Psychosocial services provided by licensed cardiac rehabilitation programs

Frontiers in Rehabilitation Sciences · 5 authors, 3 centres

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TL;DR

This cross-sectional survey of 68 North Carolina cardiac rehabilitation programs found that while 70% offer psychosocial services and 94% routinely assess mental health, most programs do not bill for these services, with lack of internal resources and patient beliefs cited as top barriers.

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A cross-sectional survey was conducted of 68 licensed outpatient cardiac rehabilitation programs in North Carolina to describe their mental health assessments, psychosocial services, and perceived barriers. Results show that 94% of programs assess depression/anxiety at enrollment, with 75% using the PHQ-9, and 88% assess health-related quality of life. Seventy percent of programs offer psychosocial services, most commonly individual counseling (59%) and counseling referrals (49%), but 73% reported not billing for these services. Program directors identified lack of internal resources (92%) and patient beliefs (45%) as major barriers to expanding services. The study highlights a gap between recommended mental health assessment practices and the resource-supported delivery of psychosocial services in cardiac rehabilitation.

STUDY TYPE

cross-sectional

SPECIALTY

cardiology

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100% · A

ORIGINAL PAPER

PMC10101325

Psychosocial services provided by licensed cardiac rehabilitation programs

Frontiers in Rehabilitation Sciences

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ABSTRACT

Abstract Background Professional health organizations recommend that outpatient cardiac rehabilitation programs include activities to optimize the physical, mental, and social well-being of patients. The study objectives were to describe among cardiac rehabilitation programs (1) mental health assessments performed; (2) psychosocial services offered; and (3) leadership's perception of barriers to psychosocial services offerings. Methods A cross-sectional survey of North Carolina licensed outpatient cardiac rehabilitation programs on their 2018 services was conducted. Descriptive statistics were used to summarize survey responses. Thematic analysis of free text questions related to barriers to programmatic establishment or expansion of psychosocial services was performed by two team members until consensus was reached. Results Sixty-eight programs (89%) responded to the survey. Forty-eight programs (70%) indicated offering psychosocial services; however, a majority (73%) of programs reported not directly billing for those services. At program enrollment, mental health was assessed in 94% of programs of which 92% repeated the assessment at discharge. Depression was assessed with the 9-item Patient Health Questionnaire by a majority (75%) of programs. Psychosocial services included individual counseling (59%), counseling referrals (49%), and educational classes (29%). Directors reported lack of internal resources (92%) and patient beliefs (45%) as the top barriers to including or expanding psychosocial services at their facilities. Conclusions Cardiac rehabilitation programs routinely assess mental health but lack the resources to establish or expand psychosocial services. Interventions aimed at improving patient education and reducing stigma of mental health are important public health opportunities. Keywords: mental health assessments, barriers and facilitative factors, post-myocardial infarction care, patient beliefs and attitudes, cardiac rehabilitation

CITATION EXPORT

Montika Bush, Kelly R Evenson, Aileen Aylward et al.. Psychosocial services provided by licensed cardiac rehabilitation programs. Frontiers in Rehabilitation Sciences. (2023). https://doi.org/10.3389/fresc.2023.1093086

AUTHORS

5 · 3 CENTRES

Montika Bush, Kelly R Evenson, Aileen Aylward, Julianne M Cyr, Anna Kucharska-Newton

1Department of Emergency Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
2Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
3Department of Epidemiology College of Public Health, University of Kentucky, Lexington, KY, United States