1. Introduction
sensations, illness, HULK
MYOCARDIAL INFARCTION (MI), ACUTE CORONARY SYNDROME, CARDIOVASCULAR DISEASE (CVD), EVENT, MYOCARDIAL INFARCTION, SECONDARY
Traditional cardiac rehabilitation (CR) programs effectively improve physical performance and outcomes after myocardial infarction (MI). However, older patients are less likely to participate in such programs. The aim of this qualitative analysis was to investigate experiences and perceptions of cardiac outpatients enrolled in an innovative and exercise-based CR program and to identify possible barriers to improving adherence and quality of life. Semi-structured interviews were conducted on a sample of 31 patients (84% male; age 76 ± 6 years) from the Physical Activity Intervention in Elderly after Myocardial Infarction (PIpELINe) trial, after about six months of the event. Three main themes were identified: Personal feelings after the event; lifestyle change and perception of barriers; and relationships with familiars. Participants perceived sensations of fear at the time of their diagnosis and showed awareness of the importance of following specific health suggestions. They reported a significative change in previous habits and highlighted the need for periodic controls. Few of them felt insecure in carrying out daily activities or practicing exercise and reported an unnecessary protection from the family members. These findings will provide valuable insights for the development of a more feasible patient-centered CR model of intervention.Cardiovascular Disease (CVD) is the leading cause of mortality globally and represents a major health challenge, with a high prevalence of myocardial infarction (MI) among older people [Cardiac rehabilitation and secondary prevention (CR) applying a multifactorial approach [As reported in the literature, many studies have investigated the perceptions and experiences of cardiac patients in relation to the management of symptoms and the stable modification of their lifestyle [In order to address typical drawbacks of traditional CR, the “Physical Activity Intervention for Elderly Patients with Reduced Physical Performance after Acute Coronary Syndrome (HULK)” study has been conducted. Assessments of the efficacy of the HULK study have demonstrated that an early and feasible intervention based on a small number of supervised sessions, combined with an individualized home-based physical activity program, effectively improved older patients’ physical performance and quality of life [Thus, to further support the quantitative research, the current qualitative study was designed. The purpose was to analyze feelings and experiences of older MI outpatients enrolled in an innovative and exercise-based CR program and to identify barriers or limitations that may reduce adherence and quality of life. Indeed, a qualitative study allows us to gain in-depth knowledge about the experiences, perceptions, and emotions of older MI outpatients. Specifically, we investigated patients’ interpretations of their illness within their recovery path, their capacity to manage daily problems, and their relationship with family members. Therefore, this study will provide a novel contribution by investigating the psychological and emotional experiences of older MI outpatients enrolled in the program and emphasizing the importance of a person-centered approach.