Exploring the experiences and rehabilitation needs of patients with coronary artery diseases: an effort to design a contextual home-based cardiac rehabilitation through a qualitative enquiry

Background: Cardiovascular diseases (CVDs) continue to be a major global public health concern, accounting for a considerable portion of the burden of morbidity and mortality. The CAD in Pakistan imposes a substantial economic and social burden on individuals, families, and the healthcare system. Despite advances in medical interventions and therapies, comprehensive cardiac rehabilitation programs in Pakistan remain underdeveloped and inaccessible to many patients, particularly those residing in rural or underserved areas. Aim: This study aims to explore the experiences and rehabilitation needs of Pakistani patients with heart disease in helping to design contextual home-based cardiac rehabilitation. Methods: Based on the data saturation, 20 individuals were interviewed using a qualitative descriptive exploratory approach. Semi-structured, in-depth interviews that lasted 40 to 50 min were used to gather the data. Thematic analysis was performed using an inductive coding approach. Results: Five major themes with 24 subthemes emerged from the data: (1) Understanding of Heart Disease which revealed limited awareness and prevalent misconceptions; (2) Cardiac Anxiety which showed emotional distress, fear of recurrence, and financial concerns; (3) Challenges Faced by Patients which included difficulties with follow-up, family resistance to physical activity, dietary modifications, medication adherence, and gendered recovery experiences; (4) Difficulties for Behaviour Change which showed ongoing unhealthy habits and skepticism toward lifestyle modification; and (5) Patient Readiness for Home-Based Cardiac Rehabilitation which reflected openness to behavior change, preference for telephonic guidance, and the need for culturally tailored support and family involvement. Conclusion: The study highlights significant gaps in awareness, emotional and behavioral challenges, and sociocultural barriers influencing recovery after myocardial infarction. Participants expressed readiness for a flexible, family-inclusive, and home-based cardiac rehabilitation model. These insights provide essential direction for developing a culturally sensitive and contextually appropriate cardiac rehabilitation program in Pakistan.