Predicting and explaining cardiac rehabilitation attendance.

BACKGROUND: A variety of factors influence patients' health behaviour; these are patterns of practitioner practice, patient characteristics and availability of resources. OBJECTIVES: To examine patient-related factors (demographic, health, psychosocial characteristics) that may influence patients' attendance at cardiac rehabilitation programs and their subsequent behaviour change. PATIENTS AND METHODS: A prospective cohort design was used. Three hundred four acute myocardial infarction and/or coronary artery bypass graft surgery patients from a tertiary care centre in a Western Canadian city were enrolled to participate in telephone interviews at two weeks and again at approximately six months after their hospital discharge. Measures of self-efficacy and behaviour performance for cardiac health maintenance and role resumption, motivation and social support were used at both interview times. A survey focusing on factors influencing patients' choices to attend cardiac rehabilitation programs was also administered at the interview six months after discharge. RESULTS: Attendance at cardiac rehabilitation programs is not associated with patients' risk factor status, and elderly and rural-living patients are at particular risk for nonattendance. CONCLUSIONS: Systematic mechanisms to guide the appropriate referral of patients to this health care resource and administer secondary prevention initiatives to those with limited access to resources need to be a priority in cardiovascular health care.