How Person-Centred Is Cardiac Rehabilitation in England? Using Bourdieu to Explore Socio-Cultural Influences and Personalisation

Author:

Blackwell Joanna1ORCID,Allen-Collinson Jacquelyn1,Evans Adam2,Henderson Hannah1

Affiliation:

1. School of Sport and Exercise Science, University of Lincoln, Lincoln, UK

2. Department of Nutrition, Exercise, and Sport, University of Copenhagen, Copenhagen, Denmark

Abstract

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.

Funder

Foundation for the Sociology of Health and Illness

PhD Studentship - University of Lincoln and University of Copenhagen

Publisher

SAGE Publications

Subject

Public Health, Environmental and Occupational Health

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