{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T07:17:48Z","timestamp":1771312668819,"version":"3.50.1"},"reference-count":44,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,5,27]],"date-time":"2024-05-27T00:00:00Z","timestamp":1716768000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2024,5,27]],"date-time":"2024-05-27T00:00:00Z","timestamp":1716768000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100007605","name":"Aarhus Universitet","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007605","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Evaluation Clinical Practice"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Rationale<\/jats:title>\n                    <jats:p>Despite cardiac rehabilitation and medical treatment being integrated parts of the pathway of patients with cardiovascular disease, as well as the well\u2010establish positive effect, cardiac rehabilitation remains underutilised. In recent years, cardiac rehabilitation has increasingly been moved from the hospitals to the community healthcare services. This transition may be challenging for patients with cardiovascular disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To investigate reflections and perspectives of patients opting out of cardiac rehabilitation in community healthcare services to improve participation and adherence to cardiac rehabilitation in the future.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of eight patients opting out of cardiac rehabilitation participated in individual interviews. Opting out of cardiac rehabilitation is defined as never enroled or did not complete cardiac rehabilitation. The Interpretive Description methodology was used in the analysis where two themes and six subthemes were identified: (1) \u2018Structural and organisational factors\u2019 with three subthemes; Being a patient in the healthcare system, Enroling into CR when it is meaningful, and Getting back to work is vital, and (2) \u2018Patients'\u00a0internal factors\u2019 with three subthemes; Feeling a desire to regain control, Seeing yourself as recovered, and Being aware of own needs. The analysis indicates that patients'\u00a0decision to opt out of CR was multidimensional and based on a combination of factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Ensuring that the healthcare professionals in the community have sufficient information regarding the patient and a clear communication plan between the healthcare professionals and the patient may reduce the transition causing confusion and frustrations for patients. Incorporating a vocational element in CR and ensuring that employers understand the importance of CR may hamper returning to work as a challenge to CR. Ensuring timely CR referral and enrolment and a transition coordinator may reduce the challenge of patients not viewing CR as meaningful. However, further studies are needed to fully understand how CR could become meaningful for patients opting out of CR.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jep.14015","type":"journal-article","created":{"date-parts":[[2024,5,27]],"date-time":"2024-05-27T03:23:50Z","timestamp":1716780230000},"page":"1039-1048","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Opting out of cardiac rehabilitation in local community healthcare services: Patients'\u00a0perspectives and reflections"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6978-6070","authenticated-orcid":false,"given":"Maiken Bay","family":"Ravn","sequence":"first","affiliation":[{"name":"Department of Public Health Aarhus University Aarhus Denmark"},{"name":"DEFACTUM Central Denmark Region Aarhus Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3158-3301","authenticated-orcid":false,"given":"Connie","family":"Berthelsen","sequence":"additional","affiliation":[{"name":"Zealand University Hospital Roskilde and K\u00f8ge Denmark"},{"name":"Department of Regional Health Research University of Southern Denmark Odense Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0856-6837","authenticated-orcid":false,"given":"Thomas","family":"Maribo","sequence":"additional","affiliation":[{"name":"Department of Public Health Aarhus University Aarhus Denmark"},{"name":"DEFACTUM Central Denmark Region Aarhus Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2467-1103","authenticated-orcid":false,"given":"Claus Vinther","family":"Nielsen","sequence":"additional","affiliation":[{"name":"Department of Public Health Aarhus University Aarhus Denmark"},{"name":"DEFACTUM Central Denmark Region Aarhus Denmark"},{"name":"Social Medicine and Rehabilitation, Region Hospital Goedstrup  Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1116-8389","authenticated-orcid":false,"given":"Charlotte G.","family":"Pedersen","sequence":"additional","affiliation":[{"name":"Department of Public Health Aarhus University Aarhus Denmark"},{"name":"Steno Diabetes Center Aarhus, Aarhus University Hospital Aarhus Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1378-2449","authenticated-orcid":false,"given":"Charlotte","family":"Handberg","sequence":"additional","affiliation":[{"name":"Department of Public Health Aarhus University Aarhus Denmark"},{"name":"National Rehabilitation Center for Neuromuscular Diseases Aarhus Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,5,27]]},"reference":[{"key":"e_1_2_11_2_1","volume-title":"Cardiovascular Diseases (CVDs)","author":"World Health Organization","year":"2021"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehad191"},{"key":"e_1_2_11_4_1","volume-title":"29. 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