| Objective:Cardiac rehabilitation(CR)is strongly recommended after myocardiac infarction.Despite the compelling evidence of the benefits of CR risk factor modification and mortality reduction,a significant proportion of eligible patients with AMI are not referred or do not participate in China.This research is conducted on studies in relation to patient and clinicians' attitudes,awareness toward CR,we sought to provides an opportunity to improve cardiac rehabilitation participation.Methods:Based on the previous research,we assuming that the patient's age,gender,health condition,economic income,education level,family support,cardiac rehabilitation knowledge level were correlate with patient's participation of cardiac rehabilitation.According to the assumption we design a questionnaire with cardiac rehabilitation intend and resistance factors for the AMI patients,we chose 4 hospitals which have been performed CR to get the AMI patient's investigation,then analysis the resistance factors and participate.For other side,we assuming that staff's work experience in cardiology,charging of CR knowledge,technical titles,which prevents employees to carry out cardiac rehabilitation program for patient,According to the assumption we design a questionnaire with clinicians' attitudes,knowledge toward CR.We chose 8 hospitals which can performance PCI to get the staff's investigation,then analysis the relationship between influence factors and the staff's willing to carry out cardiac rehabilitation.Results:1.A total of 210 cases of patients with AMI patient after PCI agreed to accept and fill the survey.203 questionnaires been returned,and 8 questionnaires were invalid with unfinished,the effective questionnaire recovery rate was 92.8%.Only 17 out of 195 patients participated in cardiac rehabilitation,the CR participation rate was 8.7%.160 staff in cardiology were received the questionnaire,and 158 copies were returned.6 copies were invalid,and 152 copies of the final effective questionnaire were valid,with the recovery rate of 95%.2.The mean score of patients knowledge about CR was 21.31±5.35.The average scores of the patients' cardiac rehabilitation knowledge and cognition were statistically significant in terms of educational level,occupation,income,perceived economic burden,and whether they had received medical staff rehabilitation education(p<0.05).3.These factors related to patients' resistance to participation to CR programs.Older patients,less knowledge about CR,and those with lower income had a lower perceive of participation to CR programs.4.74.4%patients showed their will of participation to CR.87.2%patients reported that their motivation for participating CR lecture if it is possible?Most patience will choose the hospital which nearby to their home.44.1%Patients prefer participate cardiac rehabilitation rolled by doctors than by nurses.More than 50.3%patients think that it is "ecessary" to participate CR in early stage after an acute myocardial infarction,and 52.8%patients think it is necessary to participate CR when in outpatient stage after AMI as well.But the economic costs that they can afford are low.5.The mean score of staffs in cardiology about CR knowledge is 56.68±5.06(70 in total).There is a statistically significant difference in employees' attitude towards CR(p<0.05)?The attitude score towards CR is more lower with lower professional title and lower education level.(F=10.033,p<0.001)?Conclusion:1.Patients with AMI have a low level of knowledge related to cardiac rehabilitation,but higher demand for cardiac rehabilitation2.Different characteristics of AMI patients have differences cognition to cardiac rehabilitation.The lower of education level,the lower of family income,the lower of negative awareness for cardiac rehabilitation.3.Old age,lack of knowledge of rehabilitation and heavy economic burden are the resistance factors affecting patients' participation in cardiac rehabilitation.4.The favorite cardiac rehabilitation style that patients are willing to participate in is:a face-to-face,all-round guidance and low-cost cardiac rehabilitation mode dominated by cardiologists in the close hospital is preferred.It is suggested that the community-hospital-family model can be taken into full consider if carrying out a cardiac rehabilitation projects.5.The knowledge lever of cardiac rehabilitation is high among medical and nursing staff in cardiology,but there are differences in the attitudes to implement CR of staff with different characteristics.The lower the degree,the lower the title,the more negative attitude to implement rehabilitation.6.The main factors that affect the resistance of medical staff to carry out CR are the support of medical system to CR and the attitude of medical staff to cardiac rehabilitation... |
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