Key result
Being informed about an elevated cardiovascular risk score prompted significant lifestyle changes, though only to a limited degree when such changes adversely affected quality of life.
Patients informed of elevated cardiovascular risk may only adopt lifestyle changes that do not adversely affect their quality of life, highlighting a gap between medical advice and patient interpretation.
Risk disclosure may prompt only QoL-preserving lifestyle changes; leaves open how counseling can improve adherence without trade-offs.
OBJECTIVE: To explore how persons with an elevated cardiovascular risk score (CRS) balanced health-related advice against the life they wanted to live or were able to live. SETTING: 2000 Danes aged 30-50 were invited to participate in a health-screening project in general practice. Screenings were conducted at baseline and after one and five years, and included among other screening procedures a calculation of CRS (see Figure 1). DESIGN: Participants with an elevated CRS were asked to participate in a qualitative semi-structured interview. They were selected by stratified purposeful sampling reflecting variations in age, sex. and perceived health. SUBJECTS: Nine men and five women aged 33-50 years. THEORETICAL FRAMES OF REFERENCE: Bandura's theory of self-efficacy and the Health Belief Model's consideration of individuals' cues to act against a health threat supported analysis. RESULTS: Being informed about an elevated CRS had a considerable impact on the informants. They initiated significant lifestyle changes, though only to a limited degree when such changes would affect their quality of life adversely. In cases where other results of the multiphasic screening were normal, interpreted as such, or if there were stressful circumstances in the informant's life, the elevated CRS receded into the background. INTERPRETATION: Doctors, who inform individuals about the impact of risk factors, need to know that the consequences and health advice are not always interpreted by laypeople as supposed by the medical culture.
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Nielsen et al. (2005) studied Elevated cardiovascular risk (n=14). Elevated cardiovascular risk score notification was evaluated on Impact on lifestyle changes and quality of life. Being informed about an elevated cardiovascular risk score prompted significant lifestyle changes, though only to a limited degree when such changes adversely affected quality of life.
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