Patient and Partner Strategies for Talking about Lifestyle Change Following a Cardiac Event

Abstract

Heart patients are frequently advised to make lifestyle changes and communication with a romantic partner can help or hinder adoption of heart healthy behaviors. However, talking about lifestyle change can have both positive and negative meanings and this can create dilemmas for couples. We engaged in an interpretive analysis of interviews with 25 patients and 16 partners to identify the ways they managed the meanings of lifestyle change talk. Their communicative strategies included rationing talk, saying it nicely and framing it cooperatively. Each strategy had advantages and disadvantages as well as optimal conditions. We also identified interpretive lenses that shaped the meaning of talk, including legitimacy, patience, emphasizing the positive, moderation, benefits for both people, and perceived compliance. Finally, environmental resources (such as household patterns and communication with the social network) contextualized the meaning of talk. We proposed a model of the interrelated influence of communication, interpretation, and environment on the meanings of talking about lifestyle change.

Keywords:

• Lifestyle Change
• Marital Communication
• Social Support
• Communication Dilemmas
• Strategic Communication
• Cardiac Disease

Acknowledgments

This research was supported by a grant from the University of Illinois Campus Research Board. We are grateful to the cardiac rehabilitation staff at Carle Foundation Hospital and Provena Covenant Medical Center and the Champaign-Urbana chapter of Mended Hearts for their assistance in participant recruitment. We thank Virginia McDermott and Kristen Bauer for their assistance with interviews and transcription.

Notes

1. We have given all participants pseudonyms to protect their privacy.

2. As this case shows, an example can be categorized into more than one type of strategy. Wording one's comment as an inquiry counts as saying it nicely; when the inquiry receives an answer and the inquirer chooses not to pursue the topic further, this also entails rationing talk.

3. For example, Shoham, Rohrbaugh, Trost, and Muramoto (2006) use systems-based couples therapy to address smoking and Sher and Baucom (2001) describe group cognitive-behavioral couple therapy for lifestyle change.

4. Many communication theories focus on strategies in response to conflicting goals, so these refinements to Goldsmith's theory likely have widespread application. Space limitations preclude a full comparison or exploration of other theories.

Additional information

Notes on contributors

Daena J. Goldsmith

Daena J. Goldsmith is Professor of Rhetoric & Media Studies at Lewis & Clark College, Portland, OR

Jennifer J. Bute

Jennifer J. Bute is Assistant Professor of Communication Studies at Indiana University—Purdue Unviersity, Indianapolis, IN

Kristin A. Lindholm

Kristin A. Lindholm is Associate Professor of Communication at Trinity International University, Deerfield, IL. Preliminary analyses related to this paper were presented at the meeting of the National Communication Association, November 2007, Chicago, IL