Cardiac Rehabilitation A Workbook for use

This easy-to-use manual provides a practical framework for a multi-disciplinary team to deliver a successful cardiac rehabilitation programme. Despite evidence that cardiac rehabilitation programmes reduce risk, there is no standard for hospital-based multidisciplinary programmes - which are thus complex and costly to design and implement Based on the cardiac rehabilitation work that has been carried out at in Gloucestershire over the past fifteen years, developing and constantly evaluating the evidence base for the programme Includes client handouts such as food and exercise diaries

Julian Bath is a consultant health psychologist based at Gloucestershire Royal Hospital, and manager of the Gloucestershire Cardiac Rehabilitation Psychology Service. He has a wealth of experience working clinically with groups and individuals in cardiac rehabilitation, and a wide range of clinical, consultancy and research experience in diabetes, rheumatology and renal care.

Gail Bohin is a clinical psychologist with Gloucestershire Cardiac Rehabilitation Service. Whilst Dr. Bohin’s specialist area is cardiac psychology, she also has an interest in health behaviour change and obesity, and provides teaching and consultancy in both areas. In addition to contributing to the multidisciplinary rehabilitation group programme, she also provides individual therapy for cardiac patients.

Christine Jones is a Cardiac Rehabilitation Specialist Nurse with nearly twenty years’ experience of working with cardiac patients. Christine has a keen interest in ICDs, and is the arrhythmia link nurse for Gloucestershire Cardiac Rehabilitation Service.

Eve Scarle is a physiotherapist and Lecturer in Sport and Physical Activity at the University of Gloucestershire. Eve has a keen interest in exercise referral and has been instrumental in setting up such schemes for the University. She also works for BACR as a course director and assessor for the Phase IV exercise instructor’s course.

Abbreviations Used in This Book
About the Authors
Preface
Multidisciplinary Cardiac Rehabilitation
Background
Cardiac rehabilitation
Does cardiac rehabilitation work?
Recent evidence for the efficacy of cardiac rehabilitation
Comprehensive cardiac rehabilitation
Comprehensive cardiac rehabilitation in Gloucestershire
The British Association for Cardiac Rehabilitation Standards and Core Components for Cardiac Rehabilitation (2007)
The Cardiac Rehabilitation Programme in Gloucestershire
Cardiac Rehabilitation in Gloucestershire
Where the CR service is delivered
What does CR look like in Gloucestershire?
Individual CR
The Individual CR Psychology Service
Attendance at CR in Gloucestershire
Health outcomes
Professional development of the CR team
Psychology and Cardiac Rehabilitation
Psychological factors
Anxiety and depression
Psychological factors and health outcomes
Illness perceptions
Illness perceptions and cardiac events
Illness perceptions and CR
Control theory
Applying psychological theory in CR
Anxiety at assessment
Illness perceptions at assessment
Returning home
The CR group
The Exercise Programme
Risk stratification for exercise
Using the information
Supervision following exercise
Exercise practical sessions
Calculating heart-rate training ranges
Exercise Practical
Exercise set-up
Warm-up
Circuit exercise
Cool-down
Use of music
Gym programmes
Seated exercises
Preparing for the First Session
Staff background and training
Eligibility for CR group programmes
The patient pathway
Assessment
Patient invitation
Measurement of outcomes
Timing of CR
Open/closed groups
Venues for CR
Health, safety and essential equipment
Coronary Heart Disease, Psychology and Exercise (Week 1)
Introduction to the Cardiac Rehabilitation Programme
Coronary Heart Disease and its Risk Factors
Coronary heart disease
Angina
Angioplasty and stents
Coronary artery bypass graft (CABG)
Heart attack (or myocardial infarction)
The risk factors for coronary heart disease
The Psychological Side of Having a Cardiac Event
Goal-setting and Pacing
The problem: "activity cycling"
The solution: goal-setting and pacing
The Exercise Programme
Monitoring the intensity of exercise
Heart rate
Breathing rate
Rate of Perceived Exertion/Exercise Scale
Exercise diaries
Aerobic Exercise and Stress (Week 2)
Exercise: What Sort and How Much?
Session set-up
Exercise-what sort and how much?
Activity and exercise
Exercise Practical
Stress and Coronary Heart Disease
Prolonged stress and coronary heart disease
Understanding stress
The effects of stress
The gradual build-up of stress
When stress becomes a problem
Managing stress
Abdominal breathing
Warming Up, Cooling Down, Angina and Hypertension (Week 3)
Warm Up and Cool Down
Warming up
Types of warm-up activity
Cooling down
How do we cool down?
Stretching
Exercise Practical
Angina
What is angina?
Symptoms of angina
Treatment for angina
Triggers for angina
Managing angina
What do you do if you are having angina?
High Blood Pressure (Hypertension)
What should your blood pressure be?
How can we lower our blood pressure?
Activities to Avoid, Making Changes for Life and Cholesterol (Week 4)
Activities to Avoid at the Moment
What would we regard as heavy lifting?
Exercise Practical
Mind and Body Relaxation
Deep muscle relaxation
Mental relaxation
Autogenic relaxation
Making Changes for Life
Why make changes for life?
Making changes
Setbacks and maintaining behaviour change
Cholesterol
What is cholesterol?
What should our cholesterol level be?
How to lower and improve our cholesterol levels
Enough or Too Much Exercise? Diet and Coronary Heart Disease (Week 5)
Enough or Too Much Exercise?
Exercise Practical
Diet and Coronary Heart Disease
Oily fish
Fats
Fruit and vegetables
Salt
Alcohol
The Benefits of Regular Exercise and Making the Most of your Recovery (Week 6)
The Benefits of Regular Exercise
Exercise Practical
Making the Most of Your Recovery
Thoughts and feelings
Driving
Physical activities
Holidays
Sex
Staying Fit, Cardiac Medication and the Future! (Week 7)
How to Stay Fit for Life
How to recognise that your exercise levels need to be increased
Dealing with setbacks
Maintaining exercise
How to keep motivated to exercise regularly
BACR Phase IV exercise instructor courses
Exercise Practical
Medication
Secondary prevention
Anti-platelets
Beta-blockers
ACE-inhibitors
Statins
The Future!
Follow-up sessions
Setbacks
Planning, pacing and goal-setting
Managing stress
Assessment Document
Letter of Invitation
References
Index
Table of Contents provided by Publisher. All Rights Reserved.

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Cardiac Rehabilitation A Workbook for use with Group Programmes

Summary

Author Biography

Table of Contents

Supplemental Materials