2 Effects of Cardiac Rehabilitation on Quality of Life: Role of Exercise, Cultural and Social Factors; a Qualitative Study

BackgroundIn Kuwait, coronary artery disease (CAD) has a mortality rate of 30% (World life Expectancy, 2020). In Kuwait, weather, food, cultural and social norms can act as influencing factors in developing CAD.AimThis study aims to explore the perceptions of CAD patients regarding their disease, and their experience in cardiac rehabilitation programme (CR). It also aims to investigate the role of culture in improving quality of life (QoL) and to investigate the facilitators and barriers that may affect improvement in QoL.MethodsA one-to-one semi-structured interviews were used to explore in depth the perception of CAD patients. Twenty participants were interviewed; patients who joined CR constituted the CR group and those who declined constituted the standard medical care group. Interviews were conducted eight weeks from the baseline follow-up for the standard medical care group and upon completion of the CR programme for the CR group. Data were analysed using thematic analysis resulting in well-defined themes which included responses from both groups.ResultsTwenty participants were interviewed; ten from each of the two study groups. Thematic analysis produced six main themes with their associated subthemes: conception of life before and after the cardiac event (sub-themes; ‘I was free’, life before CAD, and Impact of CAD); lifestyle modification (sub-themes; the aftermath of CAD, activity level, physical activity, habit change, the influence of others, and living in Kuwait); visiting the cardiologist (standard medical care); experiences of attending CR programme (sub-themes; benefits of the CR programme, facilitators to the adhering to the CR programme, and understanding limits); barriers to lifestyle modification (sub-themes; lack of social support, work commitment, cultural barriers, lack of self-efficacy, and anxiety and fear of reoccurrence); and future health (sub-themes; no concern, supporting self, need for more knowledge, and losing weight).ConclusionAppropriate information regarding exercise can increase awareness of the importance of behavioural change and being physically active, leading to improvement in QoL. In addition, some cultural, social, and religious factors may act as barriers against wider use of CR. These findings show that more innovative, individualistic and culturally sensitive strategies are needed in Kuwait.