Quality of Life and the Nursing Approach in Cardiopulmonary Rehabilitation: Traditional Review

Authors

DOI:

https://doi.org/10.5281/zenodo.18008092

Keywords:

Activities of daily living, Rehabilitation, Rehabilitation Nursing, Quality of Life

Abstract

Cardiac and pulmonary rehabilitation programs play a crucial role in improving the quality of life of individuals with cardiovascular and respiratory diseases. Cardiopulmonary rehabilitation is a comprehensive intervention that reduces cardiovascular risks, alleviates the physical and psychological effects of disease, prevents secondary cardiac events, and decreases symptoms such as dyspnea and fatigue. Moreover, it enhances exercise capacity, facilitates the return to an active lifestyle, stabilizes or reverses systemic manifestations of the disease, thereby improving quality of life and reducing healthcare costs. Nurses play a central role in promoting and maintaining health, identifying risk factors at an early stage, and providing patient education throughout the rehabilitation process. As key members of the multidisciplinary team, nurses collaborate with physicians, physiotherapists, clinical exercise physiologists, dietitians, and psychologists to ensure coordinated and patient-centered care, contributing significantly to patients’ overall recovery and well-being. Interventions that enhance the effectiveness of cardiopulmonary rehabilitation and improve patients’ quality of life include smoking cessation, physical activity promotion, nutritional and weight management, blood pressure and diabetes control, psychosocial support, sexual health counseling, return-to-work facilitation, adherence to medical therapy, airway clearance strategies, and cognitive-behavioral therapies. Increasing patient participation in rehabilitation programs and ensuring continuity of care should be considered primary goals for achieving optimal outcomes in cardiopulmonary rehabilitation.

References

Candelaria, D., Baptiste, D., & Park, L. G. (2025). Beyond the Bedside: Nurses as Champions for Secondary Prevention and Cardiac Rehabilitation. The Journal of Cardiovascular Nursing. 40(5):403-405. [CrossRef] [PubMed]

Khadanga, S., Savage, P., Keteyian, S., Yant, B., Gaalema, D., & Ades, P. (2024). Cardiac rehabilitation: the gateway for secondary prevention. Heart. 110(24):1427-1436. [CrossRef] [PubMed]

Laranjo, L., Lanas, F., Sun, M. C., Chen, D. A., Hynes, L., Imran, T. F., et al., (2024). World Heart Federation Roadmap for Secondary Prevention of Cardiovascular Disease: 2023 Update. Global Heart, 19(1):8. [CrossRef] [PubMed]

WHO. (1993). Rehabilitation after cardiovascular diseases, with special emphasis on developing countries. Report of a WHO Expert Committee. World Health Organ Tech Rep Ser, 831:1-122. [PubMed]

Piepoli, M. F., Hoes, A. W., Agewall, S., et al. (2016). 2016 European guidelines on cardiovascular disease prevention in clinical practice: the Sixth Joint Task Force of the European Society of Cardiology and Other Societies on cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts) developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Eur Heart J. 37(29):2315-2381. [CrossRef] [PubMed]

Promwong, W., Meenongwah, J. (2024). Clinical Outcomes of Nurse-Led Cardiac Rehabilitation Programs in Patients with Heart Failure: A Systematic Review. Journal of Thailand Nursing and Midwifery Council. 39(1):47-63. [CrossRef]

Holland, A. E., Spathis, A., Marsaa, K., Bausewein, C., Ahmadi, Z., Burge, A. T., Pascoe, a., Gadowski, A. W., & Ekström, M. (2024). European Respiratory Society clinical practice guideline on symptom management for adults with serious respiratory illness. Eur Respir J. 63:2400335. [CrossRef] [PubMed]

Güell, M. R., Cejudo, P., Rodriguez-Trigo, G., Galdiz, J. B., Casolive, V., Regueiro, M., & Soler-Catalu˜na, J. J. (2012). Standards for Quality Care in Respiratory Rehabilitation in Patients With Chronic Pulmonary Disease. Arch Bronconeumol. 48(11):396–404. [CrossRef] [PubMed]

Shenoy, M. A., & Paul, V. (2023). Pulmonary Rehabilitation. National Library of Medicine. [PubMed]

Souto-Miranda, S., Rodriguesa, G., Spruit, M. A., & Marques, A. (2022). Pulmonary rehabilitation outcomes in individuals with chronic obstructive pulmonary disease: A systematic review. Annals of Physical and Rehabilitation Medicine. 65:101564. [CrossRef] [PubMed]

