Perceived Barriers and Needs for Continuing Home-Based Cardiac Rehabilitation Among Post-Open Heart Surgery Patients

A Regional Hospital Context

Abstract

Descriptive qualitative research aims to explain the perception of barriers and needs regarding the rehabilitation of patients post open-heart surgery at home, from the perspectives of patients, caregivers, and medical personnel, within the context of a central hospital. The study uses Bandura's self-efficacy theory combined with the patient-centered care concept as the conceptual framework. Purposeful sampling was conducted, selecting 5 patients post-open-heart surgery, 3 caregivers, and 10 medical personnel, totaling 18 participants. Data were collected through in-depth interviews and focus group discussions between May and July. Prof. In 2025, the research tools included semi-structured interviews, the quality of which was verified by three experts and tested before actual data collection. Data were analyzed using content analysis, and reliability was checked through triangulation and verification with informants.

The research findings identified six main issues: (1) geographical barriers and economic burdens, with patients living 40–80 kilometers from the hospital and travel costs of 300–500 baht per visit; (2) fear of re-injury from exercise; (3) gaps in knowledge and self-care skills; (4) feelings of abandonment after discharge and lack of continuous follow-up; (5) the need for accessible learning materials; and (6) the need for communication channels with medical staff. In summary, a hybrid home rehabilitation program that integrates remote monitoring via phone and Line application with hospital follow-up appointments is necessary. Hospital administrators should establish a remote monitoring system in collaboration with primary care networks. Interdisciplinary teams should develop easily accessible communication channels to reduce barriers to service access and enhance patients' quality of life.