BackUsing the Heart Manuals
The Heart Manual based approach to cardiac rehabilitation is flexible enough to be implemented in a hospital cardiology department, as a primary care initiative driven by individual general practices or throughout a whole NHS district or area. Most delivery models have been tried and have succeeded, but more recently the tendency has been for large scale implementation through primary care trusts or local health care co-operatives.
Delivery of the Heart Manual can be readily adapted to most settings by a trained facilitator, since it is equally effective either as a stand-alone programme or as an integral part of an existing cardiac rehabilitation system.
Key Points
- The Heart Manual is an individualized and menu-based programme.
- The patient’s needs are determined by an initial assessment process which covers medical targets such as lifestyle changes and adherence to prescribed medications, with further reviews taking place at agreed intervals.
- The programme addresses the patient’s beliefs about the illness, and helps to change damaging negative thoughts and ideas to more helpful ones. This is particularly important because erroneous beliefs can lead to unhelpful coping strategies, such as the ‘over activity–rest trap.’
- Working with healthcare staff, the patient is helped to identify and change these unhelpful behaviours.
- Common psychological reactions to the diagnosis or to an acute event are explained, and self-management or appropriate referral to expert help is implemented.
- The Heart Manual has been shown to reduce unnecessary disability and to improve patients’ quality of life.
- Research has shown that the Heart Manual can dramatically improve the psychological outcome for patients, and that it also reduces health costs by decreasing the number of unplanned admissions for hospital care.