Rochester, C. L., Alison, J. A., Carlin, B., Jenkins, A. R., Cox, N. S., Bauldoff, G., Bhatt, S. P., Bourbeau, J., & Holland, A. E. (2023). Pulmonary Rehabilitation for Adults with Chronic Respiratory DiseaseAn Official American Thoracic Society Clinical Practice Guideline. American Journal of Respiratory and Critical Care Medicine. 208(4). [CrossRef] [PubMed]

Agusti, A., Celli, B. R., Criner, G., Halpin, D., Montes de Oca, M., Ozoh, O. B., Salvi, S., Vogelmeier, C., & Zheng, J. (2025). Global Strategy For The Diagnosis, Management and Prevention of Chronic Obstructive Pulmonary Disease (2025 Report). Global Initiative For Chronic Obstructive Lung Disease. https://goldcopd.org/wp-content/uploads/2024 /11/GOLD-2025-Report-v1.015Nov2024_WMV.pdf

Wang, O., Tang, H., & Zhang, M. (2025). The clinical nursing effect of empowerment-based continuing nursing combined with pulmonary rehabilitation for chronic obstructive pulmonary disease. BMC Pulmonary Medicine. 25:315. [CrossRef] [PubMed]

Bolton, C. E., Bevan-Smith, E. F., Blakey, J. D., Crowe, P., Elkin, S. L., Garrod, R., et al., (2013). British Thoracic Society guideline on pulmonary rehabilitation in adults. Thorax, 68(supp 2):ii1–ii30. [CrossRef]

Lacasse, Y., Goldstein, R., Lasserson Toby, J., et al. (2006). Pulmonary rehabilitation for chronic obstructive pulmonary disease. Cochrane Database Syst Rev. (4):CD0037993. [CrossRef] [PubMed]

Jones, P. W. (2002). Interpreting thresholds for a clinically significant change in health status in asthma and COPD. Eur Respir J, 19:398–404. [CrossRef] [PubMed]

Griffiths, T. L., Burr, M. L., Campbell, I. A., et al. (2000). Results at 1 year of outpatient multidisciplinary pulmonary rehabilitation: a randomised controlled trial. Lancet, 355.362–8. [CrossRef] [PubMed]

Coventry, P. A., & Hind, D. (2007). Comprehensive pulmonary rehabilitation for anxiety and depression in adults with chronic obstructive pulmonary disease: systematic review and meta-analysis. J Psychosom Res, 63(1), 551–65. [CrossRef] [PubMed]

Korkmaz, C., Demirbas, S., Vatansev, H., Yildirim, E., Teke, T., & Zamani, A. (2020). Effects of comprehensive and intensive pulmonary rehabilitation and nutritional support on quality of life and functional status in patients with chronic obstructive pulmonary disease. Journal of International Medical Research, 48(4), 1–14. [CrossRef] [PubMed]

Xia, X., Xia, K., Guangxi Li, X. Y., Song, J., Liu, Y., Liu, X., & Zhang, H. (2025). Factors Influencing Compliance with Pulmonary Rehabilitation in Patients with Stable COPD: a Cross Sectional Study. International Journal of Chronic Obstructive Pulmonary Disease. 20;895–904. [CrossRef] [PubMed]

McMahon, S. R., Ades, P. A., & Thompson, P. D. (2017). The role of cardiac rehabilitation in patients with heart disease. Trends Cardiovasc Med. 27(6), 420-425. [CrossRef] [PubMed]

Türen, S., Çetinkaya Işık, F., & Türen, S. (2024). The effect of cardiac rehabilitation program on quality of life, biophysiological parameters, and psychological features in patients with cardiovascular disease. Turk J Cardiovasc Nurs, 15(36), 25-32. [CrossRef]

Abraham, L. N., Sibilitz, K. L., Berg, S. K., et al. (2021). Exercise-based cardiac rehabilitation for adults after heart valve surgery. Cochrane Database Syst Rev, 5(5); CD010876. [CrossRef] [PubMed]

Moreira, J., Bravo, J., Aguiar, P., Delgado, B., Raimundo, A., & Boto, P. (2024). Physical and Mental Components of Quality of Life after a Cardiac Rehabilitation Intervention: A Systematic Review and Meta- Analysis. J. Clin. Med, 13;5576. [CrossRef] [PubMed]

Patti, A., Merlo, L., Ambrosetti, M., & Sarto, P. (2021). Exercise-based cardiac rehabilitation programs in heart failure Patients. Heart Fail Clin. 17(2), 263-271. [CrossRef] [PubMed]

Uysal, H. (2024). Nursing in Cardiac Rehabilitation. In: Rehabilitation Nursing: Basic Principles and Practice. Editors:Tülay Başak, Ayla Demirtaş. Ankara: Ankara: Nobel Medical Bookstores. p.385-415.

