Illness beliefs of patients of South Asian and European origin living in the UK

Objective: To examine and compare the illness beliefs of South Asian and European patients with coronary heart disease about causal attributions and lifestyle change. Methods: A qualitative study that used framework analysis to examine in-depth interviews. Sample: Sixty five subjects (20 Pakistani-Muslim, 13 Indian-Hindu, 12 Indian-Sikh, and 20 Europeans) admitted to one of three UK sites within the previous year with unstable angina, myocardial infarction or for coronary artery bypass surgery. Results: Beliefs about CHD cause varied considerably. Pakistani-Muslim participants were the least to report that they knew what had caused their CHD. Stress and lifestyle factors were the most frequently cited causes for CHD irrespective of ethnic grouping, although family history was frequently cited by older European participants. South Asian patients were more likely to stop smoking than their European counterparts but less likely to use audio tape stress relaxation techniques. South Asian patients found it particularly difficult to make dietary changes. Some female South Asians developed innovative indoor exercise regimens to overcome obstacles to regular exercise. Conclusion: Misconceptions about the cause of CHD and a lack of understanding about appropriate lifestyle changes were evident across ethnic groups in this study. The provision of information and advice relating to cardiac rehabilitation must be better tailored to the context of CHD patient’s specific needs, beliefs and circumstances regardless of their ethnicity.