Background Cardiac rehabilitation (CR) research often focuses on older individuals. With particular pressures faced by working-age individuals (<65 years), such as work and family responsibilities, it is important to consider how this group engages with cardiac rehabilitation. We present here a synthesis of qualitative literature and initial results of a longitudinal qualitative study.
Methods We conducted thematic synthesis of studies (2006–2016) describing CR experiences of 18–65’s. Synthesis was gender-sensitive and guided by Leventhal’s Self-Regulation Model of Illness. Results informed development of the qualitative study.
The longitudinal qualitative study recruited participants aged 18–65, following MI, from a Phase IV CR programme in Scotland. Semi-structured interviews occur at commencement and completion of the 12 week programme. Participants complete a questionnaire (Illness Perceptions Questionnaire-Revised and health behaviour questions) plus a family member is interviewed at both time points. Questionnaire data contextualises qualitative data (analysed using theoretical thematic analysis).
Results Review Nine studies were included. Heterogeneity existed in CR setting, participant numbers and gender. Thematic synthesis identified themes including illness perceptions, emotional representations and behaviour for illness control i.e. diet change. Some themes appear specific to the ‘working-age’ group. The influence of gender featured across all themes.
Study (At time of submission) Five participants and two family members interviewed, three baseline and follow-up, two baseline only. Participants are male, aged 41–61, all married and employed. Family members are female spouses. All participants had MI. Genetics or bad luck were often seen as cause of their MI, leading to limited behaviour change. Participants and family valued CR as a place of safety and reassurance due to monitoring and advice provided by staff. Participants identified themselves as fit and active, and therefore not ‘old’, suggesting recovering function/fitness may be particularly important for this age group. Following completion of CR, participants felt they could now exert themselves without causing their body or heart harm. Participants also described a lack of age-relevant support material that addressed issues like returning to work, family demands such as elderly parents, and exercise advice accounting for their greater pre-MI fitness.
Conclusion It is important to consider how working-age individuals experience CR, as it impacts on engagement and behaviour. Existing literature regarding this group that also includes gender is limited and heterogeneous. Our study thus far indicates male working-age CR attendees and their family value the reassurance monitoring provides and allowing them to regain confidence in their bodies.
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