Table 2.
Joint display of themes identified in Phase I qualitative phase, further examined in Phase II quantitative phase
| Organizing themes | Interview quotations | Questionnaire (“believe” indicates that patients “agree” or “strongly agree”) |
|---|---|---|
| Support network: Support networks are important for patients in coping with ASCVD. |
“Nobody can do it alone – you need a mother and a father, and it’s that positive reinforcement that I’m getting from my wife.” | 94.8% (N = 115) believe that a support network is important in recovery from heart disease. |
| Support network: Family plays a significant role in patients’ active participation in clinical research programs. |
“My participation in SAVE BC program is all for my daughter … because there is a family history of heart disease on my mom’s side.” | 62.6% (N = 115) believe that social support is an important area to address in clinical programs. 72.9% (N = 111) believe that family involvement encourages active participation. 61.5% (N = 75) of index patients want family members enrolled as co-participants, and 41.0% (N = 75) want them to undergo additional education. 79.3% (N = 85) of respondents who have attended a SAVE BC clinic want to see their family members enrolled compared with 47.1% (N = 35) who have not. |
| Support network: Participants prioritize a comprehensive support network. |
“Personally, I’m just one of those guys who shares stuff with my friends…mentally, emotionally, I’m pretty well taken care of.” “I think I’m going to have another heart attack and when I do, I can phone [SAVE BC] all over it. Usually within a day, he’s phoning me back.” “I talked with quite a few heart attack survivors, so we all talk about it.... It’s a therapy session for us as well.” |
Supports identified by interviewees (N = 116) 64.7% Informational support – advice, feedback 63.9% Emotional support – empathy, concern 39.7% Companionship support – sense of belonging 33.6% Tangible support –goods and services 46.1% (N = 115) currently or would like to participate in support groups for people with similar lived experiences. |
| Education: Patients desire education adapted to their own condition and interests. |
“I’m all about the why, why, why. And I will ask why 100 times if I have to…. That’s the attitude I take to SAVE BC.” | 83.5% (N = 114) expect patient-specific education in clinical programs. Top 5 topics for education in ASCVD (N = 116): 79.3% nutrition; 76.7% exercise; 67.2% etiology/pathophysiology; 66.4% psychological aspects; 66.4% medication Desired method of information delivery (N = 116): 59.4% Recommendation of reputable online resources 57.8% Private discussion w/ healthcare professional 56.0% Written information packages |
| Education: Patients want to be active members in the research process |
“Having an opportunity to participate in something that might help somebody else…. I like to do things that help people and if it’s helping my own, it’s more important. So [participation in SAVE BC] the best opportunity for me.” | 84.2% (N = 115) believe that education enables active participation in research programs. 91.4% (N = 116) want to receive updates on research findings. Top 3 reasons for participating in ASCVD research (N = 116): 84.5% Contribute to body of knowledge 75.0% Benefit personally from research 64.7% Help those close to them |
| Mental health: Acute cardiac events have a significant effect on patient and family mental health. |
“For the first 6 months after the event, I was having some depression issues. I’m seeing a psychiatrist to work through those…. It was basically fear of having another attack.” | 71.0% (N = 114) believe that heart disease has negatively affected their mental health. |
| Mental health: Patients with ASCVD desire greater mental health support for their psychosocial health and engagement. |
“They give a bunch of information, but it’s so overwhelming. They focus so much on you getting better but barely even talked about depression, which as far as I’m concerned is a major issue that needs to be dealt with as a heart attack survivor.” | 37.8% (N = 74) of index patients believe their mental health issues have been addressed by healthcare providers. 50.7% (N = 75) of index patients believe that mental health support is important for engagement in clinical programs. Top 5 avenues for mental health support (for participants who believe their mental health has been affected by ASCVD) (N = 81) 59.3% Stress management education 28.4% Shared-experience support groups 28.4% Referral to mental health specialist 19.8% Referral to community counselling |
| Lifestyle changes: Participants are well educated on the importance of lifestyle modifications. |
“The 2 pointers I give people is, I mean I know it’s common sense and it sounds funny but get moving and get rid of sugar.” | 85.1% (N = 114) believe that making lifestyle changes improves participation in clinical programs. |
| Lifestyle changes: Participants find challenges in motivating lifestyle changes and require longitudinal support to maintain it. |
“I enjoy food. It is a good time…my problem now is I just eat too much.” “Off again on again…he has times with more difficulty staying motivated to go to the gym.” |
71.3% (N = 115) believe that they have faced challenges in making lifestyle changes. 93.8% (N = 113) believe that exercise/dietary programs can help them make lifestyle changes. 69.3% (N = 114) believe that exercise/dietary components are important in cardiac clinical programs (only 8.8% disagree). Frequency participants would like to follow up for lifestyle changes (N = 114): 14.0% weekly 13.2% biweekly 42.1% monthly 20.2% yearly 5.3% 1-time event 5.3% never |
ASCVD, atherosclerotic cardiovascular disease; SAVE BC, Study to Avoid Cardiovascular Events in British Columbia.