Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on sleep in brain health

LIVE: Thursday 2nd May 2024, 18:00-19:30 (CEST)

Quality sleep is essential for health. But what happens to our brains when sleep patterns are disturbed? Join our experts to explore the interplay between sleep disruption and neurological diseases, and the questions that you need to be asking your patients to help you prevent the harmful effects of sleep deprivation.
ADVANCED SEARCH
Log in
Top
BMC Health Services Research
Published in: BMC Health Services Research 1/2017

Open Access 01-12-2017 | Research article

Community health service center-based cardiac rehabilitation in patients with coronary heart disease: a prospective study

Authors: Lixuan Zhang, Li Zhang, Jing Wang, Fang Ding, Suhua Zhang

Published in: BMC Health Services Research | Issue 1/2017

Login to get access

Abstract

Background

Despite considerable efforts to encourage participation, even in some developed countries, proportion of patients participating in institution-based cardiac rehabilitation (CR) programs remained sub-optimal. The present study was designed to investigate the acceptability of community health service center (CHSC)-based Cardiac Rehabilitation (CR), and examine its effectiveness in terms of changes in quality of life (QOL), psychological state and exercise capacity.

Methods

A consecutive series of eligible patients was recruited from the health registration system of two CHSCs in Shijiazhuang, Hebei, China. Patients in intervention site were provided with CR (CR-group) while patients in non-intervention site were offered the usual care (UC-group). Data regarding health-related QOL (HRQoL), psychological state and exercise capacity (6-min walk test = 6MWT) were collected and compared at baseline and at 6 months post-intervention.

Results

Among invited patients eligible for CR program, 65.3% participated, while 5.3% of the participants dropped out during follow-up. Patients in CR-group showed significant decrease in the scores for anxiety and depression as per the Hospital Anxiety and Depression Scale (HADS), along with marked increases in the Short-Form Health Survey (SF-12)-based Physical (PCS) and Mental Component Summary (MCS) scores. Moreover, the measurement of 6MWT showed a significant increase of 57.42 m walking distance among CR patients in contrast with a slight increase among UC patients.

Conclusions

Given the high participation and low withdrawal along with considerable improvements in HRQoL, psychological state and exercise capacity, CHSC was likely to be the optimal setting for implementing CR for patients with CHD in China.

