Status of cardiac rehabilitation services in low- and middle-income countries
Notice bibliographique
Résumé
Purpose: Despite the benefits of cardiac rehabilitation (CR), there is lack of data on the availability, characteristics, and barriers to feasible CR services in low- and middle-income countries (LMIC). The objectives of this study were to assess the availability and characteristics of CR services and identify barriers to CR implementation and participation in LMIC. Methods: Sixty national cardiac societies, heart associations, and heart foundations and 100 cardiac specialists from LMIC throughout the World Health Organization regions were asked whether CR services were provided to adult cardiac patients at any institute in their countries. Responses were received from 40 LMIC. Of these, cardiac specialists from 23 countries that offered CR services completed a questionnaire which examined the characteristics of the CR services provided by the facility, patients' barriers to CR participation, and approaches that could transcend barriers to participation in CR. Cardiac specialists from 10 countries that did not offer CR services completed another questionnaire which assessed barriers to successful implementation of a CR programme and feasible components for sustainable CR. Results: CR services were available in 26 LMIC (questionnaire non-response=3 LMIC). CR components included exercise training (100%), healthy diet advice (100%), psychological support (95.7%), and smoking cessation (91.3%). Funding sources to operate the CR programmes were private insurance (4.5%), private (40.9%), central government (50.0%), and mixed (22.7%). Cardiac specialists reported "distance to the facility," "costs," and "lack of support/referral from doctor" as the leading barriers for CR participation for patients. Many of the respondents (68.2%) were in favour of a decentralized health care system and listed automatic referral and increasing cardiac specialists' and patients' knowledge regarding CR to transcend barriers. CR services were not available in 14 LMIC (questionnaire non-response=4 LMIC). The most endorsed barriers for successful implementation of a CR programme were "lack of economic resources," "lack of qualified personnel," "lack of equipment," and "rehabilitation is not supported by health policies." Cardiac specialists listed patient education, smoking cessation, and counselling regarding medications and diet as feasible components for sustainable CR in these countries. Conclusion: The results suggest the need to increase the availability and accessibility of cost-effective and feasible CR services in low-resource settings to assist in reducing the rate of premature mortality in patients with heart disease.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,006 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,002 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,007 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».