Identifying barriers and enablers to cardiac rehabilitation participation and completion unique to South Asian individuals: a qualitative systematic review.
Joanne McAllister, Mary Harrison, Claire A Lawson and 1 others
PMID 40116848WHAT IT FOUND
South Asian adults after cardiac referral described language barriers, fatalism, family duties and culturally insensitive programmes as barriers to participation.
Interpreters, family support, prayer-friendly flexible classes and respectful staff were enablers.
Key findings
01Language and communication difficulties were reported as barriers in eleven of thirteen studies, and were linked to poorer understanding of heart disease and CR.
02All studies found attitudes and motivations towards exercise impacted CR participation, and women's home duties and low confidence with gym environments were reported as barriers.
03Clinicians who accommodated religious practices, such as alternative class times for prayer, and culturally adapted programmes were viewed as enablers.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for RNs
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What it does not show
Most included studies were rated fair or poor on quality appraisal. Most participants were already attending CR, so the review says little about why referred patients never start. The studies came only from the UK and Canada, so the themes may not fit other health systems. Grouping South Asian participants together hides differences between Indian, Pakistani, Bangladeshi, Sri Lankan and other communities. Semi-structured interviews can be shaped by interviewer skill, and not all studies said which CR stage the barriers occurred at.
Declared interests
Funding came from the Wellcome Trust, the Leicestershire Health Inequalities Improvement Doctoral Training Programme, and the National Institute for Health and Care Research Leicester Biomedical Research Centre. The supplied text does not report competing interests.
The easy way to misread this
Do not read these themes as proof that interpreters, family support, or culturally adapted classes improve cardiac rehabilitation completion. The review reports what South Asian participants said about barriers and enablers, not tested effects.