title: The cardiac patients' perceptions of their responsibilities in adherence to care: a qualitative interview study.
abstract: OBJECTIVE
  To describe cardiac patients' perceptions of their responsibilities in adherence to care.
  
  
  BACKGROUND
  The responsibilities of cardiac patients' adherence to care is a topical issue because of the increasing prevalence of noncommunicable diseases in Western countries, including cardiovascular disease (CVD). Responsibilities for cardiac patients' care have been studied, but little is described about patients' perspectives in this study.
  
  
  METHODS
  A qualitative, hermeneutic inquiry.
  
  
  METHODS
  We used face-to-face individual semistructured interviews with 21 cardiac patients (76% male) aged 58-86 in an urban area of Finland in winter 2013. The data were analysed hermeneutically with inductive content analysis.
  
  
  RESULTS
  Based on our results, patients with cardiac disease understood that autonomy provided a basis for their responsibility in adherence to care. It included being able to make independent decisions, in collaboration with health professionals, or even to entrust that responsibility to healthcare professionals. Responsibilities were understood to be an expression of adherence, perceived to benefit the patient and included the duty to adopt a healthy lifestyle and care for their own medical condition. The main factors that influenced patients' responsibilities around adherence to care were their individual resources and motivation, relationships with healthcare professionals and the resources of the healthcare system.
  
  
  CONCLUSIONS
  Autonomy is an inherent part of cardiac patients' adherence to care, but there has been little focus on their responsibilities in the literature. More attention needs to be paid to the healthcare providers' abilities to support patients' duties and responsibilities in clinical practice and to future research.
authors.affiliation: Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland.
authors.forename: Mari
authors.initials: M
authors.lastname: Kangasniemi
authors.affiliation: Department of Nursing, The School of Health and Social Studies, JAMK University of Applied Sciences, Jyväskylä, Finland.
authors.forename: Marina
authors.initials: M
authors.lastname: Hirjaba
authors.affiliation: Cardiac Surgical Intensive Care Unit M2A, HUS, Meilahti Tower Hospital, Helsinki, Finland.
authors.forename: Katja
authors.initials: K
authors.lastname: Kohonen
authors.affiliation: Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.
authors.forename: Ercole
authors.initials: E
authors.lastname: Vellone
authors.affiliation: Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland.
authors.forename: Tanja
authors.initials: T
authors.lastname: Moilanen
authors.affiliation: Social and Health Care Services, Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland.
authors.forename: Anna-Maija
authors.initials: AM
authors.lastname: Pietilä
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000523:psychology*; D005260:Female; D006282:Health Personnel; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology*; D010465:Perception; D036301:Qualitative Research; D012648:Self Care / Q000523:psychology*
keywords: adherence; autonomy; cardiac patient; duties; responsibilities; rights