Do practitioners and friends support patients with coronary heart disease in lifestyle change? a qualitative study

BMC Family Practice

Research Article

Nigel Hart¹  Susan M Smith²  Margaret E Cupples³  Judith A Cole³ 

[1] Centre for Medical Education, Queen’s University Belfast, Dunluce Health Centre, 1 Dunluce Avenue, BT9 7HR, Belfast, Northern Ireland;Department of General Practice, Royal College of Surgeons, Beaux Lane House, Mercer Street, Dublin, 2, Ireland;UKCRC Centre of Excellence for Public Health, Queen’s University Belfast, Dunluce Health Centre, 1 Dunluce Avenue, BT9 7HR, Belfast, Northern Ireland;

关键词: Coronary heart disease;    General practice;    Lifestyle change;    Secondary prevention;    Diet;    Physical activity;    Barriers;    Facilitators;   

DOI  :  10.1186/1471-2296-14-126

 received in 2013-03-13, accepted in 2013-07-16,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundHealthy lifestyles help to prevent coronary heart disease (CHD) but outcomes from secondary prevention interventions which support lifestyle change have been disappointing. This study is a novel, in-depth exploration of patient factors affecting lifestyle behaviour change within an intervention designed to improve secondary prevention for patients with CHD in primary care using personalised tailored support. We aimed to explore patients’ perceptions of factors affecting lifestyle change within a trial of this intervention (the SPHERE Study), using semi-structured, one-to-one interviews, with patients in general practice.MethodsInterviews (45) were conducted in purposively selected general practices (15) which had participated in the SPHERE Study. Individuals, with CHD, were selected to include those who succeeded in improving physical activity levels and dietary fibre intake and those who did not. We explored motivations, barriers to lifestyle change and information utilised by patients. Data collection and analysis, using a thematic framework and the constant comparative method, were iterative, continuing until data saturation was achieved.ResultsWe identified novel barriers to lifestyle change: such disincentives included strong negative influences of social networks, linked to cultural norms which encouraged consumption of ‘delicious’ but unhealthy food and discouraged engagement in physical activity. Findings illustrated how personalised support within an ongoing trusted patient-professional relationship was valued. Previously known barriers and facilitators relating to support, beliefs and information were confirmed.ConclusionsIntervention development in supporting lifestyle change in secondary prevention needs to more effectively address patients’ difficulties in overcoming negative social influences and maintaining interest in living healthily.

【 授权许可】

CC BY   
© Cole et al.; licensee BioMed Central Ltd. 2013