Assessment of the effectiveness of cardiac rehabilitation on the maintenance of healthy lifestyle modifications: An international comparison between England and New Zealand
Secondary preventive Cardiac Rehabilitation (CR) programmes are the most cost effective measure for reducing mortality and morbidity associated with Cardiovascular Disease (CVD), and are now recommended internationally (BHF, 2007a). There are two structured CV rehabilitation programmes based on specific sets of guidelines: the American Cardiology Sports Medicine (ACSM) guidelines and the British Association Cardiac Rehabilitation (BACR) guidelines. New Zealand (NZ) practice under the ACSM guidelines, while the United Kingdom (UK) practice under the BACR guidelines. The purpose of this study is to compare patients CR experiences between the UK and NZ based on their effectiveness at successfully motivating patients to maintain healthy behaviours. Data was collected from non-participant observations, and focus groups with patients 6-12months post CR. Results were analysed using thematic analyses and reflection in action. Both CR programmes have been successful in supporting the individuals to maintain healthy lifestyles. A number of similar positive CR experiences were noted between groups and countries: support, education, positive mental attitude, motivation, and help to facilitate individuals to maintain healthy lifestyles. Diet and exercise were the main themes influenced. Exercising in a friendly environment, with companionship was significant to the maintenance of exercise for participants in both countries. Barriers such as physical disabilities, time constraints, and weather conditions helped to inhibit healthy behaviour maintenance. Those in NZ seemed to be more affected by external factors such as opportunity, access, and work. Individuals’ confidence appeared higher in the UK in regards to monitoring themselves. Exploring patients’ views and experiences through discussion provided an insight in these programmes, and could assist in future CR developments, addressing the barriers to such developments. The study highlighted that less monitoring in NZ is required. Also, further future developments for NZ could include improving referrals for CR intervention, and improvements in opportunities to access exercise sessions with other CV individuals. Future research into continuing social support through exercise sessions and education discussion groups could be a step towards tackling the drop-out rates in both countries
