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Understanding Self-regulation Behaviors in South Asians With Coronary Artery Disease: A Mixed-Methods Study

Jiwani, Rozmin B. PhD, RN, ACNS-BC; Cleveland, Lisa M. PhD, RN, PNP-BC, IBCLC; Patel, Darpan I. PhD; Virani, Salim S. PhD, MD; Gill, Sara L. PhD, RN, IBCLC, FAAN

Journal of Cardiovascular Nursing: May/June 2017 - Volume 32 - Issue 3 - p 281–287
doi: 10.1097/JCN.0000000000000340
ARTICLES: International Studies

Background: South Asians (SAs) have a well-documented risk for mortality related to coronary artery disease (CAD). However, there is a lack of evidence to guide the implementation and dissemination of primary and secondary interventions to control and deter progression of CAD in SAs.

Objective: The aim of this study is to explore and describe self-regulation behaviors in SAs with CAD using Leventhal’s Common Sense Model.

Methods: In this mixed-methods study, quantitative data were collected using 3 survey questionnaires (demographics, Illness Perception Questionnaire–Revised, and Coping/Self-Regulation Behaviors). Before completing the surveys, a subset of the sample (n = 20) participated in individual face-to-face or telephone interviews.

Results: A total of 102 SAs were enrolled (age, 53.5 ± 9.98 years). On average, participants rated themselves high (63 ± 3.06) on negative perceptions. In addition, they discussed desi diet, stress, a lack of physical activity, ignoring symptoms, and kismet (fate) as the most important perceived causes of their CAD. Most of the participants modified their lifestyle after their CAD event. Participants expressed regret for not having changed their lifestyle earlier when they were experiencing early symptoms of their CAD.

Conclusion: Findings from this study enhance the understanding of self-regulation behaviors of SAs with CAD. Ultimately, these findings will inform the development and implementation of targeted interventions that address culture-specific lifestyle modification for SAs with CAD.

Rozmin B. Jiwani, PhD, RN, ACNS-BC Clinical Assistant Professor, School of Nursing, University of Texas Health Science Center at San Antonio, and Texas Center for Health Disparities STAR Fellow, Health Restoration and Care System Management.

Lisa M. Cleveland, PhD, RN, PNP-BC, IBCLC Assistant Professor, School of Nursing, University of Texas Health Science Center at San Antonio, and Texas Center for Health Disparities STAR Fellow, Family & Community Health Systems.

Darpan I. Patel, PhD Assistant Professor/Research, School of Nursing, University of Texas Health Science Center at San Antonio, Health Restoration and Care System Management.

Salim S. Virani, PhD, MD Investigator, Health Policy, Quality, and Informatics Program, Michael E. DeBakey Veterans Affairs Medical Center HSR&D Center for Innovations, and Associate Professor, Section of Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, Texas.

Sara L. Gill, PhD, RN, IBCLC, FAAN Distinguished Teaching Professor, School of Nursing, University of Texas Health Science Center at San Antonio, and PhD Program Director, Family & Community Health Systems.

Funding for this dissertation study was provided by a Sigma Theta Tau, Int, research grant and the Office for Academic Affairs at the University of Texas Health Science Center at San Antonio. The authors have no conflicts of interest to disclose.

Correspondence Rozmin B. Jiwani, PhD, RN, ACNS-BC, University of Texas Health Science Center San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229 (jiwani@uthscsa.edu).

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