Kurnianto, A.A., Kovács, S., Ágnes, N., & Kumar, P. (2025). Economic Evaluations of Rehabilitation Interventions: A Scoping Review with Implications for Return to Work Programs. Healthcare, 13;1152. [CrossRef]

Sun, Y. A., Kalpakavadi, S., Prior, S., Thrift, A. G., Waddingham, S., Hoang Phan, H., & Gall, S. L. (2023). Socioeconomic status and health related quality of life after stroke: a systematic review and meta analysis. Health and Quality of Life Outcomes, 21; 115. [CrossRef] [PubMed]

Yohannes, A. M. (2024). Psychosocial Support in Pulmonary Rehabilitation. Respir Care, 69(6), 664–677. [CrossRef] [PubMed]

Zheng, Y., Zhou, L., Qin, S., Guo, J., & Qin, B. (2024). The Impact of Home Cardiac Rehabilitation on Quality of Life and Psychological Well-Being in Patients with Coronary Heart Disease: A Randomized Controlled Study. Med Sci Monit, 30;e942803-1–e942803-9. [CrossRef] [PubMed]

Zhang, H., Hu, D., Xu, Y., Wu, L., & Lou, L. (2022). Effect of pulmonary rehabilitation in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis of randomized controlled trials, Annals of Medicine, 54(1), 262-273. [CrossRef] [PubMed]

Coleman, S. R. M., Menson, K. E., Kaminsky, D. A., & Gaalema, D. E. (2023). Smoking Cessation Interventions for Patients With Chronic Obstructive Pulmonary Disease. A Narrative Review With Implications For Pulmonary Rehabilitation. Journal of Cardiopulmonary Rehabilitation and Prevention, 43(4), 259-269. [CrossRef] [PubMed]

Wing Mei Cheng, S., McKeough, Z. J., McNamara, R. J., & Alison, J. A. (2023). Pulmonary Rehabilitation Using Minimal Equipment for People With Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis. Physical Therapy & Rehabilitation Journal, 103(5), 1-11. [CrossRef] [PubMed]

Pelliccia, A., Sharma, S., Gati, S., et al. (2021). 2020 ESC Guidelines on sports cardiology and exercise in patients with cardiovascular disease. Eur Heart J, 42(1), 17-96. [CrossRef] [PubMed]

Goel, K., Pack, Q. R., Lahr, B., et al. (2015). Cardiac rehabilitation is associated with reduced long-term mortality in patients under going combined heart valve and CABG surgery. Eur J Prev Cardiol, 22(2), 159-168. [CrossRef] [PubMed]

Crespo Garea, S., & Díaz, M. J. F. (2025). Nursing interventions for cardiovascular disease prevention: a narrative review of evidence-based strategies. BMC Nursing, 24(1), 1269. [CrossRef] [PubMed]

Kweon, S., Sohn, M. K., Jeon, J. O., Kim, S., Jeon, H., Lee, H., Ahn, S-C., Park, S. H., & Jee, S. (2017). Quality of Life and Awareness of Cardiac Rehabilitation Program in People With Cardiovascular Diseases. Ann Rehabil Med, 41(2), 248-256. [CrossRef] [PubMed]

Arjunan, P., & Trichur, R. V. (2021). The Impact of Nurse-Led Cardiac Rehabilitation on Quality of Life and Biophysiological Parameters in Patients With Heart Failure: A Randomized Clinical Trial. The Journal of Nursing Research, 29(1), 1-9. [CrossRef] [PubMed]

Li, M. (2024). Analysis of the Effect of Respiratory Rehabilitation Nursing on the Quality of Life of Patients with Chronic Obstructive Pulmonary Disease. Journal of Clinical and Nursing Research, 8(5), 361-366. [CrossRef]

Ma, H., Wang, J., Sun, J., Pan, K., Wu, K., Sun, C., & Liu, X. (2021). Effect of cardiopulmonary rehabilitation nursing on exercise endurance and quality of life of stable COPD patients. Am J Transl Res, 13(6), 7356-7362. [PubMed]

Myers, J., Prakash, M., Froelicher, V., Do, D., Partington, S., & Atwood, J. E. (2002). Exercise capacity and mortality among men referred for exercise testing. N Engl J Med, 346, 793-801. [CrossRef] [PubMed]

