Lifestyle self-management experiences of South Asians post myocardial infarction

D Davis, I Jones, M Johnson, M Howarth, F Astin, G Bagnall

Research output: Contribution to journalMeeting Abstractpeer-review


Background: Coronary heart disease is the biggest killer globally. South Asians carry the burden of increased incidence and prevalence and have poorer outcomes after a myocardial infarction than the general population. Reviews have shown lifestyle modification including physical activity, healthy diet and smoking cessation, alters the course of heart disease and reduces recurrences crystallising its significance as a cost-effective public health strategy to reduce the rising burden of this disease. There are lacunae of knowledge as to what constitutes to guarantee a therapeutic lifestyle modification for better health outcomes in the South Asian community.

Purpose: To explore the self-management experience of South Asians after a heart attack.

Method: Pioneering of its kind, this study used a grounded theory approach to elucidate how South Asians navigate these lifestyle changes. Two-phase interviews at 2 weeks and 8 weeks of discharge, were conducted with 14 participants who were newly diagnosed with myocardial infarction - from 2015 to July 2016.

Results: Theoretical categories were developed through constant comparison and theoretical sampling – these were patronage of the family, affinity towards one's group and conforming to the religious and health (causal) beliefs.

By providing a unique insight that choosing and prioritising lifestyle style changes is not an individual act, but a shared act, a case for “shared efficacy” is made. The concept of “shared efficacy” as an essential strategy to enhance an individual's ability to make a meaningful choice, is showcased. The novel presentation of making and maintaining lifestyle choices as a conflict resolution strategy with the aim of “maintaining harmony” among South Asians calls for a “harmony model” to deal with the diagnosis of heart attack and subsequent lifestyle changes. This proposed harmony model homes in on a family centred approach, where there is an awareness of the family's needs, an appreciation of the cardiac patient's religious and causal beliefs as well as an acknowledgement of their cultural priorities, in self-management programmes.

Conclusion: Migrant South Asians across the globe have an increased propensity to this disease. The findings contribute to the development of supporting negotiating strategies by capturing concepts that crystallise the significance of lifestyle self-management. To alleviate the burden, there is a need for ethno-sensitivity rather than an ethnocentricity in the delivery of services. This calls for a move from cultural competence to cultural intelligence.


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