Barriers to cardiovascular rehabilitation care in a northeast city of Brazil

Authors

  • Luciano Sá Teles de Almeida Santos
  • Emanuella Gomes
  • Júlia Vilaronga
  • Walleska Nunes
  • Alan Carlos Nery Santos Universidade Salvador - UNIFACS
  • Fernanda Oliveira Baptista Almeida
  • Jefferson Petto Faculdade Social da Bahia - FSBA https://orcid.org/0000-0002-5748-2675

DOI:

https://doi.org/10.5935/0104-7795.20170013

Keywords:

Cardiovascular Diseases, Heart Failure, Physical and Rehabilitation Medicine, Communication Barriers

Abstract

Identifying barriers by regions of Brazil can be a valuable strategy to improve the insertion and adherence of patients with cardiopathy to cardiovascular rehabilitation programs. Objective: To identify and describe the reasons that lead to the non-inclusion of individuals with cardiopathy in cardiovascular rehabilitation programs. Methods: Descriptive cross-sectional study with 79 individuals of both sexes, aged over 50 years, with cardiopathy from five private cardiology clinics. To identify the factors that interfered with the inclusion of patients in cardiovascular rehabilitation programs, the scale of barriers for cardiac rehabilitation was applied. This instrument is composed of 22 items, 21 of which are closed and objective questions. Individuals were instructed to tick "YES" or "NO" for each target item on the scale if they identified the item as a barrier to inclusion / adherence. Results: 64 (81%) of the sample did not know about the existence of cardiovascular rehabilitation and its benefits. For 50 (63%) the distance from the residence to the rehabilitation center was a barrier. In addition, the cost of urban mobility 37 (47%) and the lack of indication of the physician as unnecessary 32 (40%) were also pointed as barriers. Conclusion: The results of this study indicate that the main reasons for non-insertion in cardiovascular rehabilitation programs were the lack of knowledge about the benefits of this type of program, the distance of the patients' residence to the nearest center and the displacement cost.

Downloads

Download data is not yet available.

References

World Heart Organization. Cardiovascular diseases (CVDs) [text on the Internet]. WHO: Geneva [cited 2016 Dec 02]. Available from: http://www.who.int/mediacentre/factsheets/fs317/es/.

Sociedade Brasileira de Cardiologia [sítio na Internet]. Rio de Janeiro: SBC; c2017 [citado 2017 Jan 05]. Disponível em: http://www.cardiometro.com.br.

Silva SM, Luiz RR, Pereira RA. Fatores de risco e proteção para doenças cardiovasculares em adultos de Cuiabá, Mato Grosso, Brasil. Rev Bras Epidemiol. 2015;18(2): 425-38. DOI: http://dx.doi.org/10.1590/1980-5497201500020011.

Andrade JP, Mattos LAP, Carvalho AC, Machado AC, Oliveira GMM. Programa Nacional de Qualificação de Médicos na Prevenção e Atenção Integral às Doenças Cardiovasculares. Arq Bras Cardiol. 2013; 100(3):203-11. DOI: http://dx.doi.org/10.5935/abc.20130061.

Mansur AP, Favarato D. Tendências da taxa de mortalidade por doenças cardiovasculares no Brasil, 1980-2012. Arq Bras Cardiol. 2016;107(1):20-5.

Sociedade Brasileira de Cardiologia. Diretriz de prevenção cardiovascular. Arq Bras Cardiol. 2013; 101(6Supl.2):1-63. DOI: http://dx.doi.org/10.5935/abc.2013s002.

Sociedade Brasileira de Cardiologia. Diretriz sul-americana de prevenção e reabilitação cardiovascular. Arq Bras Cardiol. 2014; 103(2Supl.1):1-31.

Petto J, Araújo PL, Garcia NL, Santos ACN, Gardenghi G. Fatores de impedimento ao encaminhamento para a reabilitação cardíaca supervisionada. Rev Bras Cardiol. 2013;26(5):364-8.

Castinheiras Neto AG, Turco VM, Venturim FO, Farinatti PTV. Reabilitação cardíaca após alta hospitalar no sistema público de saúde do município do Rio de Janeiro. Rev SOCERJ. 2008;21(6):399-403.

