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Illness Beliefs and Walking Behavior After Revascularization for Intermittent Claudication: A QUALITATIVE STUDY

Cunningham, Maggie A. PhD; Swanson, Vivien PhD; Pappas, Elise GDipExPhys (Clin); O'Carroll, Ronan E. PhD; Holdsworth, Richard J. MD

Journal of Cardiopulmonary Rehabilitation and Prevention: May/June 2014 - Volume 34 - Issue 3 - p 195–201
doi: 10.1097/HCR.0000000000000046
Peripheral Vascular Disease

PURPOSE: Patients with peripheral artery disease (PAD) are recommended to increase physical activity to reduce cardiovascular risk. Vascular intervention (surgery or angioplasty) treats the symptom (intermittent claudication), but not the underlying cardiovascular disease. This study aims to explore the beliefs and physical activity behavior of patients with PAD who have received vascular intervention.

METHODS: Twenty participants who had received a vascular intervention for intermittent claudication between 6 months and 2 years previously participated in semistructured interviews. The interviews explored illness and treatment beliefs and walking behavior. Data were transcribed verbatim and analyzed thematically.

RESULTS: Participants described a high level of ongoing symptoms (particularly pain) in their legs, despite having received vascular intervention. They viewed their illness as acute and treatable, and believed that pain was an indication of walking causing damage. They controlled their symptoms by avoiding walking and slowing their pace. Participants were generally unaware of the causes of the disease and were unaware of their increased risk of future cardiovascular health problems. There was a low level of congruence between participant beliefs about their illness and the recommendation to increase physical activity that may affect physical activity behavior.

CONCLUSIONS: Our findings suggest that patients with PAD do not change physical activity behavior after diagnosis and treatment, because they hold dysfunctional and incongruous beliefs about PAD, treatment, and physical activity.

Interviews were conducted with 20 patients who had previously received vascular intervention for peripheral artery disease. Thematic analysis revealed that patients do not change physical activity behavior after diagnosis and treatment because they hold dysfunctional and incongruous beliefs about peripheral artery disease, treatment, and physical activity.

Psychology Department, School of Natural Sciences, University of Stirling, Stirling, Scotland (Drs Cunningham, Swanson, and O'Carroll); Queensland Research Centre for Peripheral Vascular Disease, School of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia (Ms Pappas); and NHS Forth Valley, Forth Valley Royal Hospital, Larbert, Scotland (Mr Holdsworth).

Correspondence: Maggie A. Cunningham, PhD, Psychology Department, School of Natural Sciences, Cottrell Building, University of Stirling, Stirling, Scotland FK9 4LA (

The authors declare no conflicts of interest.

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins