{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T03:50:28Z","timestamp":1773028228463,"version":"3.50.1"},"reference-count":50,"publisher":"Public Library of Science (PLoS)","issue":"1","license":[{"start":{"date-parts":[[2025,1,31]],"date-time":"2025-01-31T00:00:00Z","timestamp":1738281600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004543","name":"China Scholarship Council","doi-asserted-by":"publisher","award":["202306370010"],"award-info":[{"award-number":["202306370010"]}],"id":[{"id":"10.13039\/501100004543","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>Cardiac rehabilitation effectively reduces mortality and enhances the quality of life for individuals with cardiovascular disease. Despite that, individuals\u2019 engagement in cardiac rehabilitation remains low. Considering the significant contributions of individuals\u2019 self-management of cardiovascular disease to their progress, it is essential to understand the personal factors that influence engagement in cardiac rehabilitation. This scoping review aims to identify and map personal factors that influence cardiac rehabilitation engagement with a specific focus on the subjective experiential dimensions of personal factors (cognitive, emotional, and behavioural). It also aims to explore interventions targeting personal factors to increase cardiac rehabilitation engagement. This review will be reported using the PRISMA-ScR checklist following the Joanna Briggs Institute (JBI) methodology. It will include peer-reviewed articles published in English from January 2004, excluding grey literature. Studies reporting adult populations aged 18 and over with cardiovascular disease and addressing personal factors or interventions to increase cardiac rehabilitation engagement, will be included. Databases for the searches will include PubMed, Embase, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, Scopus, and Web of Science. The data extraction is developed by the reviewers based on JBI guidelines and relevant literature, the form will detail the characteristics of included publications, personal factors influencing cardiac rehabilitation engagement, and intervention characteristics. The data analysis will summarise descriptively the key features of the included studies and interventions, the Patient Health Engagement Model will guide the categorisation of personal factors into cognitive, emotional, and behavioural aspects, with other personal factors organised as emerging other relevant factors themes. The findings of this review will provide important evidence support for researchers, clinicians and policy makers to promote participation in cardiac rehabilitation. Within the constraints of medical and human resources, attention to personal factors can maximise the individual\u2019s role in cardiac rehabilitation and self-management, contributing to the efficient allocation and use of resources.<\/jats:p>","DOI":"10.1371\/journal.pone.0318265","type":"journal-article","created":{"date-parts":[[2025,1,31]],"date-time":"2025-01-31T18:44:52Z","timestamp":1738349092000},"page":"e0318265","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["Identification of personal factors that influence engagement in cardiac rehabilitation and interventions targeting personal factors: A scoping review protocol"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5704-4907","authenticated-orcid":true,"given":"Hongyu","family":"Zhang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8378-6835","authenticated-orcid":true,"given":"Duygu","family":"Sezgin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2025,1,31]]},"reference":[{"issue":"1","key":"pone.0318265.ref001","doi-asserted-by":"crossref","first-page":"1561","DOI":"10.1186\/s12889-023-16466-1","article-title":"The global estimate of premature cardiovascular mortality: a systematic review and meta-analysis of age-standardized mortality rate","volume":"23","author":"WSR Hasani","year":"2023","journal-title":"BMC Public Health"},{"issue":"25","key":"pone.0318265.ref002","first-page":"2982","article-title":"Global burden of cardiovascular diseases and risk factors, 1990-2019: update from the GBD 2019 study","volume":"76","author":"GA Roth","year":"2020","journal-title":"J Am Coll Cardiol"},{"key":"pone.0318265.ref003","unstructured":"Organization WH. Cardiovascular diseases. 