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Patient satisfaction with cardiac rehabilitation: association with utilization, functional capacity, and heart-health behaviors

Authors Ali S, Chessex C, Bassett-Gunter R, Grace SL

Received 23 August 2016

Accepted for publication 27 December 2016

Published 24 April 2017 Volume 2017:11 Pages 821—830

DOI https://doi.org/10.2147/PPA.S120464

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 3

Editor who approved publication: Dr Johnny Chen

Saba Ali,1 Caroline Chessex,2 Rebecca Bassett-Gunter,1 Sherry L Grace1,2

1School of Kinesiology and Health Science, York University, 2Toronto Rehabilitation Institute, University Health Network, University of Toronto, Toronto, ON, Canada

Background: Cardiac rehabilitation (CR) societies recommend assessment of patient satisfaction given its association with health care utilization and outcomes. Recently, the Patient Assessment of Chronic Illness Care (PACIC, Glasgow) was recommended as an appropriate tool for the CR setting. The objectives of this study were to 1) describe patient satisfaction with CR, 2) test the psychometric properties of the PACIC in the CR setting, and 3) assess the association of patient satisfaction with CR utilization and outcomes.
Methods: Secondary analysis was conducted on an observational, prospective CR program evaluation cohort. A convenience sample of patients from 1 of 3 CR programs was approached at their first CR visit, and consenting participants completed a survey. Clinical data were extracted from charts pre- and post-program. Participants were e-mailed surveys again 6 months (including the PACIC) and 1 and 2 years later.
Results: Of 411 consenting patients, 247 (60.2%) completed CR. The mean PACIC score was 2.8±1.1/5. Internal reliability was α=0.95. The total PACIC score varied significantly by site (F=3.12, P=0.046), indicating discriminant validity. Patient satisfaction was significantly related to greater CR adherence (r=0.22, P<0.01) and completion (t=2.63, P<0.01), greater functional status at CR discharge (r=0.17, P=0.03) and 2 years post-intake (r=0.19, P=0.03), greater physical activity at discharge (r=0.18, P=0.02), as well as lower depressive symptoms at discharge (r=-0.16, P=0.02) and 1-year follow-up (r=-0.19, P=0.03). These associations sustained adjustment for sex.
Conclusion: Patients were relatively satisfied with their care. The PACIC is a psychometrically validated scale, which could serve as a useful tool to assess patient satisfaction with CR.

Keywords: cardiac rehabilitation, patient satisfaction, cardiovascular disease, program evaluation

Corrigendum for this paper has been published

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