PDF(Pubmed)
Abstract：
Cardiac rehabilitation (CR) represents an important steppingstone for many cardiac patients into a more heart-healthy lifestyle to prevent premature death and improve quality of life years. However, CR is underutilized worldwide. In order to support the development of targeted digital health interventions, this narrative review (I) provides understandings of factors influencing CR utilization from a behavioral perspective, (II) discusses the potential of digital health technologies (DHTs) to address barriers and reinforce facilitators to CR, and (III) outlines how DHTs could incorporate shared decision-making to support CR utilization. A narrative search of reviews in Web of Science and PubMed was conducted to summarize evidence on factors influencing CR utilization. The factors were grouped according to the Behaviour Change Wheel. Patients\' Capability for participating in CR is influenced by their disease knowledge, awareness of the benefits of CR, information received, and interactions with healthcare professionals (HCP). The Opportunity to attend CR is impacted by healthcare system factors such as referral processes and HCPs\' awareness, as well as personal resources including logistical challenges and comorbidities. Patients\' Motivation to engage in CR is affected by emotions, factors such as gender, age, self-perception of fitness and control over the cardiac condition, as well as peer comparisons. Based on behavioral factors, this review identified intervention functions that could support an increase of CR uptake: Future DHTs aiming to support CR utilization may benefit from incorporating information for patients and HCP education, enabling disease management and collaboration along the patient pathway, and enhancing social support from relatives and peers. To conclude, considerations are made how future innovations could incorporate such functions.
摘要：
心脏康复（CR）是许多心脏病患者进入更心脏健康的生活方式以防止过早死亡并改善生活质量的重要一步。然而,CR在全球范围内没有得到充分利用。为了支持有针对性的数字健康干预措施的发展，这篇叙述性综述(I)从行为的角度提供了对影响CR利用的因素的理解，(II)讨论数字卫生技术(DHT)在解决障碍和加强促进CR方面的潜力，和(III)概述了DHT如何纳入共享决策以支持CR利用。对WebofScience和PubMed中的评论进行了叙述性搜索，以总结有关影响CR利用的因素的证据。根据行为变化轮对因素进行分组。患者参与CR的能力受疾病知识的影响，意识到CR的好处，收到的信息,以及与医疗保健专业人员（HCP）的互动。参加CR的机会受到医疗保健系统因素的影响，例如转诊流程和HCP意识，以及个人资源，包括后勤挑战和合并症。患者参与CR的动机受情绪影响，性别等因素，年龄,对心脏状况的健康和控制的自我感知，以及同行比较。基于行为因素，这篇综述确定了可以支持CR摄取增加的干预功能：未来旨在支持CR利用的DHT可能受益于纳入患者信息和HCP教育，沿着患者路径实现疾病管理和协作，加强亲戚和同龄人的社会支持。最后，考虑到未来的创新如何纳入这些功能。
