{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T01:57:34Z","timestamp":1787968654745,"version":"build-2784847793"},"reference-count":49,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,12,18]],"date-time":"2024-12-18T00:00:00Z","timestamp":1734480000000},"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. Public Health"],"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>This study aimed to systematically develop a nurse-led complex intervention to enhance the quality of and adherence to home-based cardiac rehabilitation (HBCR) care for patients who have undergone transcatheter aortic valve replacement (TAVR). The intervention integrated stakeholder perspectives, expert insights, empirical evidence, and theoretical frameworks.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We initially searched for initial cardiac rehabilitation strategies based on the \u201cBehavior Change Wheel\u201d model and literature review. The Delphi method was used in three rounds of consultations. The guidelines for the Conducting and Reporting of Delphi studies were also followed. The Delphi panel consisted of 15 experts in rehabilitation medicine, clinical medicine, cardiovascular nursing, behavioral science, community nursing, geriatric nursing, and nursing management from various provinces and cities in China. Panelists were asked to rate the effectiveness of HBCR strategies on a 5-point Likert scale.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A questionnaire was sent to the members of the expert panel via email. The consensus from 15 experts led to the development of a framework in round 3. The response rates for the three rounds were 88.23, 100.00, and 100.00%, respectively. The expert authority coefficients for all rounds were 0.95. The Kendall coefficients obtained in the three rounds were 0.09, 0.78, and 0.87, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>A set of strategies was developed for a comprehensive HBCR program for patients with TAVR, which can provide practical methods for relevant government departments, healthcare professionals, and patients\u2019 families. Future research should investigate the experiences of stakeholders and assess the cost-effectiveness of implementing these strategies.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2024.1491311","type":"journal-article","created":{"date-parts":[[2024,12,18]],"date-time":"2024-12-18T06:45:00Z","timestamp":1734504300000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Development of a complex intervention to prevent complications in patients recovering at home after transcatheter aortic valve replacement by optimizing home-based cardiac rehabilitation processes: a Delphi study"],"prefix":"10.3389","volume":"12","author":[{"given":"Ying Ying","family":"Jia","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhi Tin","family":"Guo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu Ping","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian Ping","family":"Song","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,12,18]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"688","DOI":"10.1177\/2047487316686442","article-title":"Cardiac rehabilitation programme after transcatheter aortic valve implantation versus surgical aortic valve replacement: systematic review and meta-analysis","volume":"24","author":"Ribeiro","year":"2017","journal-title":"Eur J Prev Cardiol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1577","DOI":"10.1111\/jocs.14226","article-title":"TAVI and the future of aortic valve replacement","volume":"34","author":"Howard","year":"2019","journal-title":"J Card Surg"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"235","DOI":"10.1016\/j.acvd.2022.04.001","article-title":"TAVI in 2022: remaining issues and future direction","volume":"115","author":"Webb","year":"2022","journal-title":"Arch Cardiovasc Dis"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1313","DOI":"10.1016\/j.jacc.2016.12.006","article-title":"2017 ACC expert consensus decision pathway for Transcatheter aortic valve replacement in the Management of Adults with Aortic Stenosis: a report of the American College of Cardiology Task Force on clinical expert consensus documents","volume":"69","author":"Otto","year":"2017","journal-title":"J Am Coll Cardiol"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"e012355","DOI":"10.1161\/jaha.119.012355","article-title":"Profiling hospital performance on the basis of readmission after Transcatheter aortic valve replacement in Ontario, Canada","volume":"8","author":"Elbaz-Greener","year":"2019","journal-title":"J Am Heart Assoc"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1019","DOI":"10.1001\/jama.2015.1474","article-title":"Clinical outcomes at 1 year following transcatheter aortic valve replacement","volume":"313","author":"Holmes","year":"2015","journal-title":"JAMA"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"102143","DOI":"10.1016\/j.cpcardiol.2023.102143","article-title":"Development and validation of a machine learning risk-prediction model for 30-day readmission for heart failure following Transcatheter aortic valve replacement (TAVR-HF score)","volume":"49","author":"Zahid","year":"2024","journal-title":"Curr Probl Cardiol"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"210","DOI":"10.1016\/j.cjca.2023.09.010","article-title":"Lifetime Management of Patients with Severe Aortic Stenosis in the era of Transcatheter aortic valve replacement","volume":"40","author":"Jubran","year":"2023","journal-title":"Can J Cardiol"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"102231","DOI":"10.1016\/j.cpcardiol.2023.102231","article-title":"Can virtual reality have effects on cardiac rehabilitation? 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