Reframing the dilemma of poor attendance at cardiac rehabilitation: An exploration of ambivalence and the decisional balance

Everett, B; Salamonson, Y; Zecchin, R; Davidson, PM

Reframing the dilemma of poor attendance at cardiac rehabilitation: An exploration of ambivalence and the decisional balance

Everett, B

Salamonson, Y Zecchin, R Davidson, PM

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Publication Type:: Journal Article
Citation:: Journal of Clinical Nursing, 2009, 18 (13), pp. 1842 - 1849
Issue Date:: 2009-07-01

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Field	Value	Language
dc.contributor.author	Everett, B https://orcid.org/0000-0003-1733-7462	en_US
dc.contributor.author	Salamonson, Y	en_US
dc.contributor.author	Zecchin, R	en_US
dc.contributor.author	Davidson, PM https://orcid.org/0000-0003-2050-1534	en_US
dc.date.issued	2009-07-01	en_US
dc.identifier.citation	Journal of Clinical Nursing, 2009, 18 (13), pp. 1842 - 1849	en_US
dc.identifier.issn	0962-1067	en_US
dc.identifier.uri	http://hdl.handle.net/10453/15557
dc.description.abstract	Aim. To discuss the problem of poor attendance at cardiac rehabilitation from the alternative perspective of patient ambivalence. Background. Evidence supports the benefits of cardiac rehabilitation as a means for secondary prevention of coronary heart disease, yet current literature continues to document poor attendance at these programmes. Whilst extrinsic factors, such as transportation and lack of physician support have been identified as barriers, patients who choose not to attend these programmes are often described as lacking motivation or being non-compliant. However, it is possible that non-attendance is the result of ambivalence - the experience of simultaneously wanting to and yet not wanting to, or the 'I want to, but I don't want to' dilemma. Design. Discussion paper. Method. This discussion paper draws on the literature of ambivalence and decision-making theory to reframe the issue of poor attendance at cardiac rehabilitation. Conclusions: This paper has demonstrated that the problem of poor attendance may be explained from the perspective of patient ambivalence and that using strategies such as the decisional balance may assist these individuals in exploring their ambivalence to engage in secondary prevention programmes. Relevance to clinical practice. Understanding the dynamics of ambivalence provides an alternative to thinking of patients as lacking motivation, being non-compliant, or even resistant. Helping patients to explore and resolve their ambivalence may be all that is needed to help them make a decision and move forward. © 2009 Blackwell Publishing Ltd.	en_US
dc.relation.ispartof	Journal of Clinical Nursing	en_US
dc.relation.isbasedon	10.1111/j.1365-2702.2008.02612.x	en_US
dc.subject.classification	Nursing	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Cardiovascular Diseases	en_US
dc.subject.mesh	Patient Compliance	en_US
dc.subject.mesh	Cardiac Rehabilitation	en_US
dc.title	Reframing the dilemma of poor attendance at cardiac rehabilitation: An exploration of ambivalence and the decisional balance	en_US
dc.type	Journal Article
utslib.citation.volume	13	en_US
utslib.citation.volume	18	en_US
utslib.for	1110 Nursing	en_US
utslib.for	1117 Public Health and Health Services	en_US
utslib.for	1701 Psychology	en_US
dc.location.activity	Sydney Australia
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Nursing
utslib.copyright.status	closed_access
pubs.issue	13	en_US
pubs.publication-status	Published	en_US
pubs.volume	18	en_US

Abstract:

Aim. To discuss the problem of poor attendance at cardiac rehabilitation from the alternative perspective of patient ambivalence. Background. Evidence supports the benefits of cardiac rehabilitation as a means for secondary prevention of coronary heart disease, yet current literature continues to document poor attendance at these programmes. Whilst extrinsic factors, such as transportation and lack of physician support have been identified as barriers, patients who choose not to attend these programmes are often described as lacking motivation or being non-compliant. However, it is possible that non-attendance is the result of ambivalence - the experience of simultaneously wanting to and yet not wanting to, or the 'I want to, but I don't want to' dilemma. Design. Discussion paper. Method. This discussion paper draws on the literature of ambivalence and decision-making theory to reframe the issue of poor attendance at cardiac rehabilitation. Conclusions: This paper has demonstrated that the problem of poor attendance may be explained from the perspective of patient ambivalence and that using strategies such as the decisional balance may assist these individuals in exploring their ambivalence to engage in secondary prevention programmes. Relevance to clinical practice. Understanding the dynamics of ambivalence provides an alternative to thinking of patients as lacking motivation, being non-compliant, or even resistant. Helping patients to explore and resolve their ambivalence may be all that is needed to help them make a decision and move forward. © 2009 Blackwell Publishing Ltd.

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http://hdl.handle.net/10453/15557