TY - JOUR
T1 - Gender matters in cardiac rehabilitation and diabetes
T2 - Using Bourdieu's concepts
AU - Angus, Jan E.
AU - Dale, Craig M.
AU - Nielsen, Lisa Seto
AU - Kramer-Kile, Marnie
AU - Lapum, Jennifer
AU - Pritlove, Cheryl
AU - Abramson, Beth
AU - Price, Jennifer A.
AU - Marzolini, Susan
AU - Oh, Paul
AU - Clark, Alex
N1 - Publisher Copyright:
© 2018 Elsevier Ltd
PY - 2018/3
Y1 - 2018/3
N2 - Background: Habitual practices are challenged by chronic illness. Cardiac rehabilitation (CR) involves changes to habits of diet, activity and tobacco use, and although it is effective for people with diabetes and cardiovascular disease (CVD), some participants are reportedly less likely to complete programs and adopt new health related practices. Within the first three months of enrolling in CR, attrition rates are highest for women and for people with diabetes. Previous studies and reviews indicate that altering habits is very difficult, and the social significance of such change requires further study. Purpose: The purpose of the study was to use Bourdieu's concepts of habitus, capital and field to analyse the complexities of adopting new health practices within the first three months after enrolling in a CR program. We were particularly interested in gender issues. Methods: Thirty-two men and women with diabetes and CVD were each interviewed twice within the first three months of their enrolment in one of three CR programs in Toronto, Canada. Results: Attention to CR goals was not always the primary consideration for study participants. Instead, a central concern was to restore social dignity within other fields of activity, including family, friendships, and employment. Thus, study participants evolved improvised tactical approaches that combined both physical and social rehabilitation. These improvised tactics were socially embedded and blended new cultural capital with existing (often gendered) cultural capital and included: concealment, mobilizing cooperation, re-positioning, and push-back. Conclusions: Our findings suggest that success in CR requires certain baseline levels of capital – including embodied, often gendered, cultural capital – and that efforts to follow CR recommendations may alter social positioning.
AB - Background: Habitual practices are challenged by chronic illness. Cardiac rehabilitation (CR) involves changes to habits of diet, activity and tobacco use, and although it is effective for people with diabetes and cardiovascular disease (CVD), some participants are reportedly less likely to complete programs and adopt new health related practices. Within the first three months of enrolling in CR, attrition rates are highest for women and for people with diabetes. Previous studies and reviews indicate that altering habits is very difficult, and the social significance of such change requires further study. Purpose: The purpose of the study was to use Bourdieu's concepts of habitus, capital and field to analyse the complexities of adopting new health practices within the first three months after enrolling in a CR program. We were particularly interested in gender issues. Methods: Thirty-two men and women with diabetes and CVD were each interviewed twice within the first three months of their enrolment in one of three CR programs in Toronto, Canada. Results: Attention to CR goals was not always the primary consideration for study participants. Instead, a central concern was to restore social dignity within other fields of activity, including family, friendships, and employment. Thus, study participants evolved improvised tactical approaches that combined both physical and social rehabilitation. These improvised tactics were socially embedded and blended new cultural capital with existing (often gendered) cultural capital and included: concealment, mobilizing cooperation, re-positioning, and push-back. Conclusions: Our findings suggest that success in CR requires certain baseline levels of capital – including embodied, often gendered, cultural capital – and that efforts to follow CR recommendations may alter social positioning.
KW - Bourdieu
KW - Cardiac rehabilitation
KW - Cardiovascular disease
KW - Diabetes
KW - Gender
KW - Health related practices
KW - Qualitative research
UR - http://www.scopus.com/inward/record.url?scp=85041475608&partnerID=8YFLogxK
U2 - 10.1016/j.socscimed.2018.01.003
DO - 10.1016/j.socscimed.2018.01.003
M3 - Journal Article
C2 - 29421471
AN - SCOPUS:85041475608
SN - 0277-9536
VL - 200
SP - 44
EP - 51
JO - Social Science and Medicine
JF - Social Science and Medicine
ER -