CARDIAC REHABILITATION - GENDER DIFFERENCES IN FACTORS INFLUENCING PARTICIPATION

This study investigates gender differences in the barriers and incenti ves that are most influential in the coronary patient's decision to pa rticipate in cardiac rehabilitation programs (CRPs) and suggests strat egies to counter these barriers. Patient surveys were administered to consecutive English-speaking attenders and referred nonattenders to a cardiac rehabilitation center at a university healthcare system in Tor onto, Canada. A survey questionnaire, constructed from a literature re view and advice from key informants, examined potential factors affect ing decisions to engage in CRPs. One hundred twenty-nine attenders at a CRP and 61 referred nonattenders completed the questionnaire. Physic ian recommendation was reported to be the most important factor influe ncing both women's and men's decisions to participate in CRPs, followe d by encouragement from family members. For women who had attended CRP , encouragement from their adult children was significantly more influ ential than it was for men. Attention to health promotion was also a s ignificantly more powerful motivator for women than it was for men. Fo r CRP nonattenders, concomitant illness, transportation problems, and inconvenient timing of the program were stated to be the three most im portant barriers to CRP participation in both sexes, although women ra ted concomitant illness as a significantly more powerful barrier than did men. The decision to participate in CRPs involves several factors, some of which are different or more important for women. As physician recommendations continue to be the single most important factor in mo tivating both men and women to attend, strengthened and increased phys ician endorsement will likely encourage higher levels of participation in CRPs. For women, permission should be sought to discuss the advant ages of CRPs with adult children who are apparently influential in the decision. As women nonattenders are more concerned than men about the effects of concomitant illnesses, reassurance should be provided abou t customized programs and exercise targets that consider the needs and limitations of individuals with other health conditions.