Lessons learned: Clinicians' perspectives, knowledge and attitudes towards a stroke-integrated cardiac rehabilitation programme.

Abstract

ObjectiveTo evaluate the perceptions, knowledge, and attitudes of multidisciplinary clinicians within a healthcare organisation completing a stroke-integrated cardiac rehabilitation research programme in addition to usual care neurorehabilitation.DesignA qualitative study based on a phenomenological approach.SettingOne-on-one, semi-structured, qualitative interview completed either face-to-face or over the telephone.ParticipantsFourteen multidisciplinary clinicians (e.g., physical therapists, occupational therapists, psychologists, speech therapists, cardiac nurses and a physician) working in usual care neuro- and cardiac-rehabilitation.Main measuresTwo independent researchers completed line-by-line coding and thematic analysis and derived relevant themes and sub-themes addressing the research question. To enhance trustworthiness and transparency of findings, a third researcher reviewed final themes.ResultsThree main themes emerged with 3-4 relevant sub-themes. The first theme was clinicians' knowledge. Participants were aware of exercise recommendations within the clinical stroke guidelines, but their knowledge of the content of the recommendations, and the stroke-integrated cardiac rehabilitation programme, varied. The second theme was clinicians' attitudes and beliefs towards the stroke-integrated cardiac rehabilitation programme. All participants described exercise as being important and believed the stroke-integrated cardiac rehabilitation programme was a good idea. However, clinicians highlighted numerous barriers and suggested programme adaptations (third theme) to the stroke-integrated cardiac rehabilitation programme. Increased awareness of the stroke-integrated cardiac rehabilitation programme, and a more flexible and adaptable programme, may enhance future implementation.ConclusionClinicians believed the stroke-integrated cardiac rehabilitation programme was important and had clinical utility. Increased awareness of evidence-based recommendations, and a more flexible and adaptable programme may aid uptake and future implementation.