By Gabriela Lima de Melo Ghisi, BSc PT, MSc, PhD, CRFC, FAACVPR

When it comes to recovering from heart disease, knowledge truly is power. Imagine being diagnosed with a heart condition and feeling overwhelmed by medical jargon, new medications, and lifestyle changes. This is where patient education in cardiac rehabilitation steps in — equipping patients with the information and skills they need to take control of their health and lead fulfilling lives.

What Is Patient Education and Why Is It Important?

Patient education is all about helping people better understand their health so they can take charge of their well-being with confidence. According to the World Health Organization (WHO),¹ patient education is structured learning process that focuses on the individual — meaning it considers a person’s unique needs, lifestyle, and circumstances. It’s not just about handing out brochures or giving medical advice; it’s a collaborative process where health care professionals, patients, and their families work together to make informed health decisions.

In the case of cardiovascular disease, patient education is especially important. Cardiovascular disease is one of the leading causes of death and disability globally, but the good news is that many of its risk factors — like high blood pressure, unhealthy eating habits, and lack of exercise — can be managed or even prevented with the right knowledge and support. That’s where patient education comes in. When people truly understand their health condition and how to take care of themselves, they are more likely to stick with their treatment plan and make lasting lifestyle changes.

Research^2,3 has shown that effective patient education can lead to:

• A better understanding of their heart condition and treatment options
• Improved ability to follow medication routines correctly
• Healthier choices when it comes to diet and exercise
• Greater success in quitting smoking and other harmful behaviors

In cardiac rehabilitation, patient education is a core component and a critical quality indicator.⁴ Research suggests that effective education can positively influence program attendance,^5,6 ensuring that patients are not only empowered to adopt healthier lifestyles but also motivated to stay engaged in their rehabilitation process.

Where Should I Start?

When it comes to educating patients, the first step is understanding that adults learn differently from children. Adults bring their own life experiences, beliefs, and habits to the learning process, and they are more likely to engage when the information is relevant, practical, and directly applicable to their daily lives.⁷ Unlike traditional classroom learning, adult education in healthcare should be a two-way conversation — one where patients feel heard, respected, and empowered to take an active role in their health journey.

One of the most important things to consider is that every patient is unique. Their background, personal experiences, cultural beliefs, and emotional state all play a significant role in how they receive and process information. Some patients may be eager to learn, while others might feel overwhelmed or even resistant to change. That’s why taking the time to understand each patient’s individual characteristics — such as their level of motivation, readiness to learn, information needs,⁸ and personal goals — can make all the difference in how successful the education process will be.

Another key factor to consider is health literacy,^9,10 which refers to a person’s ability to find, understand, and use health-related information to make informed decisions. Many people, regardless of their education level, struggle to fully grasp medical concepts and terminology. Without clear and accessible information, patients may feel confused or unsure about their treatment plans, which can lead to poor health outcomes. It’s essential to assess each patient's level of health literacy and adjust your approach accordingly — using plain language, visual aids, and hands-on demonstrations to simplify complex topics and ensure understanding.

Starting with a patient-centered approach — one that recognizes patients’ unique learning styles, cultural backgrounds, and health literacy levels — can transform patient education from a daunting task into an empowering experience that leads to better health outcomes and improved quality of life. To start the patient education journey effectively, here are a few steps to guide you:

1. Assess the patient’s background and readiness: Begin by understanding what patients already know about their condition,⁸ their concerns, and how they prefer to receive information. This helps tailor the education to their specific needs and ensures it resonates with their current understanding.
2. Set realistic and personalized goals: Collaborate with patients to set achievable health goals that align with their lifestyle and capabilities. By making these goals meaningful and manageable, the learning process becomes more engaging and relevant to their daily lives.
3. Use simple and relatable language: Avoid complex medical jargon. Instead, break down terms into everyday language and offer real-life examples that connect with the patient’s experiences.¹¹ This ensures the information is clear and easy to digest.
4. Encourage interaction and engagement: Foster a supportive environment where patients feel comfortable asking questions, sharing their thoughts, and actively participating in their care plan.
5. Blend methods for maximum flexibility and impact: Combine group sessions, one-on-one interactions, and both synchronous and asynchronous modes of communication. This approach provides flexibility to accommodate different learning preferences and schedules, making it easier for patients to engage in their education.
6. Offer continuous support and follow-up: Education should not end after one session. Regular check-ins, encouragement, and ongoing resources (such as printed guides, online videos, or pamphlets) help reinforce learning and ensure patients stay on track. Utilizing available materials¹² is essential for keeping patients engaged and reinforcing key concepts in ways they can revisit as needed.
7. Leverage exercise sessions as an opportunity for one-on-one education: During cardiac rehabilitation exercise sessions, take advantage of one-on-one interactions to reinforce educational points and address specific questions. This can be a valuable opportunity for deeper engagement, making the education process more personalized and effective.

