Barriers to cardiac rehabilitation delivery in a low-resource setting from the perspective of healthcare administrators, rehabilitation providers, and cardiac patients
Autor(a) principal: | |
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Data de Publicação: | 2019 |
Outros Autores: | , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UFMG |
Texto Completo: | https://doi.org/10.1186/s12913-019-4463-9 http://hdl.handle.net/1843/40180 https://orcid.org/ 0000-0002-9533-3654 https://orcid.org/ 0000-0001-7946-3718 https://orcid.org/0000-0002-9352-1504 https://orcid.org/ 0000-0002-1200-5680 https://orcid.org/ 0000-0003-4400-2326 https://orcid.org/ 0000-0001-7063-3610 |
Resumo: | CNPq - Conselho Nacional de Desenvolvimento Científico e Tecnológico |
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2022-03-17T14:10:38Z2022-03-17T14:10:38Z201919110https://doi.org/10.1186/s12913-019-4463-91472-6963http://hdl.handle.net/1843/40180https://orcid.org/ 0000-0002-9533-3654https://orcid.org/ 0000-0001-7946-3718https://orcid.org/0000-0002-9352-1504https://orcid.org/ 0000-0002-1200-5680https://orcid.org/ 0000-0003-4400-2326https://orcid.org/ 0000-0001-7063-3610CNPq - Conselho Nacional de Desenvolvimento Científico e TecnológicoFAPEMIG - Fundação de Amparo à Pesquisa do Estado de Minas GeraisCAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível SuperiorBackground: Despite clinical practice guideline recommendations that cardiovascular disease patients participate, cardiac rehabilitation (CR) programs are highly unavailable and underutilized. This is particularly true in low-resource settings, where the epidemic is at its’ worst. The reasons are complex, and include health system, program and patient-level barriers. This is the first study to assess barriers at all these levels concurrently, and to do so in a lowresource setting. Methods: In this cross-sectional study, data from three cohorts (healthcare administrators, CR coordinators and patients) were triangulated. Healthcare administrators from all institutions offering cardiac services, and providers from all CR programs in public and private institutions of Minas Gerais state, Brazil were invited to complete a questionnaire. Patients from a random subsample of 12 outpatient cardiac clinics and 11 CR programs in these institutions completed the CR Barriers Scale. Results: Thirty-two (35.2%) healthcare administrators, 16 (28.6%) CR providers and 805 cardiac patients (305[37.9%] attending CR) consented to participate. Administrators recognized the importance of CR, but also the lack of resources to deliver it; CR providers noted referral is lacking. Patients who were not enrolled in CR reported significantly greater barriers related to comorbidities/functional status, perceived need, personal/ family issues and access than enrollees, and enrollees reported travel/work conflicts as greater barriers than non-enrollees (all p < 0.01). Conclusions: The inter-relationship among barriers at each level is evident; without resources to offer more programs, there are no programs to which physicians can refer (and hence inform and encourage patients toattend), and patients will continue to have barriers related to distance, cost and transport. Advocacy for services is needed.engUniversidade Federal de Minas GeraisUFMGBrasilEEF - DEPARTAMENTO DE FISIOTERAPIABMC Health Services ResearchServiços de saúdeReabilitação cardíacaCuidados médicosPessoal da área médicaHealth care servicesCardiac rehabilitationCardiac care facilitiesAttitude of health personnelBarriers to cardiac rehabilitation delivery in a low-resource setting from the perspective of healthcare administrators, rehabilitation providers, and cardiac patientsinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlehttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6719378/Thaianne Cavalcante SérvioRaquel Rodrigues BrittoGabriela Lima de Melo GhisiLilian Pinto da SilvaLuciana Duarte Novais SilvaMárcia Maria Oliveira LimaDanielle Aparecida Gomes PereiraSherry Graceapplication/pdfinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFMGinstname:Universidade Federal de Minas Gerais (UFMG)instacron:UFMGLICENSELicense.txtLicense.txttext/plain; charset=utf-82042https://repositorio.ufmg.br/bitstream/1843/40180/1/License.txtfa505098d172de0bc8864fc1287ffe22MD51ORIGINALBarriers to cardiac rehabilitation delivery in a low-resource.pdfBarriers to cardiac rehabilitation delivery in a low-resource.pdfapplication/pdf657702https://repositorio.ufmg.br/bitstream/1843/40180/2/Barriers%20to%20cardiac%20rehabilitation%20delivery%20in%20a%20low-resource.pdfa058641d112da7f2a90c54d843d83276MD521843/401802022-03-17 11:10:38.933oai:repositorio.ufmg.br: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Repositório de PublicaçõesPUBhttps://repositorio.ufmg.br/oaiopendoar:2022-03-17T14:10:38Repositório Institucional da UFMG - Universidade Federal de Minas Gerais (UFMG)false |
dc.title.pt_BR.fl_str_mv |
Barriers to cardiac rehabilitation delivery in a low-resource setting from the perspective of healthcare administrators, rehabilitation providers, and cardiac patients |
