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Causal attributions, lifestyle change and coronary heart disease: illness beliefs of patients of South Asian and European origin living in the UK

Darr, A., Astin, K. and Atkin, K. (2008) Causal attributions, lifestyle change and coronary heart disease: illness beliefs of patients of South Asian and European origin living in the UK. Heart & Lung -The Journal of Acute & Critical Care, 37 (2). pp. 91-104. ISSN 0147-9563

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We examined and compared the illness beliefs of South Asian and European patients with coronary heart disease (CHD) about causal attributions and lifestyle change.


This was a qualitative study that used framework analysis to examine in-depth interviews.


The study comprised 65 subjects (20 Pakistani-Muslim, 13 Indian-Hindu, 12 Indian-Sikh, and 20 Europeans) admitted to one of three UK sites within the previous year with unstable angina or myocardial infarction, or to undergo coronary artery bypass surgery.


Beliefs about CHD cause varied considerably. Pakistani-Muslim participants were the least likely to report that they knew what had caused their CHD. Stress and lifestyle factors were the most frequently cited causes for CHD irrespective of ethnic grouping, although family history was frequently cited by older European participants. South Asian patients were more likely to stop smoking than their European counterparts but less likely to use audiotape stress-relaxation techniques. South Asian patients found it particularly difficult to make dietary changes. Some female South Asians developed innovative indoor exercise regimens to overcome obstacles to regular exercise.


Misconceptions about the cause of CHD and a lack of understanding about appropriate lifestyle changes were evident across ethnic groups in this study. The provision of information and advice relating to cardiac rehabilitation must be better tailored to the context of the specific needs, beliefs, and circumstances of patients with CHD, regardless of their ethnicity.

Item Type: Article
Copyright, Publisher and Additional Information: © 2008 Elsevier B.V. This is an author produced version of a paper published in Hearth & Lung: The Journal of Acute and Critical Care. Uploaded in accordance with the publisher's self archiving policy.
Institution: The University of Leeds
Academic Units: The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Healthcare (Leeds)
The University of Leeds > University of Leeds Research Centres and Institutes > Centre for Research in Primary Care (Leeds)
Depositing User: Sherpa Assistant
Date Deposited: 11 Dec 2008 15:46
Last Modified: 08 Feb 2013 17:05
Published Version: http://dx.doi.org/10.1016/j.hrtlng.2007.03.004
Status: Published
Publisher: Elsevier B.V.
Refereed: Yes
Identification Number: 10.1016/j.hrtlng.2007.03.004
URI: http://eprints.whiterose.ac.uk/id/eprint/4994

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