2023 [cited 2023 Jul 27]. Available from: https:\/\/www.who.int\/health-topics\/cardiovascular-diseases#tab=tab_1"},{"issue":"9","key":"pone.0318265.ref004","first-page":"e46006","article-title":"Cardiac rehabilitation in the modern era: optimizing recovery and reducing recurrence","volume":"15","author":"A Zaree","year":"2023","journal-title":"Cureus"},{"issue":"9","key":"pone.0318265.ref005","doi-asserted-by":"crossref","first-page":"e006997","DOI":"10.1161\/JAHA.117.006997","article-title":"Self-care for the prevention and management of cardiovascular disease and stroke: a scientific statement for healthcare professionals from the American Heart Association","volume":"6","author":"B Riegel","year":"2017","journal-title":"J Am Heart Assoc"},{"issue":"1","key":"pone.0318265.ref006","first-page":"38","article-title":"Cardiac rehabilitation past, present and future: an overview","volume":"2","author":"WM Mampuya","year":"2012","journal-title":"Cardiovasc Diagn Ther"},{"issue":"8","key":"pone.0318265.ref007","doi-asserted-by":"crossref","first-page":"1761","DOI":"10.12998\/wjcc.v9.i8.1761","article-title":"Cardiac rehabilitation and its essential role in the secondary prevention of cardiovascular diseases","volume":"9","author":"P Winnige","year":"2021","journal-title":"World J Clin Cases"},{"issue":"3","key":"pone.0318265.ref008","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1038\/s41569-021-00611-7","article-title":"The role of cardiac rehabilitation in improving cardiovascular outcomes","volume":"19","author":"RS Taylor","year":"2022","journal-title":"Nat Rev Cardiol"},{"issue":"2","key":"pone.0318265.ref009","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1016\/j.jphys.2023.02.011","article-title":"Appraisal of Clinical Practice Guideline: exercise intensity assessment and prescription in cardiovascular rehabilitation and beyond: why and how. A position statement from the Secondary Prevention and Rehabilitation Section of the European Association of Preventive Cardiology","volume":"69","author":"JR Zadro","year":"2023","journal-title":"J Physiother"},{"issue":"1","key":"pone.0318265.ref010","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1093\/eurjpc\/zwab154","article-title":"2021 ESC Guidelines on cardiovascular disease prevention in clinical practice","volume":"29","author":"FLJ Visseren","year":"2022","journal-title":"Eur J Prev Cardiol"},{"issue":"2","key":"pone.0318265.ref011","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1016\/j.recesp.2014.10.006","article-title":"Update in cardiology: vascular risk and cardiac rehabilitation","volume":"68","author":"E Galve","year":"2015","journal-title":"Rev Esp Cardiol (Engl Ed)"},{"issue":"Suppl. 3","key":"pone.0318265.ref012","doi-asserted-by":"crossref","first-page":"5","DOI":"10.33678\/cor.2023.060","article-title":"Secondary prevention through comprehensive cardiovascular rehabilitation: from knowledge to implementation. 2020 update. A position paper from the Secondary Prevention and Rehabilitation Section of the European Association of Preventive Cardiology. Translation of the document prepared by the Czech Society of Cardiology","volume":"65","author":"V Tuka","year":"2023","journal-title":"Cor Vasa"},{"issue":"3","key":"pone.0318265.ref013","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1177\/1474515120940534","article-title":"Symptom experience as a predictor of cardiac rehabilitation education programme attendance after percutaneous coronary intervention: A prospective questionnaire survey","volume":"20","author":"J-S Kim","year":"2021","journal-title":"Eur J Cardiovasc Nurs"},{"issue":"5","key":"pone.0318265.ref014","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1016\/j.pcad.2013.08.004","article-title":"Cardiac rehabilitation in Europe","volume":"56","author":"R Humphrey","year":"2014","journal-title":"Prog Cardiovasc Dis"},{"issue":"5","key":"pone.0318265.ref015","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1016\/j.hlc.2014.11.013","article-title":"Narrative review comparing the benefits of and participation in cardiac rehabilitation in high-, middle- and low-income countries","volume":"24","author":"KI Turk-Adawi","year":"2015","journal-title":"Heart Lung Circ"},{"issue":"1","key":"pone.0318265.ref016","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1136\/hrt.2004.045559","article-title":"Getting the most out of cardiac rehabilitation: a review of referral and adherence predictors","volume":"91","author":"L Jackson","year":"2005","journal-title":"Heart"},{"issue":"4","key":"pone.0318265.ref017","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1177\/2047487314520783","article-title":"Sex bias in referral of women to outpatient cardiac rehabilitation? A meta-analysis","volume":"22","author":"TJF Colella","year":"2015","journal-title":"Eur J Prev Cardiol"},{"issue":"3","key":"pone.0318265.ref018","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1007\/s12471-020-01492-0","article-title":"Predictors of cardiac rehabilitation referral, enrolment and completion after acute myocardial infarction: an exploratory study","volume":"29","author":"RWM Brouwers","year":"2021","journal-title":"Neth Heart J"},{"issue":"5","key":"pone.0318265.ref019","first-page":"369","article-title":"Cardiac rehabilitation after myocardial infarction in France: still not prescribed enough","volume":"63","author":"B Pavy","year":"2014","journal-title":"Ann Cardiol Angeiol (Paris)"},{"issue":"1","key":"pone.0318265.ref020","first-page":"51","article-title":"Sport, health and medicine: a sociological agenda","volume":"3","author":"D Malcolm","year":"2014","journal-title":"Asia Pac J Sport Soc Sci"},{"issue":"4","key":"pone.0318265.ref021","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3310\/KLWR9463","article-title":"Factors