The Perceptions of Healthcare Professionals on Cardiac Rehabilitation for Patients with Cardiac Conditions: A Systematic Review

Abstract

Background Cardiac Rehabilitation (CR) is a crucial component of secondary prevention for cardiac patients, such as those with heart failure (HF). Despite its well-documented benefits, including a 20%-25% reduction in all-cause mortality and a 38% decrease in recurrent myocardial infarctions, participation remains suboptimal. Understanding nurses’ and healthcare professionals’ (HCPs) perceptions of CR is essential to identifying barriers, facilitators, and preferred delivery models, particularly in Saudi Arabia and other low- and middle-income countries (LMICs). Aim This systematic review examines nurses’ and HCPs’ perceptions of CR, focusing on barriers, facilitators, and preferred delivery models. Methods A Mixed-Methods Systematic Review (MMSR) approach was followed to synthesise findings from seven studies conducted across Saudi Arabia, China, Iran, and Namibia. A systematic search of relevant databases was conducted, and studies were critically appraised using standardised tools. Key themes were identified through thematic analysis. Results Five key themes emerged: awareness and perceptions of CR, barriers to CR implementation, preferred modes of delivery (home-based vs. hospital-based), the role of training and professional development, and the integration of cultural factors. Institutional, professional, and patient-related barriers were identified, including limited CR facilities, staff shortages, and financial constraints. While home-based CR was preferred for accessibility, it faced compliance challenges, whereas hospital-based CR provided structured care but remained costly. Conclusion Findings underscore the need for context-specific, hybrid CR models integrating telehealth, enhanced professional training, and policy interventions to improve CR uptake. Addressing these factors is essential to ensure equitable access and improved cardiovascular outcomes globally. Future research should explore long-term CR effectiveness and culturally tailored interventions.