The Impact of a Cardiac Rehabilitation Programme (CRP) on the Quality of Life (QOL) of Older Cardiac Patients

The aims of this mixed methods research study were twofold: (1) To explore the impact(s) of a cardiac rehabilitation progrmme (CRP) on the quality of life (QOL) of older cardiac patients who experienced either a myocardial infarction (MI) and/or a coronary artery bypass graft (CABG) and/or a percutaneous coronary intervention (PCI), otherwise known as a coronary angioplasty; and (2), To construct a QOL conceptual model based on the quantitative and qualitative aspects of the patient‟s bio-psycho-social-spiritual aspects of QOL on a CRP. The research sought to answer four research questions devised around the physiological, psychological, and sociological domains of QOL. A mixed methods design was used, under the rubric of a critical realist theoretical approach. The physical domains of QOL focused on the cardiac patients specific physiological measurements using a pre-test-post-test design in order to develop a deeper understanding, of the structures, mechanisms, contexts and outcomes of the CRP. Qualitative components focused on the subjective domains of QOL taken from the eclectic perspectives of cardiac health care professionals and cardiac patients using semi-structured interviews to develop an in-depth understanding of the bio-psycho-social-spiritual and health impacts of the programme. Thirty-five cardiac patients (n = 35) formed a non-random purposive sample for the quantitative component of the study. Using the same type of sampling method for the qualitative component, ten cardiac health care professionals (n = 10) and seven cardiac patients (n = 7) were interviewed to determine the various impact(s) that the programme had on the patients different domains of QOL. The results, derived from dual perspectives, indicated that the CRP had strong positive impacts on the patient‟s QOL across the bio-psycho-social-spiritual domains of QOL. The newly created QOL conceptual model, entitled „The Ripple Impact Model (TRIM)‟of QOL for Older Patients with Coronary Heart Disease (CHD)‟ reflects the dynamic nature of an older cardiac patient‟s QOL on a CRP in view of how they define the concept globally from both medical and non-medical perspectives