ReviewCardiac rehabilitation and quality of life: A systematic review
Section snippets
Background
The ageing population presents challenges to national healthcare systems as they deal with rising health and social care costs (World Health Organization, WHO, 2005). Coronary heart disease (CHD) is a long term condition for which age is an independent risk factor (Joint British Societies, 2005). Cardiac rehabilitation is a cost effective intervention for CHD that improves functional capacity and quality of life and furthermore has been shown to reduce acute hospital admissions (Hedback et al.,
Aims and objectives
The review aimed to explore the effects of cardiac rehabilitation interventions on the QoL of patients with CHD with a specific focus on interventions that could be delivered within the context of a publicly funded health service. A search of the Cochrane library identified two systematic reviews of cardiac rehabilitation. The papers considered for each review included these years: Jolliffe et al. (2001) 1972–1999 (trials n = 51); and Rees et al. (2004) 1974–2001 (trials n = 36). QoL outcomes were
Findings
The 16 papers reported RCTs conducted in nine countries (Australia, Brazil, Canada, Finland, Italy, Japan, Norway, Sweden and UK). Three trials are represented by more than one paper and were included because they reported different QoL data. Eight studies: Arthur et al. (2002), Briffa et al. (2005), Lie et al. (2009), Marchionni et al. (2003), Smith et al. (2004), Dalal et al. (2007), Hanssen et al. (2007) and Jolly et al. (2007) reported a power calculation as a basis for sample size and
Discussion
The limitations of this review include the use of three databases and English language papers only. No attempt was made to include the grey literature. The starting point of this literature review was two Cochrane reviews of cardiac rehabilitation (Jolliffe et al., 2001, Rees et al., 2004) which reported contrasting results with psychological interventions not yielding mortality benefits while interventions with an exercise component yielded substantial mortality benefits. These findings
Conclusion
This review indicates that cardiac rehabilitation improves the QoL for CHD patients and that QoL improvements have a bi-directional relationship with increased physical activity and vocational status, which, in turn further improve QoL and may reduce mortality. Home-based programmes offer the opportunity to give patients more choice and may be particularly useful in improving uptake among older CHD patients who are most sensitive to the benefits of cardiac rehabilitation.
Moreover, for nurses
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