OCT 2022
VOL. 11, ISSUE 1, PAGE 15
RESEARCH
This important publication was authored by a number of nurses based at and nurse affiliates of the Royal North Shore Hospital. Remote-delivered cardiac rehabilitation during COVID- 19: a prospective cohort comparison of health-related quality of life outcomes and patient experiences D. Candelaria, A. Kirkness, M. Farrell, K. Roach, L. Gooley, A. Fletcher, S. Ashcroft, H. Glinatsis, C. Bruntsch, J. Roberts, S. Randall, J. Gullick, L. Akbar Ladak, K. Soady, R. Gallagher, Remote-delivered cardiac rehabilitation during COVID-19: a prospective cohort comparison of health-related quality of life outcomes and patient experiences, European Journal of Cardiovascular Nursing, 2022;, zvac006, https://doi.org/10.1093/eurjcn/zvac006 The paper reports an observational study in which the health related quality of life (HRQoL) and experiences of people who received remotely or in-person delivered cardiac rehabilitation was compared. The study included people who attended four publically funded cardiac rehabilitation centres. Over 450 people were screened for inclusion with a sample size of 194 patients. 134 patients completed the study (in-person delivery: 69/91; 76% and remote delivery: 65/103; 63%) Patients completed the 12-item Short Form Health Survey (SF-12) before and after completing the cardiac rehabilitation program. This is a validated instrument designed to capture eight domains of HRQoL. It is widely used in health settings including cardiac rehabilitation.
Semi-structured interviews were also conducted with patients. The interview schedule included items designed to elicit responses related to the experience of the cardiac rehabilitation delivery mode.
The results revealed improvements in both groups for HRQoL over time and some statistically significant differences in mean SF-12 scores between groups although the differences were probably not clinically important. However when the analyses were adjusted for confounders that is factors other than the mode of cardiac rehabilitation that may have affected the results such as age, gender and ethnicity, there were statistically and clinically important differences in several domains and overall SF-12 physical functioning. Qualitative analysis revealed benefits and disadvantages for the two delivery modes. Patients valued the opportunity to interact with other patients and direct contact with experts during in-person rehabilitation. In contrast the remote delivery enabled patients to attend more easily but they expressed a desire for more guidance during some of the more complex exercises. The research suggests that remote delivery cardiac is a viable alternative which may allow more people to receive rehabilitation. However further investigation is required to test the efficacy and effectiveness of different delivery modes.
Maura Farrell, Nurse Manager
Ann Kirkness, CNC
Helen Glinatsis, CNS2
Kellie Roach, CNC
Jayne Roberts and Christine Bruntsch, Exercise Physiologists
Ashlee Fletcher, Exercise Physiologist
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