Socio-cultural influences on exercise and health along the cardiac patient journey: a Bourdieusian perspective
Creators: name: Blackwell, Joanna Mary
Publisher: name: University of Lincoln
Year: 2024
Subjects: C600 - Sport &amp; exercise science

description: In the UK, there are thousands of cardiac events every year, which include MyocardialInfarctions (MIs), heart surgery, device insertions and heart failure. The journey of eachcardiac patient is likely to be influenced by many factors and follows three main temporalstages: symptom recognition and treatment, the offer of Cardiac Rehabilitation, and recovery.Symptoms may develop rapidly or more gradually. How one approaches these symptoms andthe decisions made about health care can be highly personal and contingent on socio-culturalinfluences. Cardiac Rehabilitation will typically be offered as part of the journey. Levels ofpatient participation in Cardiac Rehabilitation in the UK, which is exercise-based, have beensub-optimal for many years. This relates not only to overall participation, but also specificallyto numbers of women attending, and to those from deprived areas. Research examines inputsinto, outputs and outcomes from Cardiac Rehabilitation, but to date, scant sociologicalattention has been given to the lived experience of the cardiac patient journey. Given thattargets and initiatives have failed to instigate significant change in attendance rates at CardiacRehabilitation programmes, it is important to investigate in-depth some of the socio-culturalfactors shaping and influencing (non)participation. Further, through the exploration of howindividuals navigate the recovery stage following a cardiac event, insight can be gained intothe complexities of â€˜getting on with lifeâ€™ following serious ill-health.The theoretical framework offered by Pierre Bourdieu provides a powerful way of illuminatingseveral key aspects in understanding socio-cultural influences on exercise and health, andhealth care decision making throughout the cardiac patient journey. This includes recognitionof both structure and agency, and how the two may interact in the social world, guiding anindividualâ€™s chances and choices along the cardiac patient journey.iiEthnographically inspired fieldwork was conducted over a six-month period in the UK, duringwhich, participant observations, repeat semi-structured interviews, and reflexive journalingwere utilised. Reflexive thematic analysis subsequently enabled six key themes to beidentified. These themes are discussed in three sections. The first explores the approach tosymptoms, examining the influence of the habitusâ€™ work, and how capital has beenaccumulated and deployed within the field of health care. The second examines CardiacRehabilitation (non)participation, noting how dispositional inclinations help shape theformation of practice, and thus how one may approach the offer of rehabilitation, and whetheraccessing this field is commensurate with the habitus. The third appraises the recovery stageand considers the corporeal and psychosocial impact of the cardiac event and how socialactors might utilise their capital resources to renegotiate embodiment.The study adds to the existing literature by illuminating some of the socio-culturalcomplexities associated with: health care decision making when experiencing cardiacsymptoms, exercise experience in uptake of and adherence to Cardiac Rehabilitation, andthe process of recovery. Most notably, participantsâ€™ material conditions and personalbiography, and the influence of other people, were found to serve to constrain or enable thenavigation of fields, such as health care and Cardiac Rehabilitation.