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Abstract:
The purpose of this study was to determine effects of the Health Belief Model (HBM) variables on cardiac rehabilitation initiation. Myocardial infarction or coronary artery bypass graft surgery inpatients completed questionnaires of demographic information, perceived severity of cardiac disease, perceived susceptibility to another cardiac event, perceived cardiac threat, depression, and social support. Left ventricular ejection fraction and comorbid conditions were obtained. Results revealed that perceived severity, susceptibility, and threat were moderately correlated, but these variables did not predict cardiac rehabilitation initiation. Absence of effect may be due to inadequacies in measurement, or it may mean the HBM is not useful for this population. Other models may need to be explored.
Key words: Cardiac rehabilitation, Health Belief Model, perceived severity, perceived susceptibility, perceived threat
Cardiac rehabilitation (CR) programs began in the 1960s when telemetry monitoring was not yet available. Little information was known about risk factors and risk reduction, but CR programs were implemented with the goal of decreasing mortality and increasing collateral circulation by focusing on exercise (American Association of Cardiovascular & Pulmonary Rehabilitation, 1999).
CR programs currently include patients with myocardial infarction, coronary artery bypass graft surgery, percutaneous transluminal coronary angioplasty, residual myocardial ischemia, heart failure, and arrhythmias. Many patients have pacemakers, cardioverter defibrillators, valve surgeries, and heart transplants. Outpatient CR can begin as early as one to two weeks after discharge from the hospital. The focus is on increasing exercise capacity and habits, and reducing risk for another cardiac event (American Association of Cardiovascular & Pulmonary Rehabilitation, 2004; Wenger et al., 1995).
Cardiac Rehabilitation Benefits
CR programs have proved beneficial in the recovery of patients with cardiac disease. In her article entitled Current Status of Cardiac Rehabilitation, Wenger (2008) provided an excellent summary of many studies showing evidence of CR benefits in reducing morbidity and mortality. A recent study examined the benefits of increased functional capacity, improved quality of life, and increased survival for heart failure patients who attend CR programs (Boudreau & Genovese, 2007). Medicare and many private insurance companies do not pay for CR for heart failure patients unless they have another reimbursable diagnosis such as a myocardial infarction. Demonstration of the CR benefits for heart failure patients will provide evidence needed for insurance companies to consider reimbursement for...