Patients from lower socio-economic backgrounds who do not access cardiac rehabilitation programmes : a phenomenological journey

摘要

It has long been documented that patients from lower socio-economic backgrounds do not access health services. There have been Government led initiatives to ask service users what they want from services to provide initiatives that will improve the health and well-being of the population. There has been little or no involvement of patients who do not access services to ask them why they do not attend or involve themselves in decision making. Previous studies into access to cardiac rehabilitation have been predominantly quantitative, with very little qualitative data to explore the reasons why people from lower socio-economic backgrounds do not access the programmes provided. In this study beliefs of people who have not accessed cardiac rehabilitation are explored with a group of participants who have a diagnosis of coronary heart disease using a Heideggerian phenomenological approach. Semi-structured interviews were used to collect data. Themes were identified using line by line analysis. Three case examples were described bringing the data back together into a whole transcript for further exploration. The key findings from the research showed that the participants, all from the five poorest electoral wards of Darlington highlighted what to them were the significant factors in their health journey. The most common themes were (1) support, (2) choices and risks, (3) cardiac rehabilitation inhibitors and (4) perceptions of what had happened to them. In conclusion the findings from this study can be used to stimulate a review of current thinking and practices among health professionals, educators and other agencies involved in supporting this group of individuals to meet their long-term adjustment needs. Long term cardiac rehabilitation provision could be further enhanced if future policy initiatives reflected the needs of this group of individuals, and further research into this area could be implemented.