which facilitate or impede patient engagement with pulmonary and cardiac rehabilitation: a rapid evaluation mapping review","volume":"11","author":"L Blank","year":"2023","journal-title":"Health Soc Care Deliv Res"},{"issue":"10","key":"pone.0318265.ref022","doi-asserted-by":"crossref","first-page":"948","DOI":"10.1177\/0269215513481046","article-title":"Factors influencing participation in cardiac rehabilitation programmes after referral and initial attendance: qualitative systematic review and meta-synthesis","volume":"27","author":"AM Clark","year":"2013","journal-title":"Clin Rehabil"},{"issue":"4","key":"pone.0318265.ref023","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1017\/bec.2018.20","article-title":"The process of patient engagement in cardiac rehabilitation: a model-centric systematic review","volume":"35","author":"S Jahandideh","year":"2018","journal-title":"Behav Change"},{"issue":"1","key":"pone.0318265.ref024","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1177\/1474515118783157","article-title":"Factors associated with non-participation in and dropout from cardiac rehabilitation programmes: a systematic review of prospective cohort studies","volume":"18","author":"DM Resurrecci\u00f3n","year":"2019","journal-title":"Eur J Cardiovasc Nurs"},{"issue":"1","key":"pone.0318265.ref025","doi-asserted-by":"crossref","first-page":"27","DOI":"10.31083\/j.rcm.2019.01.53","article-title":"Treatment models of cardiac rehabilitation in patients with coronary heart disease and related factors affecting patient compliance","volume":"20","author":"Y Tian","year":"2019","journal-title":"Rev Cardiovasc Med"},{"issue":"1","key":"pone.0318265.ref026","doi-asserted-by":"crossref","first-page":"1267","DOI":"10.1186\/s12913-021-07174-w","article-title":"A systematic review of provider-and system-level factors influencing the delivery of cardiac rehabilitation for heart failure","volume":"21","author":"P Daw","year":"2021","journal-title":"BMC Health Serv Res"},{"issue":"1","key":"pone.0318265.ref027","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1186\/s13012-018-0784-z","article-title":"Engaging patients to improve quality of care: a systematic review","volume":"13","author":"Y Bombard","year":"2018","journal-title":"Implement Sci"},{"issue":"1","key":"pone.0318265.ref028","doi-asserted-by":"crossref","first-page":"1116","DOI":"10.1186\/s12913-022-08501-5","article-title":"All together now - patient engagement, patient empowerment, and associated terms in personal healthcare","volume":"22","author":"E Hickmann","year":"2022","journal-title":"BMC Health Serv Res"},{"issue":"1","key":"pone.0318265.ref029","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1186\/s12913-019-4463-9","article-title":"Barriers to cardiac rehabilitation delivery in a low-resource setting from the perspective of healthcare administrators, rehabilitation providers, and cardiac patients","volume":"19","author":"TC S\u00e9rvio","year":"2019","journal-title":"BMC Health Serv Res"},{"issue":"1","key":"pone.0318265.ref030","doi-asserted-by":"crossref","first-page":"768","DOI":"10.1186\/s12913-020-05619-2","article-title":"Implementing recommendations for inpatient healthcare provider encouragement of cardiac rehabilitation participation: development and evaluation of an online course","volume":"20","author":"C Santiago de Ara\u00fajo Pio","year":"2020","journal-title":"BMC Health Serv Res"},{"issue":"1","key":"pone.0318265.ref031","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1186\/s13643-021-01873-5","article-title":"Patient engagement strategies for adults with chronic conditions: an evidence map","volume":"11","author":"H Aboumatar","year":"2022","journal-title":"Syst Rev"},{"issue":"1","key":"pone.0318265.ref032","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1186\/s12872-019-1262-5","article-title":"Effectiveness of eHealth cardiac rehabilitation on health outcomes of coronary heart disease patients: a randomized controlled trial protocol","volume":"19","author":"JJ Su","year":"2019","journal-title":"BMC Cardiovasc Disord"},{"issue":"7","key":"pone.0318265.ref033","first-page":"CD007131","article-title":"Promoting patient uptake and adherence in cardiac rehabilitation","author":"P Davies","year":"2010","journal-title":"Cochrane Database Syst Rev"},{"issue":"2","key":"pone.0318265.ref034","first-page":"361","article-title":"Exercise-based cardiac rehabilitation for patients with coronary heart disease: a systematic review and evidence mapping study","volume":"60","author":"Z Li","year":"2024","journal-title":"Eur J Phys Rehabil Med"},{"issue":"3","key":"pone.0318265.ref035","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1016\/j.ejcnurse.2009.02.004","article-title":"Improving uptake of cardiac rehabilitation: using theoretical modelling to design an intervention","volume":"8","author":"SM Mosleh","year":"2009","journal-title":"Eur J Cardiovasc Nurs"},{"issue":"3","key":"pone.0318265.ref036","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1161\/CIRCULATIONAHA.112.121996","article-title":"An