Cardiovascular Rehabilitation: perspectives of patients and healthcare professionals on the implementation of multidisciplinary programs

Authors

  • Ana Veloso University Institute of Health Sciences, CESPU, CRL, 4585-116 Gandra, Portugal https://orcid.org/0009-0005-9175-6712
  • Rita Rocha University Institute of Health Sciences, CESPU, CRL, 4585-116 Gandra, Portugal https://orcid.org/0009-0003-0586-3980
  • Gerly Macedo Clinical and Health Psychology Unit, Psychiatry and Mental Health Service, Hospital da Senhora da Oliveira, 4835-044 Guimarães, Portugal https://orcid.org/0000-0002-6988-0822
  • Ana Teixeira Associate Laboratory i4HB—Institute for Health and Bioeconomy, University Institute of Health Sciences—CESPU, 4585-116 Gandra, Portugal; UCIBIO—Applied Molecular Biosciences Unit, Translational Toxicology Research Laboratory, University Institute of Health Sciences (1H-TOXRUN, IUCS-CESPU), 4585-116 Gandra, Portugal; UCIBIO, REQUIMTE, Laboratory of Pharmaceutical Technology, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal https://orcid.org/0000-0002-3254-5326
  • Vera Almeida UCIBIO, REQUIMTE, Laboratory of Pharmaceutical Technology, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal; UNIPRO, Oral Pathology and Rehabilitation Research Unit, University Institute of Health Sciences-CESPU (IUCS-CESPU), 4585-116 Gandra, Portugal https://orcid.org/0000-0003-2803-8038

DOI:

https://doi.org/10.48797/sl.2025.282

Keywords:

cardiovascular rehabilitation, multidisciplinarity, therapeutic adherence, psychological support, patients, healthcare professionals

Abstract

Cardiovascular diseases are one of the main causes of global mortality, requiring integrated interventions to promote patient recovery. Cardiovascular rehabilitation is an essential approach that combines multidisciplinary care to improve quality of life and prevent recurrences. This study aims to explore the perceptions of the patients and health professionals about the implementation and effectiveness of the Unidade Local de Saúde do Alto Ave (ULSAA) Cardiovascular Rehabilitation Program (CVRP), identifying barriers and opportunities to improve its effectiveness. A qualitative study with a focus group methodology comprised eight patients and five health professionals. Data were analyzed based on Bardin’s content analysis methodology. Participants recognized the importance of the multidisciplinary approach, which promoted significant advances in physical and emotional recovery. However, challenges such as fragmentation of care, ineffective communication, and stigma associated with mental health were highlighted. Family involvement was considered essential, and adherence to the program varied due to factors such as personal motivation and limited understanding of the benefits. CVRP is a valuable intervention but faces some challenges. It is recommended to improve communication, expand psychological support, and invest in resources to strengthen cohesion between areas of activity.

References

Heran, B.S., C.J.M., M.L. Challenges in Resource Allocation for Cardiac Rehabilitation Pro-grams. Heart and Lung Journal 2011, 40, 100–110.

Vrints, C.; Andreotti, F.; Koskinas, K.C.; Rossello, X.; Adamo, M.; Ainslie, J.; Banning, A.P.; Budaj, A.; Buechel, R.R.; Chiariello, G.A.; et al. 2024 ESC Guidelines for the Management of Chronic Coronary Syndromes: Developed by the Task Force for the Management of Chronic Coronary Syndromes of the European Society of Cardiology (ESC) Endorsed by the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J 2024, 45, 3415–3537, doi:10.1093/EURHEARTJ/EHAE177.

Reich, B.; Benzer, W.; Harpf, H.; Hofmann, P.; Mayr, K.; Ocenasek, H.; Podolsky, A.; Pokan, R.; Porodko, M.; Puelacher, C.; et al. Efficacy of Extended, Comprehensive Outpatient Cardiac Re-habilitation on Cardiovascular Risk Factors: A Nationwide Registry. Eur J Prev Cardiol 2020, 27, 1026–1033, doi:10.1177/2047487319898958.

Boehm, L.M.; Potter, K.; McPeake, J.; Shaw, M.; Su, H.; Jones, A.C.; Renard, V.; Eaton, T.L.; Bo-ethel, C.; Butler, J.; et al. Understanding Attendance Patterns and Determinants in Cardiac, Pulmonary, and ICU Rehabilitation/Recovery Programs: A Systematic Review and Me-ta-Analysis. Heart and Lung 2025, 69, 51–61, doi:10.1016/j.hrtlng.2024.09.010.