Trial registration

ChiCTR-TRC-12002500. Registered 16 September 2012.
Literature
1.
Murray CJ, Vos T, Lozano R, Naghavi M, Flaxman AD, Michaud C, et al. Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380:2197–223.CrossRefPubMed
2.
Gu D, Gupta A, Muntner P, Hu S, Duan X, Chen J, et al. Prevalence of cardiovascular disease risk factor clustering among the adult population of China: results from the International Collaborative Study of Cardiovascular Disease in Asia (InterAsia). Circulation. 2005;112:658–65.CrossRefPubMed
3.
He J, Gu D, Wu X, Reynolds K, Duan X, Yao C, et al. Major causes of death among men and women in China. N Engl J Med. 2005;353:1124–34.CrossRefPubMed
4.
Kerrigan DJ, Williams CT, Ehrman JK, Saval MA, Bronsteen K, Schairer JR, et al. Cardiac rehabilitation improves functional capacity and patient-reported health status in patients with continuous-flow left ventricular assist devices: the Rehab-VAD randomized controlled trial. JACC Heart Fail. 2014;2:653–9.CrossRefPubMed
5.
Rutledge T, Redwine LS, Linke SE, Mills PJ. A meta-analysis of mental health treatments and cardiac rehabilitation for improving clinical outcomes and depression among patients with coronary heart disease. Psychosom Med. 2013;75:335–49.CrossRefPubMed
6.
Ahlund K, Back M, Sernert N. Fear-avoidance beliefs and cardiac rehabilitation in patients with first-time myocardial infarction. J Rehabil Med. 2013;45:1028–33.CrossRefPubMed
7.
Turk-Adawi KI, Grace SL. Narrative review comparing the benefits of and participation in cardiac rehabilitation in high-, middle- and low-income countries. Heart Lung Circ. 2015;24:510–20.CrossRefPubMed
8.
Pack QR, Squires RW, Lopez-Jimenez F, Lichtman SW, Rodriguez-Escudero JP, Lindenauer PK, et al. Participation Rates, Process Monitoring, and Quality Improvement Among Cardiac Rehabilitation Programs in the United States: A NATIONAL SURVEY. J Cardiopulm Rehabil Prev. 2015;35:173–80.CrossRefPubMedPubMedCentral
9.
Bunker S, McBurney H, Cox H, Jelinek M. Identifying participation rates at outpatient cardiac rehabilitation programs in Victoria, Australia. J Cardiopulm Rehabil. 1999;19:334–8.CrossRefPubMed
10.
Valencia HE, Savage PD, Ades PA. Cardiac rehabilitation participation in underserved populations. Minorities, low socioeconomic, and rural residents. J Cardiopulm Rehabil Prev. 2011;31:203–10.CrossRefPubMed
11.
Witt BJ, Thomas RJ, Roger VL. Cardiac rehabilitation after myocardial infarction: a review to understand barriers to participation and potential solutions. Eura Medicophys. 2005;41:27–34.PubMed
12.
Dalal HM, Zawada A, Jolly K, Moxham T, Taylor RS. Home based versus centre based cardiac rehabilitation: Cochrane systematic review and meta-analysis. BMJ. 2010;340:b5631.CrossRefPubMedPubMedCentral
13.
Taylor RS, Watt A, Dalal HM, Evans PH, Campbell JL, Read KL, et al. Home-based cardiac rehabilitation versus hospital-based rehabilitation: a cost effectiveness analysis. Int J Cardiol. 2007;119:196–201.CrossRefPubMed
14.
Chao J, Wang Y, Xu H, Yu Q, Jiang L, Tian L, et al. The effect of community-based health management on the health of the elderly: a randomized controlled trial from China. BMC Health Serv Res. 2012;12:449.CrossRefPubMedPubMedCentral
15.
16.
Zhao Y, Thomas SL, Guthridge SL, Wakerman J. Better health outcomes at lower costs: the benefits of primary care utilisation for chronic disease management in remote Indigenous communities in Australia's Northern Territory. BMC Health Serv Res. 2014;14:463.CrossRefPubMedPubMedCentral
17.
Sun X, Li Y, Liu S, Lou J, Ding Y, Liang H, et al. Enhanced Performance of Community Health Service Centers during Medical Reforms in Pudong New District of Shanghai, China: A Longitudinal Survey. PLoS One. 2015;10:e0125469.CrossRefPubMedPubMedCentral
18.
Maddison R, Rawstorn JC, Rolleston A, Whittaker R, Stewart R, Benatar J, et al. The remote exercise monitoring trial for exercise-based cardiac rehabilitation (REMOTE-CR): a randomised controlled trial protocol. BMC Public Health. 2014;14:1236.CrossRefPubMedPubMedCentral
19.
Fiorina C, Vizzardi E, Lorusso R, Maggio M, De Cicco G, Nodari S, et al. The 6-min walking test early after cardiac surgery. Reference values and the effects of rehabilitation programme. Eur J Cardiothorac Surg. 2007;32:724–9.CrossRefPubMed
