Virtual education in cardiac rehabilitation is facilitated primarily by accessibility, empowerment, technology, and social support, while the format of delivered material is the most common barrier.
Systematic Review (n=296)
What are the barriers and facilitators to virtual education in cardiac rehabilitation?
Virtual education in cardiac rehabilitation is facilitated by accessibility and empowerment, but hindered by the format of delivered material, highlighting areas for program optimization.
BACKGROUND: Due to restrictions imposed by the severe acute respiratory syndrome coronavirus 2 pandemic much attention has been given to virtual education in cardiac rehabilitation (CR). Despite growing evidence that virtual education is effective in teaching patients how to better self-manage their conditions, there is very limited evidence on barriers and facilitators of CR patients in the virtual world. AIMS: To identify barriers and facilitators to virtual education participation and learning in CR. METHODS: A systematic review of peer-reviewed literature was conducted. Medline, Embase, Emcare, CINAHL, PubMed, and APA PsycInfo were searched from inception through April 2021. Following the PRISMA checklist, only qualitative studies were considered. Theoretical domains framework (TDF) was used to guide thematic analysis. The Critical Appraisal Skills Program was used to assess the quality of the studies. RESULTS: Out of 6662 initial citations, 12 qualitative studies were included (58% 'high' quality). A total of five major barriers and facilitators were identified under the determinants of TDF. The most common facilitator was accessibility, followed by empowerment, technology, and social support. Format of the delivered material was the most common barrier. Technology and social support also emerged as barriers. CONCLUSION: This is the first systematic review, to our knowledge, to provide a synthesis of qualitative studies that identify barriers and facilitators to virtual education in CR. Cardiac rehabilitation patients face multiple barriers to virtual education participation and learning. While 12 qualitative studies were found, future research should aim to identify these aspects in low-income countries, as well as during the pandemic, and methods of overcoming the barriers described.
Vanzella et al. (2021) conducted a systematic review in Cardiovascular disease requiring cardiac rehabilitation (n=296). Virtual education in cardiac rehabilitation was evaluated on Barriers and facilitators to virtual education participation and learning. Virtual education in cardiac rehabilitation is facilitated primarily by accessibility, empowerment, technology, and social support, while the format of delivered material is the most common barrier.