The aim of this study was to synthesize the needs of patients with coronary heart disease, heart failure or thoracic aortic dissection regarding cardiac rehabilitation.
We performed a meta-ethnographic synthesis of qualitative studies with a lines-of-argument analysis. Studies with qualitative data collection methods that reported the needs of patients with coronary heart disease, heart failure, or thoracic aortic dissection who were eligible to participate in cardiac rehabilitation were eligible for inclusion. The lines of argument were synthesised, discussed, and, ultimately, presented with a thick description. The confidence of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation Confidence in Evidence from Reviews of Qualitative Research (Cerqual) approach.
Ninety-four studies were included and provided data from 2,021 participants (1,731 patients, 185 close-relatives, and 105 healthcare professionals). We have synthesised five lines of argument that explained the needs of patients: 1) Patients need safety, though not overprotection (Cerqual: high confidence); 2) Patients need significant others to be involved (Cerqual: high confidence); 3) Patients need support from people with whom they can identify (Cerqual: moderate confidence); 4) Patients need personalized care (Cerqual: moderate confidence); and 5) Patients need help to redesign a meaningful future (Cerqual: high confidence).
Cardiac rehabilitation should be tailored to the patient's needs, such as safety and peer support. Healthcare professionals can immediately start tailoring cardiac rehabilitation by involving significant others, providing personalized care, and helping to redesign a meaningful future. Meeting patients' needs may increase participation in cardiac rehabilitation, reduce dropout, and improve long-term healthy behaviour.Cardiac rehabilitation should be tailored to the patient's needs, such as safety and peer support. Healthcare professionals can immediately start tailoring cardiac rehabilitation by involving significant others, providing personalized care, and helping to redesign a meaningful future. Meeting patients' needs may increase participation in cardiac rehabilitation, reduce dropout, and improve long-term healthy behaviour.
Physical therapists should improve safety by learning patients to manage symptoms, creating a safe environment, and providing clear exercise instructions. In addition, physical therapists should involve significant others to enable them to help patients and gain support for their own needs. Furthermore, physical therapists should bring together peers with whom they can identify, such as patients with the same age, gender, disease or fitness. Moreover, physical therapists should provide personal attention, personalized goals, and regular aftercare. Finally, physical therapists should support redesigning a meaningful future so that patients can regain control of their lives, reflect on their recovery, and learn to cope with their changed identity.
Coronary disease
Heart failure
