Challenges and solutions to implementing cardiac rehabilitation in a low- and middle-income country.

IF 1.8 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Abraham Samuel Babu, Vibha Bhat, Prinu Jose, Sebastian Padickaparambil, Ramachandran Padmakumar, Panniyammakal Jeemon
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引用次数: 0

Abstract

Background: Cardiac rehabilitation (CR) remains greatly underutilized, especially in low- and middle-income countries (LMIC). It is therefore important to explore factors that contribute to this, as perceived by health-care professionals (HCPs).

Research design and methods: This was a qualitative study using in-depth interviews that enrolled 18 HCPs (i.e. six each of physicians, physiotherapists, and nurses; mean experience in CR: 17.9 ± 11.8 yrs) working in cardiovascular care, and CR across private and government hospitals (both teaching and non-teaching) in India.

Results: The main challenges were related to lack of referrals, perceived lack of benefit from CR, poor infrastructure within hospitals and health systems, and differences in practice. The perceived inadequacies were lack of competencies in CR, limited task sharing strategies, and ineffective utilization of existing human resources. Devising strategies to improve awareness and competencies, facilitating task sharing, and remodeling holistic care with an active CR component may be beneficial to facilitate greater implementation of CR in India.

Conclusions: Challenges, inadequacies, and solutions to implementing CR have been explored by involving various HCPs commonly involved in delivering CR across different health systems in a LMIC.

Trial registration: www.ctri.nic.in with identifier CTRI/2020/07/026807.

在中低收入国家实施心脏康复的挑战和解决方案。
背景:心脏康复(CR)的利用率仍然很低,尤其是在中低收入国家(LMIC)。因此,探讨医疗保健专业人员(HCPs)认为造成这种情况的因素非常重要:这是一项采用深入访谈的定性研究,共招募了 18 名在印度私立和公立医院(包括教学医院和非教学医院)从事心血管护理和 CR 工作的 HCP(即医生、物理治疗师和护士各 6 名;平均 CR 经验:17.9 ± 11.8 年):主要挑战涉及缺乏转诊、心血管疾病治疗缺乏效益、医院和卫生系统基础设施薄弱以及实践中的差异。所发现的不足之处包括缺乏 CR 方面的能力、任务分担策略有限以及现有人力资源利用效率低下。制定提高意识和能力的策略、促进任务分担以及重塑具有积极 CR 要素的整体护理,可能有利于促进 CR 在印度的更广泛实施:通过让低收入国家不同医疗系统中通常参与提供 CR 的各种 HCP 参与其中,探讨了实施 CR 的挑战、不足和解决方案。试验注册:www.ctri.nic.in,标识符为 CTRI/2020/07/026807。
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来源期刊
Expert Review of Cardiovascular Therapy
Expert Review of Cardiovascular Therapy CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
3.70
自引率
0.00%
发文量
82
期刊介绍: Expert Review of Cardiovascular Therapy (ISSN 1477-9072) provides expert reviews on the clinical applications of new medicines, therapeutic agents and diagnostics in cardiovascular disease. Coverage includes drug therapy, heart disease, vascular disorders, hypertension, cholesterol in cardiovascular disease, heart disease, stroke, heart failure and cardiovascular surgery. The Expert Review format is unique. Each review provides a complete overview of current thinking in a key area of research or clinical practice.
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