Okur, İ., Aksoy, C. C., Yaman, F., & Şen, T. (2021). Effect of Exercise-Based Cardiac Rehabilitation Program on Functional Capacity, Kinesiophobia Level and Quality of Life in Patients with Coronary Artery Disease. Suleyman Demirel University Journal of Health Sciences, 12(3), 341-350. [CrossRef]

Troosters, T., Janssens, W., Demeyer, H., Rabinovich, R. A. (2023). Pulmonary rehabilitation and physical interventions. Eur Respir Rev, 32:220222. [CrossRef] [PubMed]

Chao, A. M., Paul, A., Hodgkins, J. V., & Wadden, T. A. (2024). A Guideline-Directed Approach to Obesity Treatment. Diabetes Spectr, 37(4), 281-295. [CrossRef] [PubMed]

Cano de la Cuerda, R., Alguacil Diego, I. M., Alonso Martı´n, J. J., Sa´nchez, A. M., & Miangolarra Page, J. C. (2012). Cardiac Rehabilitation Programs and Health-Related Quality of Life. State of the Art. Rev Esp Cardiol, 65(1), 72–79. [CrossRef] [PubMed]

World Heart Federation. (2024). World Heart Federation Roadmap for Secondary Preventıon of CVD-Update. Informing health systems approaches to CVD by prioritizing practical, proven, cost-effective action. Glob Heart, 19(1):8. [CrossRef] [PubMed]

Mc Sharry, J., Murphy, P. J., & Byrne, M. (2016). Implementing international sexual counselling guidelines in hospital cardiac rehabilitation: development of the CHARMS intervention using the Behaviour Change Wheel. Implementation Science. 11:134. [CrossRef] [PubMed]

Piegza, M., Smolarczyk, J., & Piegza, J. (2025). Sexual and Cardiovascular health.Factors Influencing on the Quality of Sexual Life of Coronary Heart Disease Patients - a Narrative Review. Vascular Health and Risk Management, 21:51–60. [CrossRef] [PubMed]

Tjahjono, C. T., & Arthamin, M. Z. (2024). The Role of Cardiac Rehabilitation in Facilitating Return to Work After Cardiovascular Events. Medical Research Archives, 12(12). [CrossRef]

Lareau, S., ZuWallack, R., & Nici, L. (2025). Increasing Quality and Quantity of Life in Individuals with Chronic Obstructive Pulmonary Disease: A Narrative Review with an Emphasis on Pulmonary Rehabilitation. Life, 15:750. [CrossRef]

Ladeira, I. T., Oliveira, P. N., Campos, L. C., Lima, R. J., & Guimarães, M. S. (2022). Quality of Life and Exercise Performance in COPD is there a Link? J Card Pulm Rehabi, 6(2), 158.

Solak, Ö., Yaman, F., Ulaşlı, A. M., Eroğlu, S., Akçi, Ö., Özkeçeci, G., Toktaş, H., & Dündar, Ü. (2015). Improvement in Life Quality, Functional Capacity and Depression Level After Cardiac Rehabilitation. Turk J Phys Med Rehab, 61.130-5. [CrossRef]

Anderson, L., Oldridge, N., Thompson, D. R., et al. (2016). Exercise-based cardiac rehabilitation for coronary heart disease: cochrane systematic reiew and meta-analysis. J Am Coll Cardiol, 67:1-12. [CrossRef] [PubMed]

Hsu, C. J., Chen, S. Y., Su, S., Yang, M. C., Lan, C., Chou, N. K., et al. (2011). The effect of early cardiac rehabilitation on health-related quality of life among heart transplant recipients and patients with coronary artery bypass graft surgery. Transplant Proc, 43:2714-7. [CrossRef] [PubMed]

Jelinek, H. F., Huang, Z. Q., Khandoker, A. H., Chang, D., Kiat, H. (2013). Cardiac rehabilitation outcomes following a 6- week program of PCI and CABG patients. Front Physiol, 4:302. [CrossRef] [PubMed]

Sanderson, B. K., Schumann, C., Breland, J., Williams, N., Saunders, K., & Bittner, V. (2005). Six-minute walk assessment in cardiac rehabilitation: is there a standard for functional performance? Med Sci Spor, 37:1186. [CrossRef]

Karapolat, H., Demir, E., Bozkaya, Y. T., Eyigor, S., Nalbantgil, S., Durmaz, B., et al. (2009). Comparison of hospital-based versus home-based exercise training in patients with heart failure: effects on functional capacity, quality of life, psychological symptoms, and hemodynamic parameters. Clin Res Cardiol, 98:635-42. [CrossRef] [PubMed]

