Knowledge, Attitudes, and Practices Regarding Cardiac Rehabilitation Among Patients with Chronic Heart Failure and Their Families: A Cross-Sectional Study

Xiaohua Gao,1,* Jianzhou Yang,2,* Wenjun Cao,3 Yaoqiang Liu,4 Tingting Zhao1 1Department of Cardiovascular Medicine, Heping Hospital Affiliated to Changzhi Medical College, Changzhi, Shanxi, People’s Republic of China; 2Department of Public Health and Preventive Medicine, Changzhi Medical College, Changzhi, Shanxi, People’s Republic of China; 3Department of Science and Technology, Changzhi Medical College, Changzhi, Shanxi, People’s Republic of China; 4Department of Internal Medicine, Huaihai Hospital Affiliated to Changzhi Medical College, Changzhi, Shanxi, People’s Republic of China*These authors contributed equally to this workCorrespondence: Xiaohua Gao, Email [email protected]: Chronic heart failure (CHF) impairs heart function and affects patients’ well-being, while cardiac rehabilitation (CR) improves outcomes. In this cross-sectional survey, we assessed knowledge, attitudes, and practices (KAP) related to CR in patients with CHF and their family caregivers.Patients and Methods: A cross-sectional survey was conducted at Heping Hospital, affiliated with Changzhi Medical College, from July 1 to October 10, 2024. Data were collected using questionnaires that included demographic information and evaluations of KAP scores. A total of 500 questionnaires were distributed to eligible participants.Results: Of the 500 questionnaires distributed, 492 valid responses were obtained, yielding a response rate of 98.4%. Among the respondents, 277 (56.3%) were patients, with 191 (38.8%) aged 60 or older. The mean knowledge, attitude, and practice scores were 6.90 ± 5.63 (range: 0– 30), 33.43 ± 3.31 (range: 9– 45), and 28.01 ± 4.46 (range: 8– 40), respectively. Multivariate logistic regression analysis identified several factors associated with proactive practice: knowledge score (OR = 1.114, 95% CI: [1.053, 1.179]), college degree (OR = 3.089, 95% CI: [1.054, 9.053]), absence of medical insurance (OR = 6.762, 95% CI: [3.597, 12.713]), no family history of heart issues (OR = 4.414, 95% CI: [2.351, 8.288]), and non-participation in CR (OR = 0.206, 95% CI: [0.087, 0.489]). The SEM results showed that knowledge directly affected attitude (β = 0.321, p < 0.001) and practice (β = 0.285, p = 0.004), and attitude directly affected practice (β = 0.217, p < 0.001). Additionally, knowledge indirectly affected practice through attitude (β = 0.355, p < 0.001).Conclusion: Patients with CHF and their families showed insufficient knowledge but positive attitudes and proactive practices regarding CR. Targeted educational interventions are recommended to improve knowledge, particularly for younger patients and those without prior CR training, to enhance rehabilitation effectiveness.Keywords: chronic heart failure, cardiac rehabilitation, KAP, cross-sectional studies, health education