This study aimed to compile existing evidence about the proposed relationships among variables at three stages of the model of therapeutic engagement (MTE): patient intention to engage in cardiac rehabilitation (CR), CR initiation, and sustained engagement. This model has not been tested in any rehabilitation setting. Therefore, this systematic literature review is key to future research and application of MTE to predict and enhance patient engagement in CR. Model-centric systematic literature reviews have been conducted for each stage of the MTE. A coherent approach to understanding and monitoring the process of patient engagement in CR is absent. Few relevant studies included in the model-centric reviews met the criteria: eight in stage 1, four in stage 2, and six in stage 3 of the MTE. In total, the tenets of the MTE were supported in patient intention to engage in CR. However, there was less evidence quantifying the proposed relationships among variables that impact on CR initiation and sustained engagement. There is a scarcity of research examining rehabilitation engagement in depth to better understand the complicated process contributing to behavioural outcomes. No decision-support models currently exist to alert patients and healthcare provider to the factors that influence non-engagement.

中文翻译：

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患者参与心脏康复的过程：以模型为中心的系统评价

本研究旨在汇编关于治疗参与模型 (MTE) 三个阶段的变量之间拟议关系的现有证据：患者参与心脏康复 (CR) 的意愿、CR 启动和持续参与。该模型尚未在任何康复环境中进行测试。因此，这项系统的文献综述是未来研究和应用 MTE 预测和增强患者参与 CR 的关键。MTE 的每个阶段都进行了以模型为中心的系统文献综述。缺乏一种连贯的方法来理解和监测患者参与 CR 的过程。以模型为中心的审查中包含的相关研究很少符合标准：MTE 的第 1 阶段有 8 项，第 2 阶段有 4 项，第 3 阶段有 6 项。总共，MTE 的原则得到了患者参与 CR 的支持。然而，量化影响 CR 启动和持续参与的变量之间的拟议关系的证据较少。很少有研究深入研究康复参与，以更好地了解导致行为结果的复杂过程。目前没有决策支持模型来提醒患者和医疗保健提供者注意影响不参与的因素。