Evid Based Nurs 11:127 doi:10.1136/ebn.11.4.127
  • Qualitative

Many patients with coronary heart disease believed that stress and lifestyle factors caused their illness

F Astin

Dr F Astin, University of Leeds, Leeds, UK;


What are the beliefs of patients with coronary heart disease (CHD) about the cause of their illness?


Framework analysis.


3 general hospitals in West Yorkshire, UK.


65 patients 40–83 years of age (mean age 63 y, 55% men, 69% South Asian) who were admitted to hospital with unstable angina or myocardial infarction or for coronary artery bypass surgery. Patients with terminal illness, severe mental illness, or drug or alcohol addictions were excluded.


Patients were interviewed within the first year of discharge. Questions addressed their experiences and beliefs about their condition, information provided after diagnosis, lifestyle modification, and the role of family members in providing support. Interviews were transcribed, coded, and analysed for themes.


Patients with CHD had various explanations for the cause of their illness and a lack of understanding about appropriate lifestyle changes. (1) Family history. Patients who believed that family history or genetics caused their CHD felt that lifestyle changes would not have prevented CHD. Others could not identify specific …

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