Cardiac rehabilitation patients' perspectives on coronary heart disease and treatment: a qualitative study

Lincoln White, Simon Jonathan (2008) Cardiac rehabilitation patients' perspectives on coronary heart disease and treatment: a qualitative study. PhD thesis, University of Nottingham.

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UK hospital-based Cardiac Rehabilitation (CR) programmes offer eligible Coronary Heart Disease (CHD) patients information on various issues including lifestyle modification and medicines. However, CR patients' perspectives on medicine-taking and lifestyle modification in relation to their perspectives on their risk of experiencing further CHD-related events remains under-researched. This study explored these topics.

Following ethical approval, a qualitative approach was taken that drew on the broad principles of grounded theory. In-depth, audiotaped interviews were conducted with sixteen CR patients approximately three months after hospital discharge. Second interviews explored whether heart attack CR patients' perspectives on risk, medicines and lifestyle modification had changed when interviewed again approximately nine months later. The perspectives of a group of CR patients who had not had a heart attack were explored for comparison.

Findings suggested that CR patients made sophisticated yet uncertain assessments of their risk. This did not just involve identifying lifestyle factors needing change or attributing the likelihood of experiencing further CHD-related events to chance or heredity alone; patients tended to also consider information about heart damage or current heart function. Heart attack patients commonly feared recurrence, which appeared to heighten short-term perceptions of risk but longer-term perspectives on risk appeared similar to CR patients who had not had a heart attack.

CR patients tended to only maintain changes to aspects of lifestyle perceived as causes, rather than viewing lifestyle recommendations as standards to achieve. Some heart attack patients initially changed aspects of lifestyle they did not cite as a cause, which seemed to be associated with heightened risk perceptions, since these changes tended not to be maintained. CR patients reported continuing to take heart-related medicines and viewed them as important to reduce their risk, despite disquiet about medicines causing harm being common. These findings have implications for health professionals' practice and CR programme improvement.

Item Type: Thesis (University of Nottingham only) (PhD)
Supervisors: Bissell, P.
Anderson, C.
Keywords: cardiac rehabilitation, qualitative research, patient perspective
Subjects: W Medicine and related subjects (NLM Classification) > WG Cardiocascular system
Faculties/Schools: UK Campuses > Faculty of Science > School of Pharmacy
Item ID: 10608
Depositing User: EP, Services
Date Deposited: 18 Nov 2008
Last Modified: 17 Jan 2018 11:12

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