PDF(Pubmed)
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.
摘要：
国家卫生服务（NHS）心脏康复患者护理途径多年来基本保持不变，尽管，平均而言,所有符合条件的患者中有一半拒绝参与。调查不参与的原因，我们探索了10名参与心脏康复的心脏病患者的经验，退出,或拒绝，以及七个人的经历被参与者认为是重要的其他人。我们的人种学研究涉及参与者的观察，重复深入的半结构化访谈，和自反日记。进行了反身性主题分析，专注于参与者的生活经历。利用布迪尤斯的习惯概念，资本，和字段,这篇文章重点介绍了个人传记，物质条件,和倾向相结合，使心脏保健决策变得个性化和复杂。尽管如此,卫生专业人员并不总是适应因患者经验和生活世界的差异而产生的具体情况。通过考虑承认社会文化影响的服务改进建议，心脏康复可以为患者及其重要的其他人提供更合适的，个性化,以人为中心的支持。
