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Examining Facilitators and Barriers to Cardiac Rehabilitation Adherence in a Low-Resource Setting in Latin America from Multiple Perspectives

Author

Listed:
  • Diana Marcela Rangel-Cubillos

    (Universidad de Santander, Facultad de Ciencias Médicas y de la Salud, Bucaramanga 680003, Colombia)

  • Andrea Vanessa Vega-Silva

    (Universidad de Santander, Facultad de Ciencias Médicas y de la Salud, Bucaramanga 680003, Colombia)

  • Yully Fernanda Corzo-Vargas

    (Universidad de Santander, Facultad de Ciencias Médicas y de la Salud, Bucaramanga 680003, Colombia)

  • Maria Camila Molano-Tordecilla

    (Universidad de Santander, Facultad de Ciencias Médicas y de la Salud, Bucaramanga 680003, Colombia)

  • Yesica Paola Peñuela-Arévalo

    (Universidad de Santander, Facultad de Ciencias Médicas y de la Salud, Bucaramanga 680003, Colombia)

  • Karen Mayerly Lagos-Peña

    (Universidad de Santander, Facultad de Ciencias Médicas y de la Salud, Bucaramanga 680003, Colombia)

  • Adriana Marcela Jácome-Hortúa

    (Universidad de Santander, Facultad de Ciencias Médicas y de la Salud, Bucaramanga 680003, Colombia)

  • Carmen Juliana Villamizar-Jaimes

    (Rehabilitation Center, Research and Development Department, Bucaramanga 680003, Colombia)

  • Sherry L. Grace

    (Faculty of Health, York University, Toronto, ON M3J 1P3, Canada
    KITE-Toronto Rehab Institute, & Director of Cardiac Rehabilitation Research, Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto, ON M4G 1R7, Canada)

  • Hugo Celso Dutra de Souza

    (Laboratory of Physiology and Cardiovascular Physioterapy, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 14049-900, Brazil)

  • Adriana Angarita-Fonseca

    (Universidad de Santander, Facultad de Ciencias Médicas y de la Salud, Bucaramanga 680003, Colombia
    Université du Québec en Abitibi-Témiscamingue, Rouyn Noranda, QC J9X 5E4, Canada
    Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Montreal, QC H2X 0A9, Canada)

  • Juan Carlos Sánchez-Delgado

    (Universidad de Santander, Facultad de Ciencias Médicas y de la Salud, Bucaramanga 680003, Colombia
    Laboratory of Physiology and Cardiovascular Physioterapy, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 14049-900, Brazil
    Grupo de Investigación Ser Cultura y Movimiento, Universidad Santo Tomás-Bucaramanga, Santander 680001, Colombia)

Abstract

Cardiac rehabilitation (CR) is under-used, particularly in low-resource settings. There are few studies of barriers and facilitators to CR adherence in these settings, particularly considering multiple perspectives. In this multiple-method study, a cross-sectional survey including the Cardiac Rehabilitation Barriers Scale (each item scored on a five-point Likert scale) was administered to patients treated between February and July, 2019, in three CR centers in Colombia. A random subsample of 50 participants was invited to a focus group, along with an accompanying relative. Physiotherapists from the programs were invited to an interview, with a similar interview guide. Audio-recordings were transcribed and analyzed using interpretive description. A total of 210 patients completed the survey, and 9 patients, together with 3 of their relatives and 3 physiotherapists, were interviewed. The greatest barriers identified were costs (mean = 2.8 ± 1.6), distance (2.6 ± 1.6) and transportation (2.5 ± 1.6); the logistical subscale was highest. Six themes were identified, pertaining to well-being, life roles, weather, financial factors, healthcare professionals and health system factors. The main facilitators were encouragement from physiotherapists, relatives and other patients. The development of hybrid programs where patients transition from supervised to unsupervised sessions when appropriate should be considered, if health insurers were to reimburse them. Programs should consider the implications regarding policies of family inclusion.

Suggested Citation

  • Diana Marcela Rangel-Cubillos & Andrea Vanessa Vega-Silva & Yully Fernanda Corzo-Vargas & Maria Camila Molano-Tordecilla & Yesica Paola Peñuela-Arévalo & Karen Mayerly Lagos-Peña & Adriana Marcela Jác, 2022. "Examining Facilitators and Barriers to Cardiac Rehabilitation Adherence in a Low-Resource Setting in Latin America from Multiple Perspectives," IJERPH, MDPI, vol. 19(4), pages 1-11, February.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:4:p:1911-:d:744912
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    References listed on IDEAS

    as
    1. Sandra Camacho & Norman Maldonado & Juan Bustamante & Blanca Llorente & Enriqueta Cueto & Fabián Cardona & Carlos Arango, 2018. "How much for a broken heart? Costs of cardiovascular disease in Colombia using a person-based approach," PLOS ONE, Public Library of Science, vol. 13(12), pages 1-14, December.
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    Cited by:

    1. Ying Zou & Sarah Janus & Jiamin Du & Ning Qu & Karel Zuidema & Huibert Burger & Kees Ahaus & Zhigang Guo & Sytse Zuidema, 2025. "Barriers and Facilitators of Cardiac Rehabilitation in a Middle-Income Country: A Qualitative Study from China," IJERPH, MDPI, vol. 22(4), pages 1-16, April.

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