Mair V, Breda AP, Nunes ME, Matos LD. Evaluating compliance to a cardiac rehabilitation program in a private general hospital. Einstein (Sao Paulo). 2013;11(3):278-84. DOI: http://dx.doi.org/10.1590/S1679-45082013000300004

Aikawa P, Cintra ARS, Oliveira Júnior AS, Silva CTM, Pierucci JD, Afonso MS, et al. Reabilitação cardíaca em pacientes submetidos à cirurgia de revascularização do miocárdio. Rev Bras Med Esporte. 2014;20(1):55-8. DOI: http://dx.doi.org/10.1590/S1517-86922014000100011.

Ghisi GLM, Santos RZ, Schveitzer V, Barros AL, Recchi TL, Oh P, et al. Desenvolvimento e validação da versão em português da Escala de Barreiras para Reabilitação Cardíaca. Arq Bras Cardiol. 2012;98(4):344-52. DOI: http://dx.doi.org/10.1590/S0066-782X2012005000025.

Grace SL, Scholey P, Suskin N, Arthur HM, Brooks D, Jaglal S, Abramson BL, et al. A prospective comparison of cardiac rehabilitation enrollment following automatic vs usual referral. J Rehabil Med. 2007;39(3):239-45. DOI: http://dx.doi.org/10.2340/16501977-0046.

Daly J, Sindone AP, Thompson DR, Hancock K, Chang E, Davidson P. Barriers to participation in and adherence to cardiac rehabilitation programs: a critical literature review. Prog Cardiovasc Nurs. 2002;17(1):8-17. DOI: http://dx.doi.org/10.1111/j.0889-7204.2002.00614.x.

Fernandes AMS, Souza VS, Borges IC, Andrade DC, Luedy FA, Martins RR, et al. Atividade educativa na sala de espera com pacientes com insuficiência cardíaca. Rev Bras Cardiol. 2013;26(2):106-11.

Herman WH, Hoerger TJ, Brandle M, Hicks K, Sorensen S, Zhang P, et al. The cost-effectiveness of lifestyle modification or metformin in preventing type 2 diabetes in adults with impaired glucose tolerance. Ann Intern Med. 2005;142(5):323-32. DOI: http://dx.doi.org/10.7326/0003-4819-142-5-200503010-00007.

Schmitt Netto A, Araujo PB, Lima DP, Sties SW, Gonzáles AI, Aranha EE, et al. Análise da aderência em diferentes programas de reabilitação cardíaca: estudo preliminar. Cinergis.2016;17(2):140-5. DOI: http://dx.doi.org/10.17058/cinergis.v17i2.7552.

Ghisi GL, Santos RZ, Aranha EE, Nunes AD, Oh P, Benetti M, et al. Perceptions of barriers to cardiac rehabilitation use in Brazil. Vasc Health Risk Manag. 2013;9:485-91. DOI: http://dx.doi.org/10.2147/VHRM.S48213.

Gaalema DE, Savage PD, Rengo JL, Cutler AY, Higgins ST, Ades PA. Financial incentives to promote cardiac rehabilitation participation and adherence among Medicaid patients. Prev Med. 2016;92:47-50. DOI: http://dx.doi.org/10.1016/j.ypmed.2015.11.032.

Brasil. Ministério da Saúde. Portaria n. 55, de 24 de Fevereiro de 1999. Dispõe sobre a rotina do Tratamento Fora do Domicílio no Sistema Único de Saúde - SUS, com inclusão dos procedimentos específicos na tabela de procedimentos do Sistema de Informações Ambulatoriais do SIA / SUS e dá outras providências. Diário Oficial da República Federativa do Brasil, Brasília (DF); 1999 Fev 26; Secção 1:116-7.

Grace SL, Shanmugasegaram S, Gravely-Witte S, Brual J, Suskin N, Stewart DE. Barriers to cardiac rehabilitation: does age make a difference? J Cardiopulm Rehabil Prev. 2009 May-Jun;29(3):183-7. DOI: http://dx.doi.org/10.1097/HCR.0b013e3181a3333c.

Menezes AR, Lavie CJ, Milani RV, Arena RA, Church TS. Cardiac rehabilitation and exercise therapy in the elderly: Should we invest in the aged? J Geriatr Cardiol. 2012;9(1):68-75.

Published

2017-06-30

Issue

Section

Original Article

How to Cite

1.
Santos LST de A, Gomes E, Vilaronga J, Nunes W, Santos ACN, Almeida FOB, et al. Barriers to cardiovascular rehabilitation care in a northeast city of Brazil. Acta Fisiátr. [Internet]. 2017 Jun. 30 [cited 2024 Jul. 18];24(2):67-71. Available from: https://revistas.usp.br/actafisiatrica/article/view/153527