How do patients at risk portray candidates for coronary heart disease? A qualitative interview study

Abstract

Objective. To explore how patients at risk of coronary heart disease (CHD) portray candidates for CHD. Design. Qualitative interview study. Setting. Norway. Subjects. A total of 20 men and 20 women diagnosed with heterozygous familial hypercholesterolemia (FH) recruited through a lipid clinic. Main outcome measures. Participants’ beliefs concerning persons who are considered candidates for CHD. Results. Some participants believed that CHD could happen to anyone, while the majority conveyed detailed notions of persons they considered to be likely victims of CHD. Participants often portrayed the coronary candidate as someone who was different from themselves. Among those who mentioned gender, all presented the candidate as a man. Some women said that they had to reconcile themselves to being at risk of CHD, since they at first had conceived CHD as a man's disease. While some participants considered their notions to be valid for assessing people's risk of CHD, others questioned how valid their notions were. Conclusion. Doctors should recognize that distancing is a way patients cope with risk and that such a strategy may have psychological and moral reasons. When communicating about risk, doctors should take into account that patients’ notions of risk may differ from medical notions of risk.

• Attitude to health
• coronary disease
• family practice
• health promotion
• hypercholesterolemia
• risk factors