Socio-cultural influences on exercise and health along the cardiac patient journey: a Bourdieusian perspective

Blackwell, Joanna Mary (2021) Socio-cultural influences on exercise and health along the cardiac patient journey: a Bourdieusian perspective. PhD thesis, University of Lincoln.

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Socio-cultural influences on exercise and health along the cardiac patient journey: a Bourdieusian perspective
PhD Thesis
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Abstract

In the UK, there are thousands of cardiac events every year, which include Myocardial
Infarctions (MIs), heart surgery, device insertions and heart failure. The journey of each
cardiac patient is likely to be influenced by many factors and follows three main temporal
stages: symptom recognition and treatment, the offer of Cardiac Rehabilitation, and recovery.
Symptoms may develop rapidly or more gradually. How one approaches these symptoms and
the decisions made about health care can be highly personal and contingent on socio-cultural
influences. Cardiac Rehabilitation will typically be offered as part of the journey. Levels of
patient participation in Cardiac Rehabilitation in the UK, which is exercise-based, have been
sub-optimal for many years. This relates not only to overall participation, but also specifically
to numbers of women attending, and to those from deprived areas. Research examines inputs
into, outputs and outcomes from Cardiac Rehabilitation, but to date, scant sociological
attention has been given to the lived experience of the cardiac patient journey. Given that
targets and initiatives have failed to instigate significant change in attendance rates at Cardiac
Rehabilitation programmes, it is important to investigate in-depth some of the socio-cultural
factors shaping and influencing (non)participation. Further, through the exploration of how
individuals navigate the recovery stage following a cardiac event, insight can be gained into
the complexities of ‘getting on with life’ following serious ill-health.
The theoretical framework offered by Pierre Bourdieu provides a powerful way of illuminating
several key aspects in understanding socio-cultural influences on exercise and health, and
health care decision making throughout the cardiac patient journey. This includes recognition
of both structure and agency, and how the two may interact in the social world, guiding an
individual’s chances and choices along the cardiac patient journey.
ii
Ethnographically inspired fieldwork was conducted over a six-month period in the UK, during
which, participant observations, repeat semi-structured interviews, and reflexive journaling
were utilised. Reflexive thematic analysis subsequently enabled six key themes to be
identified. These themes are discussed in three sections. The first explores the approach to
symptoms, examining the influence of the habitus’ work, and how capital has been
accumulated and deployed within the field of health care. The second examines Cardiac
Rehabilitation (non)participation, noting how dispositional inclinations help shape the
formation of practice, and thus how one may approach the offer of rehabilitation, and whether
accessing this field is commensurate with the habitus. The third appraises the recovery stage
and considers the corporeal and psychosocial impact of the cardiac event and how social
actors might utilise their capital resources to renegotiate embodiment.
The study adds to the existing literature by illuminating some of the socio-cultural
complexities associated with: health care decision making when experiencing cardiac
symptoms, exercise experience in uptake of and adherence to Cardiac Rehabilitation, and
the process of recovery. Most notably, participants’ material conditions and personal
biography, and the influence of other people, were found to serve to constrain or enable the
navigation of fields, such as health care and Cardiac Rehabilitation.

Keywords:Myocardial Infarctiony, Cardiac Rehabilitation, UK
Subjects:C Biological Sciences > C600 Sports Science
Divisions:College of Social Science > School of Sport and Exercise Science
ID Code:48452
Deposited On:04 Mar 2022 15:03

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