A narrative review of South Asian patients' experiences of cardiac rehabilitation

Abstract

Aims and objectives: To review the empirical literature relating to South Asian patients' experiences of cardiac rehabilitation.

Background: Individuals of South Asian origin (originating from India, Pakistan, Bangladesh, or Sri Lanka) have increased risk of coronary heart disease-related mortality and morbidity. Low levels of cardiac rehabilitation participation have been reported among South Asian groups in several English-speaking countries.

Design: Narrative review.

Methods: Primary research evidence published in English between 1999-2010 obtained using pre-defined search criteria in electronic databases MEDLINE, CINAHL, PubMed, EMBASE, Google Scholar and PsycINFO.

Results: Eleven studies met the inclusion criteria for review. Four prominent themes were identified in the literature related to: (1) exercise; (2) culture and religion; (3) programme access and structure; (4) communication and language.

Conclusions: The emerging themes distilled from the review encompass several factors associated with South Asian patients' experiences of cardiac rehabilitation that are commensurate with low uptake and poor adherence. However, few researchers have disaggregated their data by ethnic origin to describe what might best meet the needs of South Asian patients. Further research is needed to thoughtfully address issues of uptake of and compliance with cardiac rehabilitation by South Asian patients and to support the development of culturally sensitive and safe CR programmes.

Relevance to clinical practice: The findings from this review can help nurses to develop guidelines for the design and delivery of culturally competent South Asian cardiac rehabilitation programmes. Important considerations related to physical exercise, language and communication preferences, religious and cultural needs and programme access and structure, need to be addressed in a culturally relevant and culturally sensitive manner to enhance the uptake and efficacy of cardiac rehabilitation for South Asian individuals.