20.
Fletcher GF, Balady GJ, Amsterdam EA, Chaitman B, Eckel R, Fleg J, et al. Exercise standards for testing and training: a statement for healthcare professionals from the American Heart Association. Circulation. 2001;104:1694–740.CrossRefPubMed
21.
Wang W, Chair SY, Thompson DR, Twinn SF. Health care professionals' perceptions of hospital-based cardiac rehabilitation in mainland China: an exploratory study. J Clin Nurs. 2009;18:3401–8.CrossRefPubMed
22.
Lam CL, Tse EY, Gandek B. Is the standard SF-12 health survey valid and equivalent for a Chinese population? Qual Life Res. 2005;14:539–47.CrossRefPubMed
23.
Snaith RP, Zigmond AS. The hospital anxiety and depression scale. Br Med J (Clin Res Ed). 1986;292:344.CrossRef
24.
Bjarnason-Wehrens B, McGee H, Zwisler AD, Piepoli MF, Benzer W, Schmid JP, et al. Cardiac rehabilitation in Europe: results from the European Cardiac Rehabilitation Inventory Survey. Eur J Cardiovasc Prev Rehabil. 2010;17:410–8.CrossRefPubMed
25.
Centers for Disease Control and Prevention (CDC). Receipt of cardiac rehabilitation services among heart attack survivors--19 states and the District of Columbia, 2001. MMWR Morb Mortal Wkly Rep. 2003;52:1072–5.
26.
Scott IA, Lindsay KA, Harden HE. Utilisation of outpatient cardiac rehabilitation in Queensland. Med J Aust. 2003;179:341–5.PubMed
27.
Adsett J, Hickey A, Nagle A, Mudge A. Implementing a community-based model of exercise training following cardiac, pulmonary, and heart failure rehabilitation. J Cardiopulm Rehabil Prev. 2013;33:239–43.CrossRefPubMed
28.
Lundgren O, Garvin P, Jonasson L, Andersson G, Kristenson M. Psychological resources are associated with reduced incidence of coronary heart disease. An 8-year follow-up of a community-based Swedish sample. Int J Behav Med. 2015;22:77–84.CrossRefPubMed
29.
Serber ER, Todaro JF, Tilkemeier PL, Niaura R. Prevalence and characteristics of multiple psychiatric disorders in cardiac rehabilitation patients. J Cardiopulm Rehabil Prev. 2009;29:161–8. quiz 169–170.CrossRefPubMedPubMedCentral
30.
Campbell TS, Stevenson A, Arena R, Hauer T, Bacon SL, Rouleau CR, et al. An investigation of the benefits of stress management within a cardiac rehabilitation population. J Cardiopulm Rehabil Prev. 2012;32:296–304.CrossRefPubMed
31.
Intarakamhang P, Intarakamhang U. Effects of the comprehensive cardiac rehabilitation program on psychological factors and quality of life among coronary heart disease patients. Glob J Health Sci. 2013;5:145–52.
32.
Jelinek HF, Huang ZQ, Khandoker AH, Chang D, Kiat H. Cardiac rehabilitation outcomes following a 6-week program of PCI and CABG Patients. Front Physiol. 2013;4:302.PubMedPubMedCentral
33.
Jin H, Wei Q, Chen L, Sun Q, Zhang Y, Wu J, et al. Obstacles and alternative options for cardiac rehabilitation in Nanjing, China: an exploratory study. BMC Cardiovasc Disord. 2014;14:20.CrossRefPubMedPubMedCentral
Metadata
Title
Community health service center-based cardiac rehabilitation in patients with coronary heart disease: a prospective study
Authors
Lixuan Zhang
Li Zhang
Jing Wang
Fang Ding
Suhua Zhang
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2017
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-017-2036-3

Other articles of this Issue 1/2017

BMC Health Services Research 1/2017 Go to the issue

Research article

The influence of total hysterectomy in a cervical cancer screening population: a register-based cross-sectional study

Research article

The personal and workplace characteristics of uninsured expatriate males in Saudi Arabia

Research article

Validation of work pressure and associated factors influencing hospital nurse turnover: a cross-sectional investigation in Shaanxi Province, China

Research article

The development and appraisal of a tool designed to find patients harmed by falsely labelled, falsified (counterfeit) medicines

Research article

In-hospital prescription changes and documentation in the medical records of the primary care provider: results from a medical record review study

Research article

Greater involvement of HIV-infected peer-mothers in provision of reproductive health services as “family planning champions” increases referrals and uptake of family planning among HIV-infected mothers