Ethnic Minorities' Experiences of Cardiac Rehabilitation: A Scoping Review

Patient education in multilingual groups of cardiac patients: Mission (im)possible?

Objective

In Norway, cardiac rehabilitation with patient education is usually accessible only to patients who understand Norwegian. The Cardiac Care Class (CCC) in focus in this article is a unique healthcare service in that, via interpreting services, it provides patient education to patients with limited Norwegian proficiency (LNP). This article examines the adaptations carried out to make cardiac rehabilitation accessible to LNP patients.

Methods

The data stem from a qualitative study with participant observation during interpreter-mediated CCCs and from interviews with healthcare professionals, patients, and interpreters conducted by an interdisciplinary team. The collaborative data analysis focused on identifying various forms of adaptations.

Results

Providing interpreting in CCCs required organizational, logistical, and pedagogical adaptations, including having fewer class participants, engaging qualified interpreters, conducting pre-class meetings with the interpreters, and adjusting the course content and language. Communication was found to be satisfactory, although some critical issues (e.g., interpreters' working conditions) were raised.

Conclusion

This study showed that interpreter-mediated CCCs can reach multilingual groups provided that the necessary adaptations are made.

Innovation

This research is the first to show how a cardiac rehabilitation class in Norway is made accessible to multilingual patient groups by providing interpreting.

Integrating the quantitative with the qualitative: findings from a mixed methods cardiac rehabilitation exercise trial

Background

Cardiac rehabilitation is a core component of cardiovascular disease management. Eastern Corridor Medical Engineering-Cardiac Rehabilitation is a digital health platform for online cardiac rehabilitation exercise. We conducted a mixed methods pilot trial to evaluate Eastern Corridor Medical Engineering-Cardiac Rehabilitation.

Objective

The study sought to examine the difference between objectively measured outcomes and participant perceptions of benefits and improvements gained from participation in a cardiac rehabilitation exercise program.

Methods

Seventeen participants (14 male, 3 female; 69.5 ± 7.3 years of age) took part and were allocated to 1 of 2 groups; an online exercise group (n = 8), or an in-person exercise (n = 9) group. Due to the COVID-19 pandemic, a pragmatic approach to group allocation was adopted. Objective outcomes were assessed at baseline and repeated following the intervention period, with the primary outcome being 6-minute walk test distance. In addition to clinical outcome measurements, we undertook qualitative interviews with participants.

Results

Only 5 participants demonstrated a clinically meaningful improvement in 6-minute walk test distance, following the 8-week exercise program. The main theme emerging from the qualitative interviews was the valued benefits of the cardiac rehabilitation exercise program. Despite the lack of measurable physical change, participants self-defined a range of benefits they valued and attributed directly to participation in the cardiac rehabilitation exercise program.

Conclusion

The findings from this study may offer a useful starting point for further study of community-based cardiac rehabilitation exercise and also highlight the benefit of adopting a mixed methods approach that considers both the objective outcomes measured as well as the subjective reports obtained from participants.

Adolescent Social Anxiety, School Satisfaction, Family Emotional Support, and School Absenteeism: Findings from Young-HUNT3 and Norwegian National Education Data

Background: Adolescents grappling with social anxiety may experience poor school satisfaction, resorting to school-related avoidance behaviors, exemplified by absenteeism, as a coping mechanism. Understanding the role of family support in alleviating the adverse effects of social anxiety on school satisfaction is imperative for fostering supportive educational settings. Although there is literature regarding how school satisfaction promotes positive adolescent outcomes, empirical knowledge on the interrelation between social anxiety, school satisfaction, and family emotional support is limited. This study investigates the association between social anxiety, family emotional support, school satisfaction, and school absenteeism within the theoretical framework of the stage-environment fit theory to offer insight into how family emotional support can moderate the influence of social anxiety on school-related outcomes. Methods: Utilizing a population-based sample of 1861 upper secondary school pupils from the Trøndelag Young Health study "Young-HUNT3 study", we employed an index of moderated mediation to examine the role of family emotional support in moderating the association between social anxiety and school-related avoidance behavior related to school satisfaction. Results: Family emotional support had moderated mediation association for school absenteeism (β = 0.128, 95% CI 0.019, 0.278) and extracurricular activity (β = -0.003, 95% CI -0.008, -0.000). Conclusions: This urges further investigation into the specific mechanisms and individual differences influencing these relationships, aiming to deepen our understanding of adolescents' experiences and inform comprehensive strategies for promoting their well-being within school communities.