors of cardiac arrest in Denmark

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