Designing and Validating a Contextual Home-Based Physical Activity and Exercise Rehabilitation for Patients with Coronary Artery Disease in Low Resource Settings: Patients’ Experiences and Expert Opinions

Abstract Background: Cardiac rehabilitation plays a significant role in patients' lives for returning to a healthy routine. Recovery from a heart attack without a structured cardiac rehabilitation program is incomplete or delayed. Unfortunately, structured cardiac rehabilitation centers are scarce in countries with limited resources, particularly Pakistan. Home-Based Physical Activity and Exercise Rehabilitation can be an excellent alternative to CBCR because of the barriers between patients and the institution. Literature extensively suggests low-cost secondary prevention strategies like CR for every cardiac patient who has experienced a cardiac event or has undergone any cardiac procedure. Aim: This study explored patients’ and HCPs' experiences and opinions on developing and validating a convenient, home-based physical activity and exercise rehabilitation for a low-resource setting. Methods: Qualitative data were collected from 30 Participants (20 patients and 10 HCPs) through in-depth semi-structured interviews using a purposive and snowball sampling technique between July and December 2023. The data were organized and analyzed using NVIVO and ATLAS.ti software. An inductive coding approach was used to generate codes, categories, and themes. Results: Nine themes emerged from participants’ data: (1) Lack of Discharge Education by Healthcare Professionals, (2) No Written guidance - Patients’ Need Written Health Information, (3) Low Prescription and Challenges in Doing PA and Exercise, (4) Duration of Rest and Activities to Commence With, (5) Activities to be Performed Daily, (6) Activities to Improve Exercise Endurance, (7) Convenient and Safe Exercises, (8) Exercises for Patients with Joint Pain, (9) Frequency, Intensity, Time, and Type of Exercise. Conclusion: The present study’s findings align with recent literature, emphasizing the recommendation for early initiation of physical activity and exercise for heart patients. This contextual intervention based on patients and HCPs can improve patients' overall health after a heart attack.