Title Barriers for Nonparticipation and Dropout of Women in Cardiac Rehabilitation Programs: A Systematic Review
Authors RESURRECCIÓN MENA, DAVINIA MARÍA, MOTRICO MARTINEZ , EMMA, RIGABERT SÁNCHEZ-JUNCO, ALINA, Rubio-Valera, Maria, Conejo-Ceron, Sonia, Pastor, Luis, Moreno-Peral, Patricia, MOTRICO MARTINEZ , EMMA, RIGABERT SÁNCHEZ-JUNCO, ALINA, RESURRECCIÓN MENA, DAVINIA MARÍA
External publication No
Means J. Women's Health
Scope Review
Nature Científica
JCR Quartile 1
SJR Quartile 1
JCR Impact 2.09700
SJR Impact 1.04700
Area International
Web https://www.scopus.com/inward/record.uri?eid=2-s2.0-85028037851&doi=10.1089%2fjwh.2016.6249&partnerID=40&md5=20f6f3b74e20280f96638d72870ec6ec
Publication date 01/08/2017
ISI 000408200300005
Scopus Id 2-s2.0-85028037851
DOI 10.1089/jwh.2016.6249
Abstract Background: Cardiovascular disease (CVD) is a major health problem worldwide. Cardiac rehabilitation (CR) programs are effective in reducing mortality and improving the quality of life of patients with CVD. Women are under-represented in CR and have a higher dropout rate than men. We aimed to systematically review the literature on barriers perceived by women with CVD affecting their nonparticipation in and/or dropping out from CR programs. Methods: Systematic review was done using MEDLINE, Embase, Scopus, Open Grey, and Cochrane Database from inception to September 2016. Search terms included (1) heart disease and other cardiac conditions, (2) CR and secondary prevention, and (3) nonparticipation in and/or dropout. Databases were searched following the "participants, interventions, comparisons, outcomes, and study design" method. Results: A total of 24 studies (17 descriptive, 6 qualitative, and 1 randomized controlled trial) reporting several barriers were grouped into five broad categories: intrapersonal barriers (self-reported health, health beliefs, lack of time, motivation, and religious reasons); interpersonal barriers (lack of family/social support and work conflicts); logistical barriers (transport, distance, and availability of personal/community resources); CR program barriers (services offered, group format, exercise component, and CR sessions); and health system barriers (lack of referral, cost, negative experiences with the health system, and language). We found differences between the barriers related to nonparticipation in and dropout from CR programs. Conclusions: Women reported multilevel barriers for nonparticipation in and dropout from CR programs. Future clinical guidelines should evaluate and eliminate these barriers to improve adherence to CR programs in women. In addition, understanding the barriers for nonparticipation and dropout may be beneficial for future intervention trials.
Keywords cardiac rehabilitation; women; systematic review; nonparticipation; dropout; adherence
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