Hostname: page-component-586b7cd67f-r5fsc Total loading time: 0 Render date: 2024-11-23T04:41:30.830Z Has data issue: false hasContentIssue false
  • English
  • Français

Identifying elements for a comprehensive paediatric cardiac rehabilitation programme

Published online by Cambridge University Press:  11 August 2020

Tracy Curran Open the ORCID record for Tracy Curran [Opens in a new window] ,
Naomi Gauthier ,
Susan M. Duty  and
Rachele Pojednic
Tracy Curran*
Affiliation:
Department of Cardiology, Boston Children’s Hospital, Boston, MA, USA College of Natural, Behavioral, and Health Sciences, Simmons University, Boston, MA, USA
Naomi Gauthier
Affiliation:
Department of Cardiology, Boston Children’s Hospital, Boston, MA, USA
Susan M. Duty
Affiliation:
College of Natural, Behavioral, and Health Sciences, Simmons University, Boston, MA, USA
Rachele Pojednic
Affiliation:
College of Natural, Behavioral, and Health Sciences, Simmons University, Boston, MA, USA
*
Author for correspondence: Tracy Curran, PhD, 300 Longwood Ave., Boston, MA02115, USA. Tel: +1 617 355 5445; Fax: +617-730-4769. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction:

The aim of this study was to identify relevant content among four important domains for the development and structure of a paediatric cardiac rehabilitation curriculum for young patients with congenital heart disease using a consensus approach.

Methods:

A three-round e-Delphi study among congenital heart disease and paediatric exercise physiology experts was conducted. Round 1, experts provided opinions in a closed- and open-ended electronic questionnaire to identify specific elements necessary for inclusion in a paediatric cardiac rehabilitation programme. Round 2, experts were asked to re-rate the same items after feedback and summary data were provided from round 1. Round 3, the same experts were asked to re-rate items that did not reach consensus from round 2.

Results:

Forty-seven experts were contacted via e-mail to participate on the Delphi panel, 37 consented, 35 completed round 1, 29 completed round 2, and 28 completed the final round. After round 2, consensus was reached in 55 of 60 (92%) questionnaire items across four domains: exercise training, education, outcome metrics, and self-confidence.

Conclusion:

This study established consensus towards programme structure, exercise training principles, educational content, patient outcome measures, and self-confidence promotion. By identifying the key components within each domain, there is potential to benchmark recommended standards and practice guidelines for the development of a paediatric cardiac rehabilitation curriculum to be used and tested by exercise physiologists, paediatric and adult congenital cardiologists, and other healthcare team members for optimising the health and wellness of paediatric patients with congenital heart disease.

