Dagens FSV-oversigt: Managing lifestyle change to reduce coronary risk: a synthesis of qualitative research on peoples' experiences.

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Date: Fri, 23 Jan 2015 11:21:39 -0000
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Dagens #fsvoversigt:

Managing lifestyle change to reduce coronary risk: a synthesis of qualitative 
research on peoples' experiences.

BMC Cardiovasc Disord. 2014;14:96

Authors: Astin F, Horrocks J, Closs SJ

Abstract

BACKGROUND: Coronary heart disease is an incurable condition. The only approach 
known to slow its progression is healthy lifestyle change and concordance with 
cardio-protective medicines. Few people fully succeed in these daily activities 
so potential health improvements are not fully realised. Little is known about 
peoples' experiences of managing lifestyle change. The aim of this study was to 
synthesise qualitative research to explain how participants make lifestyle 
change after a cardiac event and explore this within the wider illness 
experience.

METHODS: A qualitative synthesis was conducted drawing upon the principles of 
meta-ethnography. Qualitative studies were identified through a systematic 
search of 7 databases using explicit criteria. Key concepts were identified and 
translated across studies. Findings were discussed and diagrammed during a 
series of audiotaped meetings.

RESULTS: The final synthesis is grounded in findings from 27 studies, with over 
500 participants (56% male) across 8 countries. All participants experienced a 
change in their self-identity from what was 'familiar' to 'unfamiliar'. The 
transition process involved 'finding new limits and a life worth living' , 
'finding support for self' and 'finding a new normal'. Analyses of these 
concepts led to the generation of a third order construct, namely an ongoing 
process of 'reassessing past, present and future lives' as participants 
considered their changed identity. Participants experienced a strong urge to 
get back to 'normal'. Support from family and friends could enable or constrain 
life change and lifestyle changes. Lifestyle change was but one small part of a 
wider 'life' change that occurred.

CONCLUSIONS: The final synthesis presents an interpretation, not evident in the 
primary studies, of a person-centred model to explain how lifestyle change is 
situated within 'wider' life changes. The magnitude of individual responses to 
a changed health status varied. Participants experienced distress as their 
notion of self identity shifted and emotions that reflected the various stages 
of the grief process were evident in participants' accounts. The process of 
self-managing lifestyle took place through experiential learning; the level of 
engagement with lifestyle change reflected an individual's unique view of the 
balance needed to manage 'realistic change' whilst leading to a life that was 
perceived as 'worth living'. Findings highlight the importance of providing 
person centred care that aligns with both psychological and physical dimensions 
of recovery which are inextricably linked.

PMID: 25097066 [PubMed - indexed for MEDLINE]

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Dette abstract er hentet via PubMed fra National Library of Medicine, USA 
(http://www.ncbi.nlm.nih.gov/About/disclaimer.html).
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Se abstractet i PubMed: http://evidens.link/1GGqzCi

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Dagens FSV-oversigt: Managing lifestyle change to reduce coronary risk: a synthesis of qualitative research on peoples' experiences.

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