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Kim C, Kwak HB, Sung J, Han JY, Lee JW, Lee JH, Kim WS, Bang HJ, Baek S, Joa KL, Kim AR, Lee SY, Kim J, Kim CR, Kwon OP, Sohn MK, Moon CW, Lee JI, Jee S. A survey of the perceptions of barriers to and facilitators of cardiac rehabilitation in healthcare providers and policy stakeholders. BMC Health Serv Res 2022; 22:999. [PMID: 35932056 PMCID: PMC9356496 DOI: 10.1186/s12913-022-08298-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 07/04/2022] [Indexed: 12/04/2022] Open
Abstract
Background Cardiac rehabilitation (CR) is a prognostic management strategy to help patients with CVD achieve a good quality of life and lower the rates of recurrence, readmission, and premature death from disease. Globally, cardiac rehabilitation is poorly established in hospitals and communities. Hence, this study aimed to investigate the discrepancies in the perceptions of the need for CR programs and relevant health policies between directors of hospitals and health policy personnel in South Korea to shed light on the status and to establish practically superior and effective strategies to promote CR in South Korea. Methods We sent a questionnaire to 592 public health policy managers and directors of selected hospitals, 132 of whom returned a completed questionnaire (response rate: 22.3%). The participants were categorized into five types of organizations depending on their practice of PCI (Percutaneous Coronary Intervention), establishment of cardiac rehabilitation, director of hospital, and government's policy makers. Differences in the opinions between directors of hospitals that perform/do not perform PCI, directors of hospitals with/without cardiac rehabilitation, and between hospital directors and health policy makers were analyzed. Results Responses about targeting diseases for cardiac rehabilitation, patients’ roles in cardiac rehabilitation, hospitals’ roles in cardiac rehabilitation, and governmental health policies’ roles in cardiac rehabilitation were more positive among hospitals that perform PCI than those that do not. Responses to questions about the effectiveness of cardiac rehabilitation and hospitals’ roles in cardiac rehabilitation tended to be more positive in hospitals with cardiac rehabilitation than in those without. Hospital directors responded more positively to questions about targeting diseases for cardiac rehabilitation and governmental health policies’ roles in cardiac rehabilitation than policy makers, and both hospitals and public organizations provided negative responses to the question about patients’ roles in cardiac rehabilitation. Responses to questions about targeting diseases for cardiac rehabilitation, patients’ roles in cardiac rehabilitation, and governmental health policies’ roles in cardiac rehabilitation were more positive in hospitals that perform PCI than those that do not and public organizations. Conclusions Hospitals must ensure timely referral, provide education, and promote the need for cardiac rehabilitation. In addition, governmental socioeconomic support is needed in a varity of aspects. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-08298-3.
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Affiliation(s)
- Chul Kim
- Department of Rehabilitation Medicine, Inje University Sanggye Paik Hospital, Seoul, South Korea
| | - Hae-Bin Kwak
- Department of Rehabilitation Medicine, Chungnam National University Hospital, Chungnam National Univeristy College of Medicine, Daejeon, South Korea
| | - Jidong Sung
- Division of Cardiology, Department of Medicine, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jae-Young Han
- Department of Physical Medicine and Rehabilitation, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, South Korea
| | - Jang Woo Lee
- Department of Physical Medicine and Rehabilitation, National Health Insurance Service Ilsan Hospital, Goyang, South Korea
| | - Jong Hwa Lee
- Department of Physical Medicine and Rehabilitation, Dong-A University College of Medicine, Busan, South Korea
| | - Won-Seok Kim
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Heui Je Bang
- Department of Rehabilitation Medicine, Chungbuk National University, College of Medicine, Cheongju, South Korea
| | - Sora Baek
- Department of Rehabilitation Medicine, Kangwon National University School of Medicine, Chuncheon, South Korea
| | - Kyung Lim Joa
- Department of Physical Medicine and Rehabilitation, Inha University Hospital, Incheon, South Korea
| | - Ae Ryoung Kim
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, Kyungpook National University School of Medicine, Daegu, South Korea
| | - So Young Lee
- Department of Rehabilitation Medicine, Jeju National University Hospital, Jeju National University College of Medicine, Jeju, South Korea
| | - Jihee Kim
- Department of Rehabilitation Medicine, Wonkwang University Hospital, Wonkwang University Medical School, Iksan, South Korea
| | - Chung Reen Kim
- Department of Physical Medicine and Rehabilitation, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea
| | - Oh Pum Kwon
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Min Kyun Sohn
- Department of Rehabilitation Medicine, Chungnam National University Hospital, Chungnam National Univeristy College of Medicine, Daejeon, South Korea
| | - Chang-Won Moon
- Department of Rehabilitation Medicine, Chungnam National University Hospital, Chungnam National Univeristy College of Medicine, Daejeon, South Korea
| | - Jae-In Lee
- Department of Rehabilitation Medicine, Chungnam National University Hospital, Chungnam National Univeristy College of Medicine, Daejeon, South Korea
| | - Sungju Jee
- Department of Rehabilitation Medicine, Chungnam National University Hospital, Chungnam National Univeristy College of Medicine, Daejeon, South Korea.
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Improved oxygen uptake efficiency slope in acute myocardial infarction patients after early phase I cardiac rehabilitation. Int J Rehabil Res 2017; 40:215-219. [PMID: 28410336 DOI: 10.1097/mrr.0000000000000229] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
A predischarge submaximal exercise test is often recommended after acute myocardial infarction (AMI) as part of phase I cardiac rehabilitation. In this study, a submaximal exercise parameter, oxygen uptake efficiency slope (OUES), was used to monitor the benefit of early mobilization within 48 h after AMI. An early mobilization protocol within 48 h after AMI has been initiated since 1 September 2012 in our center. Patients with onset time of AMI within 1 year before and 1 year after initiation of the early mobilization protocol were recruited for comparisons. Sixty patients were analyzed on the basis of this criterion, and were subjected to predischarge submaximal exercise tests. The OUES calculated with 100% exercise duration (OUES100) and calculated with the first 50% of exercise duration (OUES50) were obtained and analyzed. Both OUES100 and OUES50 of the AMI patients with early mobilization were significantly higher than those without early mobilization (P=0.025 and 0.007, respectively). The OUES100 and OUES50 were also highly correlated (r=0.891, P<0.001). The subgroup analysis using patients within 3 months before and 3 months after initiation of the protocol also showed a significant difference. OUES could be used to measure the exercise capacity and monitor the effect of phase I cardiac rehabilitation in patients soon after AMI. Early mobilization within 48 h following AMI significantly enhanced the patient's exercise capacity.
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