Perspectives of older cardiac patients towards lifestyle modification: a qualitative study

Abstract

Rationale: Cardiovascular diseases (CVDs) take the lives of millions of people every year. Due to the aging, there is a growing number of people with CVD, which results in an increased number of CVD-related hospital admissions. Secondary prevention is important to prevent recurrent cardiovascular events and consists of smoking cessation, healthier food choices and physical activity. These preventive activities are proven effective in every age, but lifestyle changes are difficult to maintain and it is unclear what older patients’ perspectives are towards these lifestyle changes. Aim: The aim of this study was to describe the perspectives of older cardiac patients towards lifestyle modification after a cardiac hospital admission. Method: Using an exploratory qualitative generic approach, semi-structured face-to-face interviews were conducted with 13 participants who participated in the control group of the Cardiac Care Bridge program. Patients were are older than 70 years and were admitted to the hospital in the past three months due to CVD. An interviewguide was developed using the ASE-model for behavior change. Thematic analysis according to Braun & Clarke was used. Results: Several perspectives are seen towards lifestyle modification. Quality of life is important and the benefits of lifestyle changes are not clear. Analysis revealed five main themes: attitude; social norm; self-efficacy; barriers and stimuli; knowledge and skills. Conclusion: Quality of life is an important factor why many participants make decisions to not make any lifestyle adjustments. It is being questioned what the benefits of lifestyle changes are for elderly in concrete terms. Participants are often being held back by physical impairments and unclear advice. Recommendations: Further research is needed to investigate what the adjustments of the lifestyle actually yields for the elderly and how interventions can be personalized.