title: Understanding the context of patient experiences in order to explore adherence to secondary prevention guidelines after heart surgery.
abstract: After coronary artery bypass surgery, many patients do not incorporate healthy behaviors into their postoperative lifestyle or enroll in cardiac rehabilitation, key aspects of secondary prevention. This qualitative study examined patients' post-coronary artery bypass surgery experiences to explore barriers in adhering to dietary and activity guidelines. We conducted semi-structured, in-depth interviews with 30 male patients from a military veteran's hospital, using emergent, thematic analysis to identify experiences that led to poor adherence. RESULTS were grouped according to barriers to diet, activities, and enrolling in cardiac rehabilitation. Overall, understandings of postoperative health, priorities that diverged from guidelines, and the context of household members and other health conditions impacted postoperative health behaviors. Many participants were familiar with secondary prevention guidelines. However, postoperative perceptions of health as well as the context of recovery influenced self-management. Providers must consider a patient's context when discussing secondary prevention. Venues such as cardiac rehabilitation may provide an opportunity to improve adherence to secondary prevention guidelines by expanding available class times, engaging patients' household members, or tailoring recommendations to also address other health conditions.
authors.affiliation: Center for Health Quality, Outcomes and Economic Research, Department of Veterans Affairs, ENMR Veterans Hospital, USA. gemmae.fix@va.gov
authors.forename: Gemmae M
authors.initials: GM
authors.lastname: Fix
authors.forename: Barbara G
authors.initials: BG
authors.lastname: Bokhour
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001026:Coronary Artery Bypass / Q000534:rehabilitation*; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D009511:New England; D010349:Patient Compliance / Q000523:psychology*; D011184:Postoperative Period; D055502:Secondary Prevention; D012648:Self Care / Q000523:psychology*; D011795:Surveys and Questionnaires; D014728:Veterans / Q000523:psychology*