{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,15]],"date-time":"2025-08-15T00:17:42Z","timestamp":1755217062519,"version":"3.43.0"},"reference-count":57,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T00:00:00Z","timestamp":1754352000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Acute myocardial infarction remains a major contributor to global morbidity and mortality. Cardiac rehabilitation is widely recognized as an essential component of the comprehensive medical management for patients with ST-elevation myocardial infarction, especially among those who have undergone percutaneous coronary intervention. Adherence to cardiac rehabilitation encompasses patient collaboration with a healthcare provider, active involvement in the treatment regimen, and persistence in practice, characterized by self-efficacy and relapse prevention. Outpatient cardiac rehabilitation constitutes the second phase of the continuum of care, bridging the inpatient and long-term maintenance stages. However, adherence to outpatient cardiac rehabilitation programs in China remains suboptimal. The factors influencing outpatient cardiac rehabilitation in patients with ST-elevation myocardial infarction after percutaneous coronary intervention have not yet been fully elucidated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To investigate the status and influencing factors of adherence to outpatient cardiac rehabilitation in patients with ST-elevation myocardial infarction after percutaneous coronary intervention one month after discharge in China and gain a deeper understanding of this phenomenon of interest.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>An explanatory sequential mixed-methods design will be employed to conduct this study with three phases. The first phase is a quantitative study with a cross-sectional design to assess the level of adherence to outpatient cardiac rehabilitation and related influences based on the Health Belief Model among 198 patients with ST-elevation myocardial infarction after percutaneous coronary intervention in two tertiary hospitals in Zhenjiang, Jiangsu Province, China. The second phase is followed by a qualitative study to explore the patients\u2019 perceived facilitators and barriers to adherence to outpatient cardiac rehabilitation. Purposive sampling, semi-structured interviews, and conventional content analysis approaches will be used to collect and analyze the data. The final phase links to integrating the data and developing a targeted strategy to improve adherence to outpatient cardiac rehabilitation among patients with ST-elevation myocardial infarction after percutaneous coronary intervention. The nominal group technique and &amp;amp;quot;weaving techniques&amp;amp;quot; will be implemented in accordance with the results of the preceding two phases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>A targeted strategy to improve outpatient cardiac rehabilitation adherence would be designed considering the factors affecting adherence to outpatient cardiac rehabilitation in patients with ST-elevation myocardial infarction after percutaneous coronary intervention.\n<\/jats:p><\/jats:sec><jats:sec><jats:title>Clinical Trial Registration<\/jats:title><jats:p>This study has been registered in the Chinese Clinical Trial Registry: ChiCTR2400080035.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcvm.2025.1542942","type":"journal-article","created":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T05:24:38Z","timestamp":1754371478000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Adherence to outpatient cardiac rehabilitation and related factors in STEMI after PCI in China: a sequential explanatory mixed method study 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