title: "I can't just follow any particular textbook": immigrants in cardiac rehabilitation.
abstract: OBJECTIVE
  The study purpose was to examine how and under what circumstances immigrants combine diabetes self-care with cardiac rehabilitation recommendations.
  
  
  BACKGROUND
  Cardiac rehabilitation can improve and lengthen life in people with coronary heart disease as it promotes healthy physical and psychosocial behaviours and outcomes. This study is the first to examine the convergence of two common issues on participation: (1) the problems posed when cardiac rehabilitation patients must also contend with type II diabetes and (2) the experiences of immigrants in cardiac rehabilitation.
  
  
  METHODS
  A critical ethnographic approach was employed.
  
  
  METHODS
  Two in depth interviews were conducted with 18 immigrants (eight men, ten women) enrolled in cardiac rehabilitation. Data were collected from 2008-2010.
  
  
  RESULTS
  Threaded throughout immigrant participants' descriptions were biographical accounts of crossing geographical borders, establishing a sense of belonging in their adopted country and trying to feel 'at home' in cardiac rehabilitation. Participants described creative hybridization of transnationally informed knowledges and particularized practices to manage diabetes self-care and to reduce cardiac risk. Participants judiciously considered, assessed and blended knowledges from cardiac rehabilitation, experience with their own bodies and general 'wisdoms' passed on within their own and other immigrant communities.
  
  
  CONCLUSIONS
  These findings suggest that migration constitutes an important social positioning that contextualizes individual efforts to activate diabetes self-care and cardiac rehabilitation. Support to immigrants may improve when nurses recognize the significance of such experiences. Efforts are needed in practice and research to recognize and explore immigrants' creative efforts to engage in cardiac rehabilitation.
authors.affiliation: Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Ontario, Canada. lisa.seto@utoronto.ca
authors.forename: Lisa
authors.initials: L
authors.lastname: Seto Nielsen
authors.forename: Jan E
authors.initials: JE
authors.lastname: Angus
authors.forename: Jennifer
authors.initials: J
authors.lastname: Lapum
authors.forename: Craig
authors.initials: C
authors.lastname: Dale
authors.forename: Marnie
authors.initials: M
authors.lastname: Kramer-Kile
authors.forename: Beth
authors.initials: B
authors.lastname: Abramson
authors.forename: Susan
authors.initials: S
authors.lastname: Marzolini
authors.forename: Paul
authors.initials: P
authors.lastname: Oh
authors.forename: Jennifer
authors.initials: J
authors.lastname: Price
authors.forename: Alex
authors.initials: A
authors.lastname: Clark
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000884:Anthropology, Cultural; D003327:Coronary Disease / Q000208:ethnology / Q000451:nursing / Q000534:rehabilitation*; D054521:Cultural Competency; D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology / Q000451:nursing / Q000628:therapy*; D054242:Emigrants and Immigrants; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D033262:Narration; D009864:Ontario; D010349:Patient Compliance / Q000208:ethnology*; D012648:Self Care