Goodwin, L.; Ostuzzi, G.; Khan, N.; Hotopf, M.H.; Moss-Morris, R. Can We Identify the Active Ingredients of Behaviour Change Interventions for Coronary Heart Disease Patients? A Sys-tematic Review and Meta-Analysis. PLoS One 2016, 11, e0153271, doi:10.1371/JOURNAL.PONE.0153271.

Fletcher, G.F.; Landolfo, C.; Niebauer, J.; Ozemek, C.; Arena, R.; Lavie, C.J. Promoting Physical Activity and Exercise: JACC Health Promotion Series. J Am Coll Cardiol 2018, 72, 1622–1639, doi:10.1016/J.JACC.2018.08.2141.

Zijl, A.L. van; Vermeeren, B.; Koster, F.; Steijn, B. Interprofessional Teamwork in Primary Care: The Effect of Functional Heterogeneity on Performance and the Role of Leadership. J Interprof Care 2021, 35, 10–20, doi:10.1080/13561820.2020.1715357.

Duda-Sikuła, M.; Kurpas, D. Barriers and Facilitators in the Implementation of Prevention Strategies for Chronic Disease Patients—Best Practice GuideLines and Policies’ Systematic Re-view. Journal of Personalized Medicine 2023, Vol. 13, Page 288 2023, 13, 288, doi:10.3390/JPM13020288.

Sarkar, U.; Schillinger, D.; Bibbins-Domingo, K.; Nápoles, A.; Karliner, L.; Pérez-Stable, E.J. Pa-tient–Physicians’ Information Exchange in Outpatient Cardiac Care: Time for a Heart to Heart? Patient Educ Couns 2011, 85, 173–179, doi:10.1016/J.PEC.2010.09.017.

Alves, E.; Magalhães, P.; Lunet, N.; Ferreira, P.M.; Silva, S. Acessibilidade e utilização de fontes de informação em saúde cardiovascular: perceção de doentes e médicos. Arquivos de Medicina 2014, 28, 137–144.

de Lima Andrade, E.; da Cunha e Silva, D.C.; de Lima, E.A.; de Oliveira, R.A.; Zannin, P.H.T.; Martins, A.C.G. Environmental Noise in Hospitals: A Systematic Review. Environmental Science and Pollution Research 2021, 28, 19629–19642, doi:10.1007/S11356-021-13211-2/TABLES/6.

Shi, W.; Ghisi, G.L.M.; Zhang, L.; Hyun, K.; Pakosh, M.; Gallagher, R. A Systematic Review, Meta-Analysis, and Meta-Regression of Patient Education for Secondary Prevention in Pa-tients with Coronary Heart Disease: Impact on Psychological Outcomes. European Journal of Cardiovascular Nursing 2022, 21, 643–654, doi:10.1093/EURJCN/ZVAC001.

Bourke, A.; Niranjan, V.; O’Connor, R.; Woods, C. Barriers to and Motives for Engagement in an Exercise-Based Cardiac Rehabilitation Programme in Ireland: A Qualitative Study. BMC Primary Care 2022, 23, 28, doi:10.1186/s12875-022-01637-7.

Douma, E.R.; Wirtz, S.; Fernandez, M.S.; Schäfer, H.; Widdershoven, J.W.M.G.; Habibović, M.; Gil, C.P.; Bosch, J.A.; Schmitz, B.; Kop, W.J. Patient-Reported Preferences in EHealth-Based Cardiac Rehabilitation: A Qualitative Investigation of Behavior Change Techniques, Barriers and Facilitators. Internet Interv 2024, 35, 100728, doi:10.1016/J.INVENT.2024.100728.

Hennink, M.M..; Hutter, Inge.; Bailey, Ajay. Qualitative Research Methods; SAGE, 2020; ISBN 1473944252.

Bardin, L. Análise de Conteúdo.; Edições 70: Lisboa, 1977; ISBN 972-44-0898-1.

Bracewell, N.J.; Plasschaert, J.; Conti, C.R.; Keeley, E.C.; Conti, J.B. Cardiac Rehabilitation: Ef-fective yet Underutilized in Patients with Cardiovascular Disease. Clin Cardiol 2022, 45, 1128–1134, doi:10.1002/clc.23911.

