Training status, needs, and factors associated with prior participation in phase II cardiac rehabilitation exercise prescription training among cardiopulmonary rehabilitation nurses: a cross-sectional study with an exploratory nomogram analysis.

backgroundPhase II cardiac rehabilitation is essential for patient recovery, and nurses play a central role in implementing exercise prescriptions. However, training systems for this competency remain underdeveloped in China. This study examined the training status and self-reported training needs of nurses working in cardiopulmonary rehabilitation settings, and explored factors associated with prior formal participation in phase II cardiac rehabilitation exercise prescription training. An exploratory nomogram was further developed as a preliminary tool for characterizing differences in prior formal participation

methodsA cross-sectional survey was conducted from September to October 2024 among 281 nurses from cardiopulmonary rehabilitation centers in eight hospitals across Guangxi, Yunnan, and Sichuan using purposive sampling. Data were collected through a self-developed electronic questionnaire covering participant characteristics, training status, and training needs. Prior formal participation in phase II cardiac rehabilitation exercise prescription training was used as the outcome variable. A theory-informed analytical strategy that combined a DAG, univariable logistic regression, and multivariable logistic regression was used to identify associated factors and construct an exploratory nomogram. Internal validation was performed using a 7:3 training-validation split, and model performance was assessed in terms of discrimination and calibration for describing differences in prior formal participation.

resultsAlthough respondents reported high awareness of phase II cardiac rehabilitation exercise prescription training and strong institutional support, prior formal participation remained insufficient. Existing programs were largely theory-based, with limited practical components and incomplete alignment with clinical needs. Nurses reported substantial demand for further training and generally preferred small-group, blended, and practice-oriented formats. In the multivariable model, age, city, sex, professional title, and cardiopulmonary rehabilitation experience were retained as factors associated with prior formal participation. The nomogram showed moderate discrimination in the training set (AUC=0.77, 95% CI: 0.71-0.84) and acceptable discrimination in the validation set (AUC=0.71, 95% CI: 0.60-0.83), with acceptable calibration in both sets (H-L P = 0.548 and 0.665, respectively).

conclusionNurses working in cardiopulmonary rehabilitation settings reported clear unmet training needs related to phase II cardiac rehabilitation exercise prescription training. The exploratory nomogram showed moderate discrimination and acceptable calibration for estimating prior formal participation and may help characterize subgroup differences in prior formal participation. Given the cross-sectional design, the historical nature of the outcome, and the lack of external validation, these findings should be interpreted with caution. CLINICAL

trial registrationNot applicable REPORTING

methodThis study was reported in accordance with the STROBE checklist. Because the nomogram was retained, model development and reporting were additionally guided by the TRIPOD statement.