early appointment to outpatient cardiac rehabilitation at hospital discharge improves attendance at orientation: a randomized, single-blind, controlled trial","volume":"127","author":"QR Pack","year":"2013","journal-title":"Circulation"},{"issue":"2","key":"pone.0318265.ref037","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1136\/hrt.82.2.234","article-title":"Why patients do not attend cardiac rehabilitation: role of intentions and illness beliefs","volume":"82","author":"A Cooper","year":"1999","journal-title":"Heart"},{"key":"pone.0318265.ref038","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1186\/s12913-014-0619-9","article-title":"Wake up, wake up! It\u2019s me! It\u2019s my life! patient narratives on person-centeredness in the integrated care context: a qualitative study","volume":"14","author":"G Greenfield","year":"2014","journal-title":"BMC Health Serv Res"},{"issue":"2","key":"pone.0318265.ref039","first-page":"2","article-title":"Medscape\u2019s response to the Institute of Medicine Report: Crossing the quality chasm: a new health system for the 21st century","volume":"3","author":"M Leavitt","year":"2001","journal-title":"MedGenMed"},{"issue":"Suppl","key":"pone.0318265.ref040","doi-asserted-by":"crossref","first-page":"S80","DOI":"10.1177\/0022146510383489","article-title":"Examining critical health policy issues within and beyond the clinical encounter: patient-provider relationships and help-seeking behaviors","volume":"51","author":"CA Boyer","year":"2010","journal-title":"J Health Soc Behav"},{"issue":"2","key":"pone.0318265.ref041","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1016\/j.socscimed.2004.11.067","article-title":"From a relationship to encounter: an examination of longitudinal and lateral dimensions in the doctor-patient relationship","volume":"61","author":"SJ Potter","year":"2005","journal-title":"Soc Sci Med"},{"issue":"Suppl","key":"pone.0318265.ref042","doi-asserted-by":"crossref","first-page":"S94","DOI":"10.1177\/0022146510383500","article-title":"The continued social transformation of the medical profession","volume":"51","author":"S Timmermans","year":"2010","journal-title":"J Health Soc Behav"},{"key":"pone.0318265.ref043","first-page":"27","article-title":"Modelling patient engagement in healthcare: insight for research and practice.","author":"G Graffigna","year":"2015","journal-title":"Patient engagement: a consumer-centered model to innovate healthcare"},{"key":"pone.0318265.ref044","author":"S Barello","year":"2014","journal-title":"The challenges of conceptualizing patient engagement in health care: a lexicographic literature review"},{"issue":"3","key":"pone.0318265.ref045","doi-asserted-by":"crossref","first-page":"e005582","DOI":"10.1136\/bmjopen-2014-005582","article-title":"\u201cEngage me in taking care of my heart\u201d: a grounded theory study on patient-cardiologist relationship in the hospital management of heart failure","volume":"5","author":"S Barello","year":"2015","journal-title":"BMJ Open"},{"key":"pone.0318265.ref046","doi-asserted-by":"crossref","first-page":"648","DOI":"10.1186\/1471-2458-14-648","article-title":"How to engage type-2 diabetic patients in their own health management: implications for clinical practice","volume":"14","author":"G Graffigna","year":"2014","journal-title":"BMC Public Health"},{"issue":"4 Pt 1","key":"pone.0318265.ref047","doi-asserted-by":"crossref","first-page":"1005","DOI":"10.1111\/j.1475-6773.2004.00269.x","article-title":"Development of the Patient Activation Measure (PAM): conceptualizing and measuring activation in patients and consumers","volume":"39","author":"JH Hibbard","year":"2004","journal-title":"Health Serv Res"},{"issue":"1","key":"pone.0318265.ref048","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1097\/XEB.0000000000000277","article-title":"Updated methodological guidance for the conduct of scoping reviews","volume":"19","author":"MDJ Peters","year":"2021","journal-title":"JBI Evid Implement"},{"issue":"1","key":"pone.0318265.ref049","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/2046-4053-4-1","article-title":"Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement","volume":"4","author":"D Moher","year":"2015","journal-title":"Syst Rev"},{"key":"pone.0318265.ref050","article-title":"Chapter 11: scoping reviews (2020 version).","author":"MDJ Peters","year":"2020","journal-title":"JBI manual for evidence synthesisJBI"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0318265","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,31]],"date-time":"2025-01-31T18:45:10Z","timestamp":1738349110000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0318265"}},"subtitle":[],"editor":[{"given":"Eisuke","family":"Amiya","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2025,1,31]]},"references-count":50,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,1,31]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0318265","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,31]]}}}