Cardiac rehabilitation: the importance of patient expectations - a practitioner survey

Background. Numerous cardiac rehabilitation national guidelines consistently endorse the need for psychological support to create effective individualized care. Recent surveys suggest that the psychological factors remain poorly assessed and the measurement of psychological parameters remains patchy. Aim. To examine cardiac rehabilitation practitioners' perception and understanding of the importance of patient expectations and their capacity to assess and utilize these expectations to develop individualized care. Methods. A survey of cardiac rehabilitation professionals from 10 hospitals in the south-east of England. The questionnaire used in the survey was developed from content analyses of the current cardiac rehabilitation literature and expectancy theory articulated in Bandura's writings. Results. The results of the study show that cardiac rehabilitation practitioners are very aware of the general importance of patient expectations but have little structured support in the development of techniques to either assess these expectations or to utilize them in a therapeutic context. This leaves them unsure about the extent to which patients do receive individualized care and how best to develop their own practice in this regard. Relevance to clinical practice. This study suggests that there is a need for the development of a structured assessment tool, which has a sound theoretical basis to assess patients' expectation if good practice is to be established in providing individualized car in cardiac rehabilitation.