In conclusion, health care providers, caregivers, and policymakers must collaborate to prioritize patient education in cardiac rehabilitation, recognizing its vital role in improving outcomes and fostering long-term heart health. By creating an environment that supports learning and engagement, we can empower patients to take charge of their well-being. Whether you're a clinician or a patient, the journey toward better heart health starts with taking that first step: ask questions, seek resources, and embrace lifelong learning. Together, we can ensure that cardiac rehabilitation becomes not just a recovery process, but a pathway to sustained health and vitality.

References

1. Therapeutic patient education: an introductory guide. World Health Organization (2023): https://www.who.int/europe/publications/i/item/9789289060219
2. Shi, Wendan et al. “Systematic review, meta-analysis and meta-regression to determine the effects of patient education on health behaviour change in adults diagnosed with coronary heart disease.” Journal of clinical nursing vol. 32,15-16 (2023): 5300-5327. doi:10.1111/jocn.16519
3. Shi, Wendan et al. “A systematic review, meta-analysis, and meta-regression of patient education for secondary prevention in patients with coronary heart disease: impact on psychological outcomes.” European journal of cardiovascular nursing vol. 21,7 (2022): 643-654. doi:10.1093/eurjcn/zvac001
4. Brown, Todd M et al. “Core Components of Cardiac Rehabilitation Programs: 2024 Update: A Scientific Statement From the American Heart Association and the American Association of Cardiovascular and Pulmonary Rehabilitation: Endorsed by the American College of Cardiology.” Journal of cardiopulmonary rehabilitation and prevention, 10.1097/HCR.0000000000000930. 18 Nov. 2024, doi:10.1097/HCR.0000000000000930
5. Pedersen, Charlotte Gjørup et al. “The patient education strategy "learning and coping" improves adherence to cardiac rehabilitation in primary healthcare settings: a pragmatic cluster-controlled trial.” BMC cardiovascular disorders vol. 22,1 364. 8 Aug. 2022, doi:10.1186/s12872-022-02774-8
6. Ghisi GLM, Rouleau F, Ross MK, Dufour-Doiron M, Belliveau SL, Brideau JR, Aultman C, Thomas S, Colella T, Oh P. Effectiveness of an Education Intervention Among Cardiac Rehabilitation Patients in Canada: A Multi-Site Study. CJC Open. 2020 Mar 4;2(4):214-221. doi: 10.1016/j.cjco.2020.02.008.
7. Caffarella, R. S. (2001). Planning Programs for Adult Learners: A Practical Guide for Educators, Trainers, and Staff Developers (2nd ed.). San Francisco, CA: Jossey-Bass. [ISBN: 0787952257]
8. Ghisi, Gabriela Lima de Melo et al. “Psychometric validation of the short version of the Information Needs in Cardiac Rehabilitation scale through a first global assessment.” European journal of preventive cardiology vol. 31,16 (2024): 1927-1936. doi:10.1093/eurjpc/zwae148
9. Understanding Health Literacy. Centers for Disease Prevention and Control (2024): https://www.cdc.gov/health-literacy/php/about/understanding.html
10. Health Literacy Universal Precautions Toolkit, 3rd Edition. AHRQ (2023): https://www.ahrq.gov/health-literacy/improve/precautions/toolkit.html
11. Plain Language Materials and Resources. Centers for Disease Prevention and Control (2024): https://www.cdc.gov/health-literacy/php/develop-materials/plain-language.html
12.  Cardiac College Website: cardiaccollege.ca

Dr. Ghisi is an Affiliate Scientist at the KITE Research Institute, University Health Network (Canada), and Chair of the International Council of Cardiovascular Prevention and Rehabilitation (ICCPR). Her research focuses on patient education in chronic disease management and global access to cardiac rehabilitation (CR). She has led the development and implementation of educational curricula in over 10 countries and has published more than 160 scientific manuscripts, including clinical guidelines and validated CR-related scales used worldwide.