111536
论文已发表
注册即可获取德孚的最新动态
IF 收录期刊
- 3.4 Breast Cancer (Dove Med Press)
- 3.2 Clin Epidemiol
- 2.6 Cancer Manag Res
- 2.9 Infect Drug Resist
- 3.7 Clin Interv Aging
- 5.1 Drug Des Dev Ther
- 3.1 Int J Chronic Obstr
- 6.6 Int J Nanomed
- 2.6 Int J Women's Health
- 2.9 Neuropsych Dis Treat
- 2.8 OncoTargets Ther
- 2.0 Patient Prefer Adher
- 2.2 Ther Clin Risk Manag
- 2.5 J Pain Res
- 3.0 Diabet Metab Synd Ob
- 3.2 Psychol Res Behav Ma
- 3.4 Nat Sci Sleep
- 1.8 Pharmgenomics Pers Med
- 2.0 Risk Manag Healthc Policy
- 4.1 J Inflamm Res
- 2.0 Int J Gen Med
- 3.4 J Hepatocell Carcinoma
- 3.0 J Asthma Allergy
- 2.2 Clin Cosmet Investig Dermatol
- 2.4 J Multidiscip Healthc
已发表论文
中国基于运动的心脏康复的背景障碍与促进因素：一项基于 CFIR 2.0 框架的政策、文化及组织决定因素的系统综述
Authors Liang J , Tan X, Li Y, Yang X, Miao J, Xu Y, Li W
Received 4 September 2025
Accepted for publication 5 December 2025
Published 17 December 2025 Volume 2025:18 Pages 8067—8080
DOI https://doi.org/10.2147/JMDH.S565297
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Editor who approved publication: Professor Charles V Pollack
Jing Liang,1 Xiaoli Tan,2 Yuling Li,1 Xiaobing Yang,1 Jingmei Miao,1 Yanfang Xu,1 Wenjuan Li1
1Department of Cardiology, Handan First Hospital, Handan, Hebei, People’s Republic of China; 2Department of Cardiology, Bishan Hospital Affiliated to Chongqing Medical University (Bishan District People’s Hospital), Chongqing, People’s Republic of China
Correspondence: Xiaoli Tan, Department of Cardiology, Bishan Hospital Affiliated to Chongqing Medical University (Bishan District People’s Hospital), Bishan District, Chongqing, 402760, People’s Republic of China, Tel +86 136 3547 7612, Email 13635477612@163.com
Purpose: Exercise-based cardiac rehabilitation (CR) is internationally recognized as an essential component of secondary prevention for coronary heart disease (CHD). However, participation in China remains low. Although barriers to CR have been extensively reported worldwide, China’s regional disparities and distinct exercise traditions create context-specific constraints and opportunities. This study conducted a systematic review using the updated Consolidated Framework for Implementation Research (CFIR) 2.0 to identify multi-level factors that facilitate or impede CR implementation within Chinese healthcare systems.
Methods: Seven major databases were searched through October 2024 for studies examining determinants of participation in, or delivery of, exercise-based CR among CHD patients or clinical staff. Study quality was evaluated using the Mixed Methods Appraisal Tool, and extracted findings were organized according to the five CFIR 2.0 domains.
Results: Twenty studies met the inclusion criteria, and several influences distinctive to the Chinese context were identified. For example, hospitals in better-resourced provinces provided more complete and structured CR services, whereas those in less developed regions faced fragmented referral pathways and severely limited rehabilitation infrastructure. Cultural expectations further shaped engagement, with many patients favoring medication-based management over exercise, despite traditional practices such as Tai Chi and Baduanjin being viewed positively and offering a culturally acceptable entry point for rehabilitation. Digital tools, including mobile-health platforms and wearable devices, increasingly supported participation, particularly where in-person services were difficult to access. At the institutional level, CR implementation was more successful in centers with established multidisciplinary teams and stable funding, while hospitals lacking such support struggled to maintain consistent programs.
Conclusion: By clarifying how structural, institutional, and patient-level barriers interact to restrict cardiac rehabilitation in China, the review emphasizes that nationwide advancement will require policy reinforcement, better-trained rehabilitation teams, and implementation approaches tailored to patient needs.
Keywords: coronary heart disease, exercise rehabilitation, facilitators, barriers, consolidated framework for implementation research, mixed methods research
1Department of Cardiology, Handan First Hospital, Handan, Hebei, People’s Republic of China; 2Department of Cardiology, Bishan Hospital Affiliated to Chongqing Medical University (Bishan District People’s Hospital), Chongqing, People’s Republic of China
Correspondence: Xiaoli Tan, Department of Cardiology, Bishan Hospital Affiliated to Chongqing Medical University (Bishan District People’s Hospital), Bishan District, Chongqing, 402760, People’s Republic of China, Tel +86 136 3547 7612, Email 13635477612@163.com
Purpose: Exercise-based cardiac rehabilitation (CR) is internationally recognized as an essential component of secondary prevention for coronary heart disease (CHD). However, participation in China remains low. Although barriers to CR have been extensively reported worldwide, China’s regional disparities and distinct exercise traditions create context-specific constraints and opportunities. This study conducted a systematic review using the updated Consolidated Framework for Implementation Research (CFIR) 2.0 to identify multi-level factors that facilitate or impede CR implementation within Chinese healthcare systems.
Methods: Seven major databases were searched through October 2024 for studies examining determinants of participation in, or delivery of, exercise-based CR among CHD patients or clinical staff. Study quality was evaluated using the Mixed Methods Appraisal Tool, and extracted findings were organized according to the five CFIR 2.0 domains.
Results: Twenty studies met the inclusion criteria, and several influences distinctive to the Chinese context were identified. For example, hospitals in better-resourced provinces provided more complete and structured CR services, whereas those in less developed regions faced fragmented referral pathways and severely limited rehabilitation infrastructure. Cultural expectations further shaped engagement, with many patients favoring medication-based management over exercise, despite traditional practices such as Tai Chi and Baduanjin being viewed positively and offering a culturally acceptable entry point for rehabilitation. Digital tools, including mobile-health platforms and wearable devices, increasingly supported participation, particularly where in-person services were difficult to access. At the institutional level, CR implementation was more successful in centers with established multidisciplinary teams and stable funding, while hospitals lacking such support struggled to maintain consistent programs.
Conclusion: By clarifying how structural, institutional, and patient-level barriers interact to restrict cardiac rehabilitation in China, the review emphasizes that nationwide advancement will require policy reinforcement, better-trained rehabilitation teams, and implementation approaches tailored to patient needs.
Keywords: coronary heart disease, exercise rehabilitation, facilitators, barriers, consolidated framework for implementation research, mixed methods research