Keywords

Paediatric cardiac rehabilitationexercisecongenital heart diseasechildren and adolescentscurriculum
Type
Original Article
Information
Cardiology in the Young , Volume 30 , Issue 10 , October 2020 , pp. 1473 - 1481
Copyright
© The Author(s), 2020. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Triedman, J, Newburger, J. Trends in congenital heart disease. Circulation 2016; 133 2716–2733.CrossRefGoogle ScholarPubMed
Centers for Disease Control and Prevention. Data and statistics on congenital heart defects. 2010 Available from: https://www.cdc.gov/ncbddd/heartdefects/data.html Google Scholar
Riner, W, Sellhorst, S. Physical activity and exercise in children with chronic health conditions. J Sport Health Sci 2013; 2: 12–20.CrossRefGoogle Scholar
Takken, T, Giardini, A, Reybrouck, T, et al. Recommendations for physical activity, recreation sport, and exercise training in paediatric patients with congenital heart disease: a report from the Exercise, Basic & Translational Research Section of the European Association of Cardiovascular Prevention and Rehabilitation, the European Congenital Heart and Lung Exercise Group, and the Association for European Paediatric Cardiology. Eur J Cardiovasc Prev Rehab 2012; 19: 1034–1065.CrossRefGoogle ScholarPubMed
Mampuya, W. Cardiac rehabilitation past, present and future: an overview. Cardiovasc Diagn Ther 2012; 2: 38–49. doi: 10.3978/j.issn.2223-3652.2012.01.02 Google ScholarPubMed
Longmuir, P, Brothers, J, de Ferranti, S, et al. Promotion of physical activity for children and adults with congenital heart disease. Circulation 2013; 127: 2147–2159.CrossRefGoogle ScholarPubMed
Tikkanen, A, Oyaga, A, Riano, O, Alvaro, E, Rhodes, J. Paediatric cardiac rehabilitation in congenital heart disease: a systematic review. Cardiol Young 2012; 3: 241–250.CrossRefGoogle Scholar
Bradley, L, Galioto, F, Vaccaro, P, Hansen, D, Vaccaro, J. Effect of intense aerobic training on exercise performance in children after surgical repair of tetralogy of Fallot or complete transposition of the great arteries. Am J Cardiol 1985; 56: 816–818.CrossRefGoogle ScholarPubMed
Driscoll, D, Danielson, G, Puga, F, Schaff, H, Heise, C, Statts, B. Exercise tolerance and cardiorespiratory response to exercise after the Fontan operation for tricuspid atresia or functional single ventricle. Am J Cardiol 1986; 5: 1087–1094.CrossRefGoogle Scholar
Goldberg, B, Fripp, R, Lister, G, Loke, J, Nicholas, J, Talner, N. Effect of physical training on exercise performance in children following surgical repair of congenital heart disease. Pediatrics 1981; 68: 691–699.Google ScholarPubMed
Rhodes, J, Curran, T, Camil, L, et al. Impact of cardiac rehabilitation on the exercise function of children with serious congenital heart disease. Pediatrics 2005; 116: 1339–1345.CrossRefGoogle ScholarPubMed
Pediatric Heart Network. What is the pediatric heart network (PHN)? 2017. http://www.pediatricheartnetwork.org/ForProviders/WhatisthePediatricHeartNetwork.aspx Google Scholar
de Villiers, M, de Villiers, P, Kent, A. The Delphi technique in health sciences education research. Med Teacher 2005; 27: 639–643. doi: 10.1080/13611260500069947 CrossRefGoogle ScholarPubMed
Fink, A, Kosecoff, M, Chassin, M, Brook, R. Consensus methods: characteristics and guidelines for use. Am J Public Health 1984; 74: 979–983.CrossRefGoogle ScholarPubMed
Donohoe, H, Needham, R. Moving best practice forward: Delphi characteristics, advantages, potential problems and solutions. Int J Tour Res 2009; 11: 415–437. doi: 10.1002/jtr.709 CrossRefGoogle Scholar
Stone Fish, L, Osborn, J. Therapists’ views of family life: a Delphi study. Fam Relat 1992; 41: 409–416.CrossRefGoogle Scholar
Keeney, S, Hasson, F, McKenna, H. The Delphi Technique in Nursing and Health Research. Wiley-Blackwell, Oxford, 2010.Google Scholar
Hsu, C, Sandford, B. The Delphi technique: making sense of consensus. Pract Assess Res Eval 2007; 12: 1–8.Google Scholar
Shah, H, Kalaian, S. Which parametric statistical method to use for analyzing Delphi data? J Mod Appl Stat Method 2009; 8: 226–232.CrossRefGoogle Scholar
Sumsion, T. The Delphi technique. Br J Occup Ther 1998; 61: 153–156.CrossRefGoogle Scholar
Harris, P, Taylor, R, Thielke, R, et al. Research electronic data capture (REDCap) – a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform 2009; 42: 377–381.CrossRefGoogle ScholarPubMed
Morrison, M, Sands, A, McCusker, C, et al. Exercise training improves activity in adolescents with congenital heart disease. Heart 2013; 99: 1122–1128.CrossRefGoogle ScholarPubMed
Rhodes, J, Curran, T, Camil, L, et al. Sustained effects of cardiac rehabilitation in children with serious congenital heart disease. Pediatrics 2006; 118: 586–593.CrossRefGoogle ScholarPubMed
Fredriksen, P, Kahrs, N, Blaasvaer, S, et al. Effect of physical training in children and adolescents with congenital heart disease. Cardiol Young 2000; 10: 107–114.CrossRefGoogle ScholarPubMed
Moons, P, Barrea, C, De Wolf, D. Changes in perceived health of children with congenital heart disease after attending a special sports camp. Pediatr Cardiol 2006; 27: 67–72.CrossRefGoogle ScholarPubMed
Riebe, D, Ehrman, J, Liguori, G, Magal, M. ACSMs Guidelines for Exercise Testing and Prescription, 10th edn. Wolters Kluwer, Philadelphia, PA, 2018.Google Scholar
U.S. Department of Health and Human Services. Physical Activity Guidelines for Americans, 2nd edn. U.S. Department of Health and Human Services, Washington, DC, 2018. https://health.gov/paguidelines/second-edition/pdf/Physical_Activity_Guidelines_2nd_edition.pdf Google Scholar
Moholdt, T, Madssen, E, Rognmo, O, Aamot, I. The higher the better? Interval training intensity in coronary heart disease. J Sci Med Sport 2014; 17: 506–510.CrossRefGoogle ScholarPubMed
American Association of Cardiovascular & Pulmonary Rehabilitation. Guidelines for Cardiac Rehabilitation and Secondary Prevention Programs/American Association of Cardiovascular and Pulmonary Rehabilitation, 5th edn. Human Kinetics, Champaign, IL, 2013. 214 p.Google Scholar
Supplementary material: PDF

Curran et al. supplementary material

Curran et al. supplementary material 1

Download Curran et al. supplementary material(PDF)
PDF 167.3 KB
Supplementary material: PDF

Curran et al. supplementary material

Curran et al. supplementary material 2

Download Curran et al. supplementary material(PDF)
PDF 656.5 KB