Astin Felicity, Atkin Karl, Darr Aliya
University of Leeds School of Healthcare, Baines Wing LS2 9JT United Kingdom.
Eur J Cardiovasc Nurs. 2008 Mar;7(1):43-51. doi: 10.1016/j.ejcnurse.2007.06.002. Epub 2007 Oct 24.
Effective lifestyle modification facilitated by cardiac rehabilitation is known to reduce the occurrence of adverse coronary events and mortality. South Asians have poorer outcomes after a myocardial infarction than the general UK population, but little is known about their experiences of family support, cardiac rehabilitation and lifestyle change.
To explore the nature of family support available to a sample of South Asian and White-European cardiac patients and to highlight similarities and differences between these groups with regard to cardiac rehabilitation and lifestyle modification.
Using a qualitative approach, semi-structured interviews (in 1 of 6 languages) were conducted by researchers with; 45 South Asian patients and 37 carers and 20 White-European patients and 17 carers. Interviews were conducted in a home setting, up to eighteen months after discharge from hospital following myocardial infarction, coronary artery bypass surgery or unstable angina.
The main themes that emerged related to the provision of advice and information, family support and burden, dietary change and exercise regimes.
Several cultural and ethnic differences were identified between patients and their families alongside similarities, irrespective of ethnicity. These may represent generic characteristics of recovery after a cardiac event. Health professionals should develop a cultural repertoire to engage with diversity and difference. Not every difficulty a person encounters as they try to access appropriate service delivery can be attributed to ethnic background. By improving services generally, support for South Asian populations can be improved. The challenge is to know when ethnicity makes a difference and mediates a person's relationship with service support and when it does not.
心脏康复所促进的有效的生活方式改变已知可减少不良冠状动脉事件的发生和死亡率。南亚人在心肌梗死后的预后比英国普通人群更差,但对于他们在家庭支持、心脏康复和生活方式改变方面的经历了解甚少。
探讨南亚和白种欧洲心脏病患者样本可获得的家庭支持的性质,并突出这些群体在心脏康复和生活方式改变方面的异同。
采用定性方法,研究人员用6种语言之一进行半结构化访谈,访谈了45名南亚患者及其37名护理人员以及20名白种欧洲患者及其17名护理人员。访谈在家庭环境中进行,时间为心肌梗死、冠状动脉搭桥手术或不稳定型心绞痛出院后长达18个月。
出现的主要主题涉及建议和信息的提供、家庭支持与负担、饮食改变和锻炼方式。
无论种族如何,患者及其家庭之间都存在一些文化和种族差异以及相似之处。这些可能代表心脏事件后康复的一般特征。卫生专业人员应发展一种文化技能,以应对多样性和差异。一个人在试图获得适当服务时遇到的每一个困难并非都可归因于种族背景。通过总体上改善服务,可以改善对南亚人群的支持。挑战在于了解种族何时产生影响并调节人与服务支持的关系,何时不产生影响。