title: Health beliefs about lifestyle habits differ between patients and spouses 1 year after a cardiac event - a qualitative analysis based on the Health Belief Model.
abstract: BACKGROUND
  Spousal concordance on risk factors and lifestyle habits exists and can partly be explained by patients' and spouses' health beliefs and underuse of cardiac rehabilitation. However, there have been very few qualitative comparisons of health beliefs between patients and spouses after a cardiac event.
  
  
  OBJECTIVE
  To examine and qualitatively compare the health beliefs of patients with coronary heart disease and their spouses about lifestyle habits, 1 year after the cardiac event.
  
  
  METHODS
  Explorative and descriptive.
  
  
  METHODS
  Semi-structured focus group interviews were conducted with patients (n = 14) 1 year after a cardiac event, as well as individual interviews with spouses (n = 8). The transcriptions underwent a deductive qualitative content analysis, within the framework of the Health Belief Model.
  
  
  RESULTS
  Patients' and spouses' health beliefs about lifestyle habits qualitatively differed in most predetermined main analytical categories of the Health Belief Model. The patients relied more on their own capacity and the healthcare system than on collaboration with their spouses who instead emphasised the importance of mutual activities to establish lifestyle habits. The spouses therefore experienced problems with different family preferences compared to the patients' wishes. Moreover, only patients believed supervised exercise was beneficial for risk reduction of coronary heart disease and they related barriers for medication to a self-healing body and a meaningless life without relatives and old habits. Patients and spouses agreed that despite the severity of illness, life was captured and that normalisation to a life as usual was possible.
  
  
  CONCLUSIONS
  The patients' and spouses' qualitatively different health beliefs regarding health-related behaviours imply a new approach. Nurses and associated professionals need to follow-up patients' and spouses' in primary health care to support them in a tailored way, for example in problem-based sessions. Recognition and understanding of their different views and otherness could lead to compromises and goals to work with.
authors.affiliation: Department of Social and Welfare Studies Div. Nurs. Sci., Linkoping University, Linkoping, Sweden.
authors.forename: Anita Kärner
authors.initials: AK
authors.lastname: Köhler
authors.affiliation: Department of Medical and Health Sciences (IMH), Linkoping University, Linkoping, Sweden.|Vikbolandet Health Care Center, Primary Health Care in eastern Ostergotland, Region Ostergotland, Norrkoping, Sweden.
authors.forename: Staffan
authors.initials: S
authors.lastname: Nilsson
authors.affiliation: Department of Social and Welfare Studies Div. Nurs. Sci., Linkoping University, Linkoping, Sweden.
authors.forename: Tiny
authors.initials: T
authors.lastname: Jaarsma
authors.affiliation: Department of Medical and Health Sciences (IMH), Linkoping University, Linkoping, Sweden.
authors.forename: Pia
authors.initials: P
authors.lastname: Tingström
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D010361:Patients; D036301:Qualitative Research; D018454:Spouses
keywords: Coronary Heart Disease; Health Psychology; Primary Care; Qualitative content analysis