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You Won't Know If You Don't Ask: Discrepancy and Ambivalence in Attitudes Toward Behavior Change

Everett, Bronwyn PhD, MSc(Hons), BAppSc(Nurs), RN; DiGiacomo, Michelle PhD, BA, MHSc(Hons); Rolley, John X. PhD, RN, BN(Hons); Salamonson, Yenna PhD, MA, BSc, RN, Grad Dip Nsg Stds (Ed); Davidson, Patricia M. PhD, MEd, BA, RN, ITC

Journal of Cardiovascular Nursing:
doi: 10.1097/JCN.0b013e3182076a4e
ARTICLES: Behavioral Change

Background: Behavior change is challenging following an acute cardiac event, and commonly, individuals are ambivalent.

Aim: The objective of this study was to describe the experience of behavior change of survivors of an acute cardiac event.

Method: Semistructured interviews were undertaken with 25 participants attending 3 cardiac rehabilitation programs. An inductive process of qualitative thematic analysis was used to analyze the transcripts.

Results: Analysis revealed ambivalence to change, misconceptions, and confusion about terminology. Discrepancies between what participants felt they should be doing and what they actually were doing reflected their ambivalence. Further inconsistencies were reflected in participants' misunderstandings and confusion regarding disease processes and management of heart disease.

Conclusions: These findings reflect the misconception and ambivalence regarding behavior change that individuals experience. Clinicians may require greater skills in detecting conflicting or ambivalent discourse to support patients through sustainable health behavior change.

Author Information

Bronwyn Everett, PhD, MSc(Hons), BAppSc(Nurs), RN Senior Lecturer, University of Technology, Sydney, Australia.

Michelle DiGiacomo, PhD, BA, MHSc(Hons) Postdoctoral Research Fellow, Centre for Cardiovascular and Chronic Care, University of Technology Sydney, Curtin University, Australia.

John X. Rolley, PhD, RN, BN(Hons) Senior Research Fellow, Australian Catholic University, Melbourne.

Yenna Salamonson, PhD, MA, BSc, RN, Grad Dip Nsg Stds (Ed) Senior Lecturer, School of Nursing, University of Western Sydney, Australia.

Patricia M. Davidson, PhD, MEd, BA, RN, ITC Professor of Cardiovascular and Chronic Care, Centre for Cardiovascular and Chronic Care, University of Technology Sydney, Curtin University, Australia.

Dr Everett was supported by an Australian Research Council Linkage Project (LP056051) scholarship during the writing of this article.

The authors have no conflicts of interest to disclose.

Correspondence Bronwyn Everett, PhD, MSc(Hons), BAppSc(Nurs), RN, Faculty of Nursing, Midwifery & Health, University of Technology Sydney, Sydney, Australia (

© 2011 Lippincott Williams & Wilkins, Inc.