Introduction: 

Low participation and adherence to cardiac rehabilitation (CR) leads to ineffective care and increased risk of cardiac complications. There is a need to identify effective motivational strategies and concepts to increase participation and adherence to CR.

Purpose: 

The aim of this review was to synthesize and integrate the current knowledge about motivational strategies and concepts to increase participation and adherence to CR.

Methods: 

A literature search was performed using five electronic databases: CINAHL, Medline via PubMed, Scopus, Embase, and Rehabilitation & Sports Medicine Source. The search was limited to peer-reviewed studies, written in English, and publications from 2010 to 2019. A matrix and narrative synthesis were employed to organize and synthesize the findings, respectively.

Results: 

Eight of 522 articles met the inclusion criteria. Four articles used motivational interviewing (MotI) and counseling strategy, three articles investigated the autonomy, competence, and relatedness of self-determination theory (SDT) concepts, and one article used a reinforced motivational strategy. Use of MotI led to improving the CR completion rate from 14% to 39%. The number of sessions attended/patient improved from 12 to 20 when the staff was provided attendance feedback and a reward. Autonomy, competence, and relatedness motivated patients to participate in and adhere to CR.

Conclusions: 

Motivational interviewing and counseling, motivational and reinforcement strategies, and the autonomy, competence, and relatedness of SDT concepts should be utilized to promote participation and motivation for CR. The effects of these techniques on long-term CR require further research, including combining the identified methods to investigate the efficacy of these techniques on CR adherence.

中文翻译：

---

提高心脏康复参与度和依从性的激励策略和概念：综合综述

介绍： 

心脏康复 (CR)参与度和依从性低会导致护理无效并增加心脏并发症的风险。有必要确定有效的激励策略和概念，以增加对 CR 的参与和遵守。

目的： 

本次审查的目的是综合和整合当前有关激励策略和概念的知识，以提高对 CR 的参与和遵守。

方法： 

使用五个电子数据库进行文献检索：CINAHL、Medline via PubMed、Scopus、Embase 和 Rehabilitation & Sports Medicine Source。该检索仅限于 2010 年至 2019 年以英文撰写的同行评审研究和出版物。分别采用矩阵和叙述综合来组织和综合研究结果。

结果： 

522 篇文章中有 8 篇符合纳入标准。四篇文章使用了动机访谈（MotI）和咨询策略，三篇文章研究了自我决定理论（SDT）概念的自主性、能力和相关性，一篇文章使用了强化动机策略。MotI 的使用将 CR 完成率从 14% 提高到 39%。当向工作人员提供出勤反馈和奖励时，参加的会议/患者数量从 12 次增加到 20 次。自主性、能力和相关性激励患者参与并坚持 CR。

结论： 

应利用动机性访谈和咨询、动机和强化策略以及 SDT 概念的自主性、能力和相关性来促进CR 的参与和动机。这些技术对长期 CR 的影响需要进一步研究，包括结合已确定的方法来研究这些技术对 CR 依从性的功效。