The role of psychosocial factors in cardiac rehabilitation

Background and Relevance. Adherence to cardiac rehabilitation represents a primary challenge in the organization of secondary prevention of cardiovascular complications. Objective. To synthesize current research on adherence to cardiac rehabilitation and to identify psychosocial targets for collaborative practice within a multidisciplinary rehabilitation team. Methods. The multifactorial psychosocial model developed by A.B. Kholmogorova and N.G. Garanyan, encompassing macrosocial, family, personal, and interpersonal levels, was utilized as the theoretical and methodological framework for this literature review. Results. At the family level, the regulatory, informational, and emotionally supportive functions of the family were identified as key contributors to adherence to cardiac rehabilitation and its efficacy. At the interpersonal level, the influence of social relationships, including the patient's perception of interactions with healthcare providers, on physical health status and long-term treatment attitudes was highlighted. At the personal level, the impact of depressive and anxiety states on achieving cardiac rehabilitation outcomes and maintaining treatment adherence was established. Conclusion. The application of the multifactorial psychosocial model by A.B. Kholmogorova and N.G. Garanyan enabled the structuring of heterogeneous data regarding cardiac rehabilitation adherence, thereby delineating the role of psychosocial factors and identifying specific targets for future clinical interventions and research.