Giuliano, C.; Parmenter, B.J.; Baker, M.K.; Mitchell, B.L.; Williams, A.D.; Lyndon, K.; Mair, T.; Maiorana, A.; Smart, N.A.; Levinger, I. Cardiac Rehabilitation for Patients With Coronary Ar-tery Disease: A Practical Guide to Enhance Patient Outcomes Through Continuity of Care. Clin Med Insights Cardiol 2017, 11, doi:https://doi.org/10.1177/1179546817710028.

Bohplian, S.; Bronas, U.G. Motivational Strategies and Concepts to Increase Participation and Adherence in Cardiac Rehabilitation. J Cardiopulm Rehabil Prev 2022, 42, 75–83, doi:10.1097/HCR.0000000000000639.

Vazquez-Guajardo, M.; Rivas, D.; Duque, G. Exercise as a Therapeutic Tool in Age-Related Frailty and Cardiovascular Disease: Challenges and Strategies. Canadian Journal of Cardiology 2024, 40, 1458–1467, doi:10.1016/j.cjca.2024.01.005.

McCutcheon, L.R.M.; Haines, S.T.; Valaitis, R.; Sturpe, D.A.; Russell, G.; Saleh, A.A.; Clauson, K.A.; Lee, J.K. Impact of Interprofessional Primary Care Practice on Patient Outcomes: A Scoping Review. Sage Open 2020, 10, doi:10.1177/2158244020935899.

Epstein, N. Multidisciplinary In-Hospital Teams Improve Patient Outcomes: A Review. Surg Neurol Int 2014, 5, 295, doi:10.4103/2152-7806.139612.

Andersen, E.B.; Kristiansen, M.; Bernt Jørgensen, S.M. Barriers and Facilitators to Return to Work Following Cardiovascular Disease: A Systematic Review and Meta-Synthesis of Qualita-tive Research. BMJ Open 2023, 13, e069091, doi:10.1136/bmjopen-2022-069091.

Shoushi, F.; Janati, Y.; Mousavinasab, N.; Kamali, M.; Shafipour, V. The Impact of Family Sup-port Program on Depression, Anxiety, Stress, and Satisfaction in the Family Members of Open-Heart Surgery Patients. Journal of Nursing and Midwifery Sciences 2020, 7, 69, doi:https://doi.org/10.4103/jnms.jnms_21_19.

Schulz, D.L.; McBurney, H. Factors Which Influence Attendance at a Rural Australian Cardiac Rehabilitation Program. Coronary Health Care 2000, 4, 135–141, doi:10.1054/chec.2000.0086.

Chamosa, S.; Alarcón, J.A.; Dorronsoro, M.; Madruga, F.J.; Barrera, J.; Arrazola, X.; de la Cuesta, P.; Alkiza, M.-E.; Begiristain, J.M.; Carrera, I.; et al. Predictors of Enrollment in Cardiac Reha-bilitation Programs in Spain. J Cardiopulm Rehabil Prev 2015, 35, 255–262, doi:10.1097/HCR.0000000000000126.

Haslam, C.; Cruwys, T.; Haslam, S.A.; Dingle, G.; Chang, M.X.-L. Groups 4 Health: Evidence That a Social-Identity Intervention That Builds and Strengthens Social Group Membership Improves Mental Health. J Affect Disord 2016, 194, 188–195, doi:10.1016/j.jad.2016.01.010.

Zambrano, J.; Celano, C.M.; Januzzi, J.L.; Massey, C.N.; Chung, W.; Millstein, R.A.; Huffman, J.C. Psychiatric and Psychological Interventions for Depression in Patients With Heart Disease: A Scoping Review. J Am Heart Assoc 2020, 9, doi:10.1161/JAHA.120.018686.

Derksen, F.; Bensing, J.; Lagro-Janssen, A. Effectiveness of Empathy in General Practice: A Systematic Review. British Journal of General Practice 2013, 63, e76–e84, doi:10.3399/BJGP13X660814.

Bouchard, K.; Brownrigg, J.; Quinlan, B.; Bilodeau, J.; Higdon, G.; Tulloch, H. Supporting the Health and Well-Being of Caregivers. Journal of Cardiovascular Nursing 2020, 35, 268–272, doi:10.1097/JCN.0000000000000678.

Cover SL282

Downloads

Published

2025-06-04

How to Cite

Veloso, A. ., Rocha, R., Macedo, G., Teixeira, A., & Almeida, V. (2025). Cardiovascular Rehabilitation: perspectives of patients and healthcare professionals on the implementation of multidisciplinary programs. Scientific Letters, 1(1), 9. https://doi.org/10.48797/sl.2025.282

Issue

Section

Research Articles