Key result
Personal biography and material conditions heavily shape cardiac rehabilitation engagement and decision-making.
Why the study?
The NHS cardiac rehabilitation pathway has remained largely unchanged despite roughly half of eligible patients declining engagement, prompting an investigation into reasons for non-engagement.
Observational (n=17)
No
Cardiac rehabilitation services need to better acknowledge socio-cultural influences and individual lifeworlds to improve uptake and provide truly person-centred support.
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.
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Blackwell et al. (2023) conducted an observational in Cardiac event (n=17). Cardiac rehabilitation vs. Non-participation or dropout was evaluated on Socio-cultural influences on cardiac rehabilitation decision-making. Personal biography, material conditions, and dispositional inclinations heavily influence cardiac rehabilitation decision-making, highlighting a need for more socio-culturally attuned, person-centred care.
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