Change and continuity in the lives of cardiac patients : a study of exercise-based rehabilitation

Abstract

The thesis sought to contribute to an interpretative understanding of the ways that cardiac patients choose either to adhere to a physically active lifestyle or not.  An ethnographic methodology was adopted and fieldwork involved collecting material through a range of qualitative methods including semi-structured interviews, participant observation and opportunistic unstructured interviews.  These data were analysed, and further data generated, through a method informed by grounded theory, within a symbolic interactionist framework.

Within the current culture that emphasises individual responsibility for health it is important to respond to illness in ‘the right way’.  This study found that cardiac patients, as social actors, biographically create the circumstances within which they can legitimately choose to engage in physical activity or not.  Efforts to maintain continuity are central to both courses of action.  For some cardiac patients, the only way of maintaining continuity and regaining their identity is to alter their lifestyle and engage in exercise.  For others, continuity is maintained and identity regained by maintaining the same lifestyle.  A key finding is that both types of biographical work have the same ultimate purpose of maintaining continuity.  A cardiac event can be biographically disruptive and can disturb the roles that comprise one’s identity.  Central to identity are self-presentational concerns.  These self-presentational concerns relate both to the micro perspective of the gym setting as well as the wider consideration of managing an impression to others.

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