Increasing attendance at cardiac rehabilitation
Wyer, Sarah Jane (2001) Increasing attendance at cardiac rehabilitation. DClinPsych thesis, University of Warwick.
WRAP_THESIS_Wyer_2001.pdf - Submitted Version - Requires a PDF viewer such as GSview, Xpdf or Adobe Acrobat Reader
Official URL: http://webcat.warwick.ac.uk/record=b1373785~S1
As cardiac rehabilitation (CR) results in reduced mortality and morbidity (e.g. Dusseldorp et al,
1999), it is essential that as many people as possible are given the opportunity to benefit from
it. Yet despite proven benefits, uptake of services can be low. This study sought to explore
and possibly influence factors which predict attendance, with the ultimate goal of increasing
attendance at a CR programme.
Whilst sociodemographic and health care systemic factors predict CR attendance, recent
research has focused on investigating the role of factors more amenable to change such as
psychological factors (e.g. Johnston et al, 1999). Recommendations based on the reviewed
research literature are presented as ways of increasing attendance at CR.
It was evident from the review that psychological factors predicted attendance. In order to
increase our understanding of these factors, interviews were carried out with attenders and
non-attenders of CR (n=21). Several differentiating themes were identified: use of medical
versus psychological model, illness perception, causal attribution, and attitude to CR. The
results were interpreted using the Self Regulatory Model and the Theory of Planned
Finally, a simple cost effective psychological intervention was developed and implemented to
influence patients' beliefs about recovery and CR, in order to increase their attendance rates
at a CR programme (n=87). Using a randomised control trial design, MI patients who received
an intervention in the form of two letters, were shown to be significantly more likely to attend
CR than those who received normal care (p <0.0025).
In conclusion, there are a number of different ways that CR attendance can be increased.
Firstly by being aware of how sociodemographic and health care systemic factors influence
attendance and providing services accordingly. And secondly by understanding the role of
psychological factors on attendance and implementing psychological interventions
|Item Type:||Thesis or Dissertation (DClinPsych)|
|Subjects:||R Medicine > RC Internal medicine|
|Library of Congress Subject Headings (LCSH):||Heart -- Diseases -- Patients -- Rehabilitation , Medical care -- Psychological aspects|
|Official Date:||May 2001|
|Institution:||University of Warwick|
|Theses Department:||Department of Psychology|
|Supervisor(s)/Advisor:||Earll, Louise ; Joseph, Stephen, Dr. ; Johnston, Marie|
Completed in conjunction with Coventry University. School of Health and Social Sciences
|Extent:||117,  leaves|
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