4 DISCUSSION
Cardiac rehabilitation programs for those patients could present a
reasonably acceptable method to promote the smooth transition of
patients to their new life post CABG. The impact of (CRP) on patient
health outcomes, including adaptation in lifestyle and improved
bio-physiological markers, has been well-documented in the
literature.18
This review assessed the impact of CRP
on CABG patients in terms of improving the HRQoL and their physiological
outcomes. Most of the literature involved in this review mentioned the
content for their CRP content (different dimensions of health-promoting
behaviors (HPBs) such as dietary counseling, smoking cessation…,
physiotherapy, breathing exercises, psychological counseling,
pharmacological treatment. Facts about their illness, clinical
manifestations, and potential complications), and the ways of applying
these types of CRP (face to face training, educational booklet and a
pamphlet, lecture, demonstration, question‑and‑answer, reinforcement,
feedback‑giving, and summarization, follow‑up telephone, and home
visits). The most common outcomes measured were HRQOL and physiological
variables which CRP displayed a positive effect on these outcomes. The
number of sessions and duration varies from 4 sessions, 45-60 minutes10,14 to 3 times training/week for 12
weeks12, to 60-220 min sessions9, to
16 sessions (15 minutes each) 11, and 7 times/week for
3 weeks (inpatients) with 2 training sessions daily, 45 minutes, each,
to 5 times/week for 6 months (outpatients).15 One
study by Akbari et al.9 includes family caregivers in
the CRP, by training them to help patients achieve self‑care activities
post‑discharge. Multi health professionals can give rehabilitation
interventions, some given by intensive care unit nurses, some were
physiotherapists, some studies used dietitians, physicians, and others.
Some studies reported some major limitations that may affect the
generalizability or external validity, such as small
sample8,11,13,15, in addition to selection problems of
participants12, or using convenience sampling method;
no randomization or random assignment.9 Also, short
follow-up period8-11, single-center of CRP /single
geographic area.8,13 Illiteracy of
participants10, no control group, and muscle training
was not telemonitored.12 Finally, not enough data for
economic evaluation.13