Long-term impact of elevated cardiovascular risk detected by screening. A qualitative interview study.
OBJECTIVE
To explore how persons with an elevated cardiovascular risk score (CRS) balanced health-related advice against the life they wanted to live or were able to live.


METHODS
2000 Danes aged 30-50 were invited to participate in a health-screening project in general practice. Screenings were conducted at baseline and after one and five years, and included among other screening procedures a calculation of CRS (see Figure 1).


METHODS
Participants with an elevated CRS were asked to participate in a qualitative semi-structured interview. They were selected by stratified purposeful sampling reflecting variations in age, sex. and perceived health.


METHODS
Nine men and five women aged 33-50 years. THEORETICAL FRAMES OF REFERENCE: Bandura's theory of self-efficacy and the Health Belief Model's consideration of individuals' cues to act against a health threat supported analysis.


RESULTS
Being informed about an elevated CRS had a considerable impact on the informants. They initiated significant lifestyle changes, though only to a limited degree when such changes would affect their quality of life adversely. In cases where other results of the multiphasic screening were normal, interpreted as such, or if there were stressful circumstances in the informant's life, the elevated CRS receded into the background.


CONCLUSIONS
Doctors, who inform individuals about the impact of risk factors, need to know that the consequences and health advice are not always interpreted by laypeople as supposed by the medical culture.
Bach Nielsen
Karen-Dorthe
KD
The Ebeltoft Health Promotion Project, Noerreport 4, DK-8400 Ebeltoft, Denmark. karen-dorthe.bach.nielsen@dadlnet.dk
Dyhr
Lise
L
Lauritzen
Torsten
T
Malterud
Kirsti
K
D000328:Adult; D001294:Attitude to Health; D002318:Cardiovascular Diseases / Q000209:etiology / Q000517:prevention & control* / Q000523:psychology; D003718:Denmark; D005194:Family Practice; D005260:Female; D015438:Health Behavior; D006266:Health Education; D006801:Humans; D007407:Interviews as Topic; D008019:Life Style; D008297:Male; D008403:Mass Screening / Q000523:psychology; D008875:Middle Aged; D036301:Qualitative Research; D011788:Quality of Life; D018570:Risk Assessment; D012307:Risk Factors; D020377:Self Efficacy; D013997:Time Factors