title: Living with heart disease after angioplasty: A qualitative study of patients who have been successful or unsuccessful in multiple behavior change.
abstract: OBJECTIVE
  To document values, attitudes, and beliefs that influence behavior change among a diverse group of patients post-angioplasty.
  
  
  METHODS
  Purposive and maximum-variation sampling were used to assemble a demographically diverse patient cohort (N=61) who had been successful or unsuccessful at post-angioplasty multibehavior change. Semistructured interviews and grounded theory methods were used to collect and analyze qualitative data.
  
  
  RESULTS
  Themes showed the following: a) Patients reported surviving a life-threatening event and feared disease recurrence and death; b) the perception of a turning point and self-determination facilitated behavior change; c) social support and spiritual beliefs promoted coping with the uncertainty of living with heart disease; and d) unsuccessful behavior change was related to physical limitations, a sense that "nothing helps," and the belief that angioplasty "cures" heart disease.
  
  
  CONCLUSIONS
  Lifestyle interventions should be culturally relevant and adapted to physical abilities. Fostering self-determination and social support may promote successful behavior change.
authors.affiliation: Center for Complementary and Integrative Medicine, Weill Cornell Medical College, 1300 York Ave, Box 46, New York, NY 10065, USA. jcpeters@med.cornell.edu
authors.forename: Janey C
authors.initials: JC
authors.lastname: Peterson
authors.forename: John P
authors.initials: JP
authors.lastname: Allegrante
authors.forename: Paul A
authors.initials: PA
authors.lastname: Pirraglia
authors.forename: Laura
authors.initials: L
authors.lastname: Robbins
authors.forename: K Patrick
authors.initials: KP
authors.lastname: Lane
authors.forename: Kathryn A
authors.initials: KA
authors.lastname: Boschert
authors.forename: Mary E
authors.initials: ME
authors.lastname: Charlson
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017130:Angioplasty / Q000523:psychology*; D016009:Chi-Square Distribution; D015897:Comorbidity; D003327:Coronary Disease / Q000523:psychology* / Q000601:surgery*; D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007407:Interviews as Topic; D008019:Life Style; D008297:Male; D008875:Middle Aged; D036301:Qualitative Research; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D018709:Statistics, Nonparametric