Constructs of adherence and non-adherence to lifestyle modification among post-cardiac rehabilitation patients in Serdang Hospital / Noraini Mansor

Recurrent event of cardiovascular diseases is often associated with adherence and non-adherence to lifestyle modification. However, very few studies have examined adherent and non-adherent behaviors from the perspectives and experiences of postcardiac rehabilitation patients in Malaysia. The literature showed domain of adherence and non-adherence such as beliefs, norms and values may influence dietary, exercise and smoking behaviors, as a means to lead either adherence or non-adherence with lifestyle modification. The modified Health Belief Model was used as the conceptual framework. Therefore, this phenomenological study that was guided by the social constructionism lens, aims to explore the constructs of adherence and non-adherence to lifestyle modification among post-cardiac rehabilitation patients. Twenty-eight indepth semi-structured interviews with four females and twenty-four males postcardiac rehabilitation patients aged between 32 to 70 years old from rehabilitation centre of Serdang Hospital, Selangor were analysed using thematic analysis. The main themes of adherence constructs are values life, values health after representation of illness and values of the culture of respect of each others. The main themes of nonadherence constructs are the representations of disease and treatment, practice of coping behavior, values of social roles and responsibility, practice of food intake and preparation, values of social role, values religion, daily physical activities as considerable exercise, peer influence, and maladaptive beliefs of smoking cessation. These findings suggest that modifying factors of cultural beliefs, norms and values may influenced perceived susceptibility, severity, benefits and barriers of the likelihood to adherence or non-adherence to lifestyle modification. This study has given a significant contribution to the current knowledge with respect to the methodological approach and the conceptual framework of constructs of adherence and non-adherence to lifestyle modification in the form of a newly developed framework. The proposed framework may explain the constructs of adherence and non-adherence to lifestyle modification among post-cardiac rehabilitation patients in Malaysia.