Patient Adherence to Self-Monitoring Recommendations Taught in Extended Phase I Cardiac Rehabilitation

Background: Patients in cardiac rehabilitation programs are taught to self-monitor heart rate (HR), rate of perceived exertion (RPE), and signs and symptoms of cardiac distress when they are performing strenuous activities. These interventions are emphasized in phase I cardiac rehabilitation in an effort to decrease the work on the heart in order to minimize the patient's risk for further cardiac damage. The purpose of this study is to describe patients' knowledge of and adherence to self-monitoring recommendations 1 month following completion of extended phase I cardiac rehabilitation. Method: Twenty-eight subjects who completed an extended phase I cardiac rehabilitation program at a metropolitan inpatient rehabilitation facility in 2003 completed 2 questionnaires, 1 at discharge and another 1 month following discharge. The questionnaires were based on the health belief model and measured patient perceptions, knowledge, adherence, and factors that were associated with adhering or not adhering to the self-monitoring recommendations. Results: At 1 month following discharge, none of the subjects participated in phase II cardiac rehabilitation and 92% indicated they participated in hard physical activities that increased their heart rate and breathing rate at least once per week. None of the subjects monitored RPE, 36% were adherent to monitoring HR, and 71 % were adherent to monitoring signs and symptoms of heart trouble during hard physical activity. Common factors that made it harder to self-monitor were memory and confidence. Conclusion: Participants did not adhere to education regarding selfmonitoring of HR and RPE taught to them in the extended phase I cardiac rehabilitation program.