TY - JOUR
T1 - Transient Ischemic Attack and Mild Stroke Participant Perspectives on Barriers and Enablers to Participation in Cardiovascular Rehabilitation A Qualitative Study Guided by the Theoretical Domains Framework and Capability, Opportunity, Motivation and Behavior Model
AU - Walton, Lucy
AU - Mendonca, Juliana De
AU - Preston, Elisabeth
AU - Davey, Rachel
AU - Flynn, Allyson
AU - Freene, Nicole
N1 - Funding Information:
Funding: This work was supported by the Australian Capital Territory Health Research and Innovation Fund grant. This funding body was not involved in the design, analysis, interpretation, or writing of this article.
Funding Information:
We would like to acknowledge and thank the Stroke Liaison Nurses, supporting allied health teams within the Canberra Health Services, and the National Stroke Foundation, for their assistance in recruitment throughout this study.
Publisher Copyright:
Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2024/11
Y1 - 2024/11
N2 - Background: Exercise-based cardiac rehabilitation reduces the risk factors and recurrence of cardiovascular disease in patients with coronary heart disease. Despite similar risk factors, people with transient ischemic attack (TIA) and mild stroke do not attend cardiac rehabilitation. Cardiovascular rehabilitation (CVR), including TIA, stroke, and coronary heart disease, could be a solution for increasing participation. Perspectives from TIA and stroke survivors on barriers and enablers to participation in CVR are limited, and implementation strategies for CVR are currently unknown. Objectives: We sought to determine (1) What were the perspectives of participants with TIA and mild stroke on barriers and enablers to uptake, engagement, and participation in CVR? and (2) What implementation strategies may influence people with TIA and mild stroke to participate in CVR? Methods: In-depth semistructured interviews were conducted with CVR participants. Inductive thematic analysis was completed before deductively mapping themes to implementation frameworks, the Capability, Opportunity, Motivation, and Behavior Model and Theoretical Domains Framework. Results: Twenty participants aged 73 ± 11 years were interviewed. Most were men, stroke survivors, tertiary educated, and retired. Six themes were generated to explain the barriers and enablers to CVR participation. Themes and subthemes mapped to 8 Theoretical Domains Framework domains and 5 Capability, Opportunity, Motivation, and Behavior constructs. Prioritizing participants' physical and social opportunities, reflective motivation, and physical and psychological capabilities may improve their participation in CVR. Conclusions: Barriers and enablers to CVR participation were similar to those in the coronary heart disease population. Increasing access and availability of CVR for people with TIA and mild stroke should be prioritized for future implementation.
AB - Background: Exercise-based cardiac rehabilitation reduces the risk factors and recurrence of cardiovascular disease in patients with coronary heart disease. Despite similar risk factors, people with transient ischemic attack (TIA) and mild stroke do not attend cardiac rehabilitation. Cardiovascular rehabilitation (CVR), including TIA, stroke, and coronary heart disease, could be a solution for increasing participation. Perspectives from TIA and stroke survivors on barriers and enablers to participation in CVR are limited, and implementation strategies for CVR are currently unknown. Objectives: We sought to determine (1) What were the perspectives of participants with TIA and mild stroke on barriers and enablers to uptake, engagement, and participation in CVR? and (2) What implementation strategies may influence people with TIA and mild stroke to participate in CVR? Methods: In-depth semistructured interviews were conducted with CVR participants. Inductive thematic analysis was completed before deductively mapping themes to implementation frameworks, the Capability, Opportunity, Motivation, and Behavior Model and Theoretical Domains Framework. Results: Twenty participants aged 73 ± 11 years were interviewed. Most were men, stroke survivors, tertiary educated, and retired. Six themes were generated to explain the barriers and enablers to CVR participation. Themes and subthemes mapped to 8 Theoretical Domains Framework domains and 5 Capability, Opportunity, Motivation, and Behavior constructs. Prioritizing participants' physical and social opportunities, reflective motivation, and physical and psychological capabilities may improve their participation in CVR. Conclusions: Barriers and enablers to CVR participation were similar to those in the coronary heart disease population. Increasing access and availability of CVR for people with TIA and mild stroke should be prioritized for future implementation.
KW - cardiac rehabilitation
KW - cardiovascular disease
KW - ischemic attack
KW - risk factors
KW - secondary prevention
UR - http://www.scopus.com/inward/record.url?scp=85209565357&partnerID=8YFLogxK
U2 - 10.1097/JCN.0000000000001155
DO - 10.1097/JCN.0000000000001155
M3 - Article
AN - SCOPUS:85209565357
SN - 0889-4655
SP - 1
EP - 11
JO - Journal of Cardiovascular Nursing
JF - Journal of Cardiovascular Nursing
ER -