title |
Barriers to cardiac rehabilitation delivery in a low-resource setting from the perspective of healthcare administrators, rehabilitation providers, and cardiac patients |
spellingShingle |
Barriers to cardiac rehabilitation delivery in a low-resource setting from the perspective of healthcare administrators, rehabilitation providers, and cardiac patients Thaianne Cavalcante Sérvio Health care services Cardiac rehabilitation Cardiac care facilities Attitude of health personnel Serviços de saúde Reabilitação cardíaca Cuidados médicos Pessoal da área médica |
title_short |
Barriers to cardiac rehabilitation delivery in a low-resource setting from the perspective of healthcare administrators, rehabilitation providers, and cardiac patients |
title_full |
Barriers to cardiac rehabilitation delivery in a low-resource setting from the perspective of healthcare administrators, rehabilitation providers, and cardiac patients |
title_fullStr |
Barriers to cardiac rehabilitation delivery in a low-resource setting from the perspective of healthcare administrators, rehabilitation providers, and cardiac patients |
title_full_unstemmed |
Barriers to cardiac rehabilitation delivery in a low-resource setting from the perspective of healthcare administrators, rehabilitation providers, and cardiac patients |
title_sort |
Barriers to cardiac rehabilitation delivery in a low-resource setting from the perspective of healthcare administrators, rehabilitation providers, and cardiac patients |
author |
Thaianne Cavalcante Sérvio |
author_facet |
Thaianne Cavalcante Sérvio Raquel Rodrigues Britto Gabriela Lima de Melo Ghisi Lilian Pinto da Silva Luciana Duarte Novais Silva Márcia Maria Oliveira Lima Danielle Aparecida Gomes Pereira Sherry Grace |
author_role |
author |
author2 |
Raquel Rodrigues Britto Gabriela Lima de Melo Ghisi Lilian Pinto da Silva Luciana Duarte Novais Silva Márcia Maria Oliveira Lima Danielle Aparecida Gomes Pereira Sherry Grace |
author2_role |
author author author author author author author |
dc.contributor.author.fl_str_mv |
Thaianne Cavalcante Sérvio Raquel Rodrigues Britto Gabriela Lima de Melo Ghisi Lilian Pinto da Silva Luciana Duarte Novais Silva Márcia Maria Oliveira Lima Danielle Aparecida Gomes Pereira Sherry Grace |
dc.subject.por.fl_str_mv |
Health care services Cardiac rehabilitation Cardiac care facilities Attitude of health personnel |
topic |
Health care services Cardiac rehabilitation Cardiac care facilities Attitude of health personnel Serviços de saúde Reabilitação cardíaca Cuidados médicos Pessoal da área médica |
dc.subject.other.pt_BR.fl_str_mv |
Serviços de saúde Reabilitação cardíaca Cuidados médicos Pessoal da área médica |
description |
CNPq - Conselho Nacional de Desenvolvimento Científico e Tecnológico |
publishDate |
2019 |
dc.date.issued.fl_str_mv |
2019 |
dc.date.accessioned.fl_str_mv |
2022-03-17T14:10:38Z |
dc.date.available.fl_str_mv |
2022-03-17T14:10:38Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/article |
format |
article |
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publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/1843/40180 |
dc.identifier.doi.pt_BR.fl_str_mv |
https://doi.org/10.1186/s12913-019-4463-9 |
dc.identifier.issn.pt_BR.fl_str_mv |
1472-6963 |
dc.identifier.orcid.pt_BR.fl_str_mv |
https://orcid.org/ 0000-0002-9533-3654 https://orcid.org/ 0000-0001-7946-3718 https://orcid.org/0000-0002-9352-1504 https://orcid.org/ 0000-0002-1200-5680 https://orcid.org/ 0000-0003-4400-2326 https://orcid.org/ 0000-0001-7063-3610 |
url |
https://doi.org/10.1186/s12913-019-4463-9 http://hdl.handle.net/1843/40180 https://orcid.org/ 0000-0002-9533-3654 https://orcid.org/ 0000-0001-7946-3718 https://orcid.org/0000-0002-9352-1504 https://orcid.org/ 0000-0002-1200-5680 https://orcid.org/ 0000-0003-4400-2326 https://orcid.org/ 0000-0001-7063-3610 |
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1472-6963 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
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BMC Health Services Research |
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info:eu-repo/semantics/openAccess |
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openAccess |
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Universidade Federal de Minas Gerais |
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UFMG |
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Brasil |
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EEF - DEPARTAMENTO DE FISIOTERAPIA |
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Universidade Federal de Minas Gerais |
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reponame:Repositório Institucional da UFMG instname:Universidade Federal de Minas Gerais (UFMG) instacron:UFMG |
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Universidade Federal de Minas Gerais (UFMG) |
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UFMG |
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