학술논문

How Person-Centred Is Cardiac Rehabilitation in England? Using Bourdieu to Explore Socio-Cultural Influences and Personalisation.
Document Type
Article
Source
Qualitative Health Research. Feb2024, Vol. 34 Issue 3, p239-251. 13p.
Subject
*THERAPEUTICS
*ATTITUDE (Psychology)
*RESEARCH methodology
*PSYCHOLOGY of cardiac patients
*SOCIAL theory
*PATIENT decision making
*PATIENT-centered care
*INDIVIDUALIZED medicine
*SOCIAL factors
*INTERVIEWING
*NATIONAL health services
*PATIENTS' attitudes
*EXPERIENCE
*ETHNOLOGY research
*CARDIAC rehabilitation
*PARTICIPANT observation
*THEMATIC analysis
*JUDGMENT sampling
*STATISTICAL sampling
*PATIENT compliance
Language
ISSN
1049-7323
Abstract
The National Health Service (NHS) cardiac rehabilitation patient care pathway has remained largely unchanged for many years despite, on average, half of all eligible patients declining to engage. To investigate reasons for non-engagement, we explored the experiences of ten cardiac patients who participated in cardiac rehabilitation, dropped out, or declined, as well as experiences of seven people deemed significant others by participants. Our ethnographic study involved participant observations, repeat in-depth semi-structured interviews, and reflexive journaling. Reflexive thematic analysis was conducted, focusing on participants' lived experiences. Utilising Bourdieusian concepts of habitus, capital, and field, this article highlights how personal biography, material conditions, and dispositional inclinations combine to make cardiac health care decision-making individual and complex. Despite this, health professionals were not always attuned to specific circumstances arising from differences in patients' experiences and lifeworlds. By considering service improvement recommendations that acknowledge socio-cultural influences, cardiac rehabilitation can work towards providing patients and their significant others with more appropriate, personalised, and person-centred support. [ABSTRACT FROM AUTHOR]