title: Men and women managing coronary artery disease risk: urban-rural contrasts.
abstract: People's beliefs about health and making lifestyle changes associated with risk reduction and disease prevention can vary based on their gender and ethnocultural affiliation. Our objective was to describe and explain how gender and ethnocultural affiliation influence the process that people undergo when faced with making lifestyle changes related to their coronary artery disease (CAD) risk. A series of grounded theory studies were undertaken in Alberta, Canada, with men and women from five ethnocultural groups diagnosed with CAD. Here, we describe the cultural aspects associated with urban- and rural-living in 42 Euro-Celtic men and women. Data were collected through semi-structured, audio-recorded interviews and analysed using constant comparative methods. The core variable that emerged through the process was 'meeting the challenge'. There were three phases to the process of managing CAD risk: pre-diagnosis/event, liminal self, and living with CAD. Intra-personal, inter-personal, extra-personal, and socio-demographic factors influenced the participants' capacity to meet the challenge of managing their CAD risk. The influence of these factors was either direct or indirect through the intertwined elements of the participants' knowledge about CAD and perceived extent of necessary change. Each element of this process was influenced by the participants' gender and culture (urban- versus rural-living). When healthcare providers understand and work with the gender- and ethnoculturally based components that influence people's appraisal of their cardiac health and their decision-making, appropriate secondary prevention interventions and positive health outcomes are more likely to follow.
authors.affiliation: Faculty of Nursing, University of Calgary, 2500 University Drive NW, Calgary, AB, Canada T2N 1N4. kingk@ucalgary.ca
authors.forename: Kathryn M
authors.initials: KM
authors.lastname: King
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Thomlinson
authors.forename: Julianne
authors.initials: J
authors.lastname: Sanguins
authors.forename: Pamela
authors.initials: P
authors.lastname: LeBlanc
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000416:Alberta / Q000453:epidemiology; D003327:Coronary Disease / Q000208:ethnology* / Q000517:prevention & control; D003466:Cultural Characteristics; D005260:Female; D015438:Health Behavior / Q000208:ethnology*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008019:Life Style / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D012423:Rural Health / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014504:Urban Health / Q000706:statistics & numerical data*; D044465:White People / Q000523:psychology*