Cardiac rehabilitation in rural and remote areas of North Queensland: How well are we doing?

• Published in: The Australian journal of rural health 2022-08, Vol.30 (4), p.488-500
• Main Authors: Field, Patricia, Franklin, Richard C., Barker, Ruth, Ring, Ian, Leggat, Peter A
• Format: Article
• Language: English
• Subjects: Aboriginal and Torres Strait Islanders people; Access; Aftercare; Allied health professionals; Cardiac Rehabilitation; Cardiovascular disease; Cardiovascular diseases; Community; Coronary artery disease; Data collection; Education; Guidelines; Health care; Health services; Health Services, Indigenous; Heart Diseases; holistic; Hospital discharged; Humans; Indigenous peoples; Medical personnel; Medical treatment; multidisciplinary; Multipurpose; Nurses; Patient Discharge; Primary care; Qualitative analysis; Quality of care; Queensland; Referrals; Rehabilitation; remote; Remote areas; Returning home; rural; Rural areas; Rural communities; secondary prevention; Support services
• ISSN: 1038-5282; 1440-1584; 1440-1584
• DOI: 10.1111/ajr.12861

Objective To address access to cardiac rehabilitation (CR) for people in R&R areas, this research aimed to investigate: (1) post discharge systems and support for people returning home from hospital following treatment for heart disease (HD). (2) propose changes to improve access to CR in R&R areas of NQ. Setting Four focus communities in R&R areas of NQ. Participants Focus communities’ health staff (resident/visiting) (57), community leaders (10) and community residents (44), discharged from hospital in past 5 years following treatment for heart disease (purposeful sampling). Design A qualitative descriptive case study, with data collection via semi‐structured interviews. Inductive/deductive thematic analysis was used to identify primary and secondary themes. Health service audit of selected communities. Results Health services in the focus communities included multipurpose health services, and primary health care centres staffed by resident and visiting staff that included nurses, Aboriginal and Torres Strait Islander Health Workers, medical officers, and allied health professionals. Post‐discharge health care for people with HD was predominantly clinical. Barriers to CR included low referrals to community‐based health professions by discharging hospitals; poorly defined referral pathways; lack of guidelines; inadequate understanding of holistic, multidisciplinary CR by health staff, community participants and leaders; limited centre‐based CR services; lack of awareness, or acceptance of telephone support services. Conclusion To address barriers identified for CR in R&R areas, health care systems’ revision, including development of referral pathways to local health professionals, CR guidelines and in‐service education, is required to developing a model of care that focuses on self‐management and education: Heart: Road to Health.