Phase II cardiac rehabilitation

This is the initial post-discharge stage, and can tend to be rather low key, although it is a time when patients may feel isolated and somewhat insecure, and when high levels of anxiety may be present. Thus, it is important that patients and their families/significant others have access to appropriate health care professionals. Depending on the service available, contact with the cardiac rehabilitation team may be by phone or home visit, with primary care also involved. This is the stage where modification of risk factors will start and goals set in phase I CR should start to be realised. For patients issued with the heart manual post-MI, this can be used immediately (Lewin, et al., 1992), and for other patients an individualised walking programme may be started at this stage. The use of pedometers can help patients and CR staff monitor home walking programmes.

Progression to phase III is important, yet despite evidence of the benefits of CR, studies have shown that uptake of the outpatient CR programmes remains low. In a study by Beswick, et al. (2004) between 45% and 67% of patients who were referred attended phase III.

For patients who do not proceed to phase III it is important that phase I or II is relevant to and specific for their needs. These patients and families should have information on other sources of support and information on CHD. Health professionals involved in phases I and II need to be aware of the importance of relevant, robust follow-up and of a referral system that enables progress to appropriate, accessible phase III. Utilisation of motivational interviewing and exercise consultation is one method that can be used to influence behaviour change. (See Chapter 8.)

Do Not Panic

Do Not Panic

This guide Don't Panic has tips and additional information on what you should do when you are experiencing an anxiety or panic attack. With so much going on in the world today with taking care of your family, working full time, dealing with office politics and other things, you could experience a serious meltdown. All of these things could at one point cause you to stress out and snap.

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