Managing lifestyle change after coronary angioplasty: an interview study

Introduction: Lifestyle change is the cornerstone of secondaryprevention for people with established coronary heart disease. For optimumbenefit, people with established heart disease are advised to adopt healthylifestyle behaviours and cease harmful ones. Success with such activities issuboptimal despite the acknowledged potential for a significant reduction indeath & disability. Little is known about the process of managing lifestylechange from patients’ perspectives. What is known is thatthere is considerable room for improvement. Aims: Toexplore the way in which people self-manage their lifestyle after coronaryangioplasty. Emphasis was given to understanding the complexity of factors thatinfluence people’s decisions about which lifestylefactor(s) they chose to target and why. Factors that enable or constrain selfmanagement of lifestyle factors were also identified. Methods: A series of one-to-one interviews were conducted with 26participants recruited from a specialist cardiac centre after coronaryangioplasty. Each participant was interviewed in a home setting at 1-2 weeksand 6-8 weeks after hospital discharge. The average age of participants was61.8 years (range 48-85), 55% were male. Interviews were audio- taped and transcribedverbatim. NVivo software was used to systematically order and synthesizefindings. Results: Participants generally attributed coronary heart disease tolifestyle factors. However the way in which they interpreted this informationwithin their own personal context varied and did not consistently reflect thecharacteristics of their individual coronary risk factor profile. Coronaryangioplasty was seen as an effective “repair” for clogged arteries. Although participants generallyrecognised the benefits associated with making lifestyle changes they were lessclear about exactly how such changes could be achieved. Few were able todemonstrate the skills to set and review lifestyle change goals. Participants often lacked detailed information aboutdietary changeand how far they could “push” with physical activity levels. They were often uncertainabout when hospital care ended and whether other support was available.Co-existing conditions such as diabetes and obesity made dietary changeand physical activity a challenge. Conclusion: Participants in this study were aware that they needed to make lifestylechanges but would be better equipped if given more practical skills about howthis could be achieved.