Sharif, F., Shoul, A., Janati, M., Kojuri, J., & Zare, N. (2012). The effect of cardiac rehabilitation on anxiety and depression in patients undergoing cardiac bypass graft surgery in Iran. BMC Cardiovasc Disord, 12:40. [CrossRef] [PubMed]

Stauber, S., Guera, V., Barth, J., Schmid, J. P., Saner, H., Znoj, H., et al. (2013). Psychosocial outcome in cardiovascular rehabilitation of peripheral artery disease and coronary artery disease patients. Vasc Med, 18:257-62. [CrossRef] [PubMed]

Choo, C. C., Chew, P. K. H., Lai, S. M., et al. (2018). Effect of cardiac rehabilitation on quality of life, depression and anxiety in Asian patients. Int J Environ Res Public Health, 15(6), 1095. [CrossRef] [PubMed]

Demir Gündoğmuş, P., Topçu Özcan, B., Hayıroğlu, M., et al. (2020). The effect of the age on outcomes at a cardiac rehabilitation center in Turkey. Archives of the Turkish Society of Cardiology, 48(3), 270-277. [CrossRef] [PubMed]

Premkumar, S., Ramamoorthy, L., & Pillai, A. A. (2022). Impact of nurse-led cardiac rehabilitation on patient’s behavioral and physiological parameters after a coronary intervention: A pilot randomized controlled trial. J Family Community Med. 29(1):17-23. [CrossRef] [PubMed]

Sibilitz, K. L., Berg, S. K., Rasmussen, T. B., et al. (2016). Cardiac rehabilitation increases physical capacity but not mental health after heart valve surgery: a randomised clinical trial. Heart. 102(24), 1995- 2003. [CrossRef] [PubMed]

Arıkan, F., & Altınışık, M. (2024). Nursing in Pulmonary Rehabilitation. In: Rehabilitation Nursing: Basic Principles and Practices. Editors: Tülay Başak, Ayla Demirtaş. Ankara: Ankara: Nobel Medical Bookstores. p.417-432.

Hill, K., Vogiatzis, I., & Burtin, C. (2013). The importance of components of pulmonary rehabilitation, other than exercise training, in COPD. Eur Respir Rev, 22(129), 405–413. [CrossRef] [PubMed]

Belli, S., Prince, I., Savio, G., Paracchini, E., Cattaneo, D., Bianchi, M., Masocco, F., Bellanti, M. T. & Balbi, B. (2021). Airway Clearance Techniques: The Right Choice for the Right Patient. Front. Med, 8:544826. [CrossRef] [PubMed]

Hansen, T. S., Poulsen, I., Norholm, V., Loft, M. I., & Jensen, P. S. (2024). Nutritional Support and Physical Activity Intervention Programs with a Person-Centred Approach in People with Chronic Obstructive Pulmonary Disease: a Scoping Review. International Journal of Chronic Obstructive Pulmonary Disease, 19, 2193–2216. [CrossRef] [PubMed]

Salazar, J. J., Mirza, F. T., Uzzaman, M. N., Shunmugam, R. H., Shazana, N. Z., Pinnock, H., Hirani, N., & Rabinovich, R. A. (2025). Characteristics of pulmonary rehabilitation programs and their effects on exercise capacity and health related quality of life (HRQoL) in patients with interstitial lung disease: A systematic review and meta-analysis. Respiratory Medicine, 237:107936. [CrossRef] [PubMed]

Ghanem, M., ELaal, E. A., Mehany, M., & Tolba, K. (2010). Home-based pulmonary rehabilitation program: Effect on exercise tolerance and quality of life in chronic obstructive pulmonary disease patients. Annals of Thoracic Medicine, 5(1), 18-25. [CrossRef] [PubMed]

Moazeni, S. S., Ghaljeh, M., & Ali Navidian, A. (2020). The Effect of Pulmonary Rehabilitation on Fatigue and Quality of Life in Patients with Chronic Obstructive Pulmonary Disease: A Quasi-Experimental Study. Med Surg Nurs J, 9(1).e103899. [CrossRef]

Tuncay, F. (2021). Pulmoner Rehabilitasyon. J PMR Sci. 24(2):169-79. [CrossRef]

Downloads

Published

2025-12-30

How to Cite

Uysal, H. (2025). Quality of Life and the Nursing Approach in Cardiopulmonary Rehabilitation: Traditional Review. International Journal of Active & Healthy Aging, 3(2), 76–90. https://doi.org/10.5281/zenodo.18008092