Abdulelah M Aldhahir1, Munyra Alhotye2, Jaber S Alqahtani3, Ibrahim A AlDraiwiesh3, Saeed M Alghamdi4,5, Abdullah S Alsulayyim1,5, Abdullah A Alqarni6, Shahad K Khormi6, Eidan M Alzahrani7, Ahmed M Al Rajeh8, Yousef S Aldabayan8, Rayan A Siraj8, Naif A Tawhari1, Faisal M Alhazmi1, Ayat A Najmi9, Khalid S Alwadeai10, Hassan Alwafi11. 1. Respiratory Therapy Department, Faculty of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia. 2. Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia. 3. Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dammam, Saudi Arabia. 4. Clinical Technology Department, Respiratory Care Program, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia. 5. National Heart and Lung Institute, Imperial College London, London, UK. 6. Department of Respiratory Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah, Saudi Arabia. 7. Department of Physiotherapy, Prince Sultan Military College of Health Sciences, Dammam, Saudi Arabia. 8. Department of Respiratory Therapy, College of Applied Medical Sciences, King Faisal University, Al-Hasa, Saudi Arabia. 9. Physical Therapy Department, Faculty of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia. 10. Rehabilitation Health Sciences Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia. 11. Faculty of Medicine, Umm Al-Qura University, Mecca, Saudi Arabia.
Abstract
Background: Cardiopulmonary rehabilitation (CR) is an effective management approach for heart failure (HF) patients and is delivered by multidisciplinary teams including physiotherapists (PTs). PT attitudes about delivering CR and barriers that might affect referral have not been explored. Thus, this study is aimed to explore PT attitudes about delivering CR programs to patients with HF and identify factors and barriers that might affect referral decisions. Methods: A cross-sectional online survey was disseminated to all PTs in Saudi Arabia between 19 February and 27 June, 2022. The characteristics of the respondents were described using descriptive statistics. Percentages and frequencies were used to report categorical variables. Results: Overall, 553 PTs, 289 (52.30%) male and 264 (47.70%) females, completed the online survey. Of these, 360 (65.1%) strongly agreed that CR would improve patients' physical fitness and 334 (60.4%) strongly agreed that CR would reduce breathlessness in patients with HF. The majority of PTs (321, 58%) strongly agreed that CR would improve HF patients' palpitation and fatigue. Out of 553 PTs, 349 (63.1%) strongly agreed that CR would improve patients' ability to perform daily activities. A hospital-supervised program was the preferred mode of delivering CR programs by 499 (90.20%) of the respondents. Apart from the exercise component, stress management was perceived by 455 (82.30%) as an essential component of CR programs. The most common patient-related factor that strongly influenced referral decisions was "fatigue related to disease" (42%). A lack of CR centers was reported by 59.90% as the most common referring barrier. Conclusion: PTs perceived CR as a successful strategy for patients with HF. Although a supervised hospital-based program with stress management as an essential component aside from the exercise component was perceived as the preferred mode of delivery, CR was lacking, which caused a significant barrier to CR referral from the PTs' perspective.
Background: Cardiopulmonary rehabilitation (CR) is an effective management approach for heart failure (HF) patients and is delivered by multidisciplinary teams including physiotherapists (PTs). PT attitudes about delivering CR and barriers that might affect referral have not been explored. Thus, this study is aimed to explore PT attitudes about delivering CR programs to patients with HF and identify factors and barriers that might affect referral decisions. Methods: A cross-sectional online survey was disseminated to all PTs in Saudi Arabia between 19 February and 27 June, 2022. The characteristics of the respondents were described using descriptive statistics. Percentages and frequencies were used to report categorical variables. Results: Overall, 553 PTs, 289 (52.30%) male and 264 (47.70%) females, completed the online survey. Of these, 360 (65.1%) strongly agreed that CR would improve patients' physical fitness and 334 (60.4%) strongly agreed that CR would reduce breathlessness in patients with HF. The majority of PTs (321, 58%) strongly agreed that CR would improve HF patients' palpitation and fatigue. Out of 553 PTs, 349 (63.1%) strongly agreed that CR would improve patients' ability to perform daily activities. A hospital-supervised program was the preferred mode of delivering CR programs by 499 (90.20%) of the respondents. Apart from the exercise component, stress management was perceived by 455 (82.30%) as an essential component of CR programs. The most common patient-related factor that strongly influenced referral decisions was "fatigue related to disease" (42%). A lack of CR centers was reported by 59.90% as the most common referring barrier. Conclusion: PTs perceived CR as a successful strategy for patients with HF. Although a supervised hospital-based program with stress management as an essential component aside from the exercise component was perceived as the preferred mode of delivery, CR was lacking, which caused a significant barrier to CR referral from the PTs' perspective.
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