Cardiac rehabilitation tracking challenges for the elderly

Background: Many cardiovascular patients especially those undergoing coronary artery bypass graft are candidates for cardiac rehabilitation. Cardiac rehabilitation (CR) goals include promoting secondary prevention, improving quality of life and exercise tolerance, regulating blood lipid levels and blood pressure, controlling weight, increasing knowledge level, smoking behavior, improving psychosocial functioning, accelerating the return to work, and reducing the disease recurrence and mortality and morbidity rate. CR/SP services are the standards of care for patients with CHD. Although there are many advantages for CR, attendance rates were between 30 and 45%. High rates of dropout of patients initially enrolling in programs are widely (40 to 55%). Assessment and recognition of the confounding factors for increasing the participation rate are very important. This study aimed at describing these challenges.Materials & Methods: This study is a systematic review on published articles about cardiac rehabilitation challenges in Iran (2007-2017). Given the research question, an extensive search was conducted to identify all studies on the effects of cardiac rehabilitation programs and their importance, barriers to the elderly participation in cardiac rehabilitation, and prevention of postoperative complications. Finally, the results were extracted.Results: The results showed cardiac rehabilitation could improve patients’ exercise tolerance and quality of life, reduce resting heart rate, increase peak heart rate at maximal exercise, reduce total cholesterol significantly, relieve chest pain, and early and late mortality and morbidity rate, and accelerate return to work. However, the results showed low participation rate. Results of quantitative and qualitative studies to identify the participation rate and CR completion and the related factors in Iran revealed patients with hypertension and high education level had attended more sessions. Psychological distress, economic problems, personal attitudes and believes, grade of awareness of CR programs, transport problems, number of CR centers, and kind of communication with healthcare staff were factors influencing on patients’ participation in CR programs.Conclusion: Healthcare staff should adopt the best approach and interventions that are appropriate for the elderly with cultural sensitivity. It is important to consider patients health beliefs and literacy before suggesting the lifestyle advices. In education and counseling program of cardiac patients, psychologists and other specialists should be involved to teach patients skills before making lifestyle changes. CR programs should be flexible and pay more attention to planning, processing and performing.

کلیدواژه ها:

Cardiac Rehabilitation ، Elderly ، Challenge ، Systematic Review