Abstracts
Résumé
Les effets bénéfiques des programmes de réadaptation cardiaque ont été largement documentés. Par contre, peu d’études se sont penchées sur la faible participation des populations moins bien nanties. En employant l’approche socioculturelle de Pierre Bourdieu, cette étude qualitative contribue à élargir la base des connaissances à l’égard des pratiques de réadaptation cardiaque d’hommes de milieux socio-économiquement défavorisés. Des entrevues semi-structurées ont été effectuées auprès de 22 hommes francophones (âge moyen : 51,7 ans) de l’Outaouais urbain et ayant subi un accident cardiovasculaire. Les résultats suggèrent que les conditions de défavorisation façonnent un rapport au corps incompatible avec les normes de santé publique. Deux thèmes principaux sont développés : (a) les faibles dispositions à adopter des pratiques préventives en santé et (b) les faibles dispositions à participer à un programme de réadaptation cardiaque.
Mots-clés :
- réadaptation cardiaque,
- hommes,
- inégalités sociales,
- maladies cardiovasculaires,
- Pierre Bourdieu
Abstract
Positive effects of numerous cardiac rehabilitation programs have been largely documented. However, very few studies have addressed the low participation rates of underprivileged populations. Using Pierre Bourdieu’s sociocultural approach, this qualitative research helps to expand the knowledge base with regard to cardiac rehabilitation practices of men from socio-economically disadvantaged environments. Semi-structured interviews were conducted with 22 French-speaking males (average age : 51.7 years) in the urban Outaouais region, and having suffered a cardiovascular event. Results suggest that social and material deprivation shapes their relation to their bodies that is inconsistent with public health standards. Two main themes are expanded on: a) low disposition towards prevention practices and b) low disposition to participate in a cardiac rehabilitation program.
Keywords:
- cardiac rehabilitation,
- men,
- social inequality,
- cardiovascular disease,
- Pierre Bourdieu
Appendices
Bibliographie
- Bock, B.C., Albrecht, A.E., Traficante, R.M., Clark, M.M, Pinto, B.M., Tilkemeir, P. et Marcus, B.H. (1997). Predictors of exercise adherence following participation in a cardiac rehabilitation program, International Journal of Behavioural Medicine. 4:1.60-75.
- Boltanski, L. (1971). Les usages sociaux du corps.Les Annales. 1.205-233.
- Bouchard, L. (2008). Capital social, solidarité réticulaire et santé. In Frohlich, K., De Koninck, M., Demers, A. et Bernard, P. (dir.). Les inégalités sociales de santé au Québec. Montréal : Les presses de l’Université de Montréal. 187-208.
- Bourdieu, P. (1979). La distinction : Critique sociale du jugement. Paris : Minuit.
- Clark, A.M., Barbour, R.S. et McIntyre, P.D. (2002). Preparing for change in the secondary prevention of coronary heart disease : a qualitative evaluation of cardiac rehabilitation within a region of Scotland. Journal of Advanced Nursing. 39:6.589-598.
- Clark, A.M., MacIntyre, P.D. et Cruickshank, J. (2007). A critical realist approach to understanding and evaluation heart health programmes. Health : An InterdisciplinaryJournal for the Social Study of Health, Illness and Medicine. 11:4.513-539.
- Condon, C. et McCarthy, G. (2006). Lifestyle changes following acute myocardial infarction: Patients perspectives. European Journal of Cardiovascular Nursing. 5.37-44.
- Courteau, J.-P. et Finès, P. (2004). Évolution de 1986 à 1996 de la relation entre le revenu et la mortalité en Outaouais urbain, dans l’ensemble des grandes villes du Québec et au sein de l’agglomération d’Ottawa-Gatineau. Direction de santé publique de l’Outaouais et Statistiques Canada.
- Daly, J., Sindone, A.P., Thompson, D.R., Hancock, K. et coll. (2002). Barriers to participation in and adherence to cardiac rehabilitation programs... Progress in cardiovascular nursing. ProQuest Nursing & Allied Health Source. 17:1.8-17.
- Emslie, C. (2005). Women, men and coronary heart disease : A review of the qualitative literature. Journal of Advanced Nursing. 51:4.382-395.
- Emslie, C. et Hunt, K. (2009). Men, masculinities and heart disease : A systematic review of the qualitative literature. Current Sociology. 57.155-191.
- Evenson, K.R., Johnson, A. et Aytur, S.A. (2006). Five-year changes in North Carolina outpatient cardiac rehabilitation. Journal of Cardiopulmonary Rehabilitation. 26.366-376.
- Farley, R.L., Wade, T.D. and Birchmore, L. (2003). Factors influencing attendance at cardiac rehabilitation among coronary heart disease patients. European Journal of Cardiovascular Nursing. 2:3.205-212.
- Grace, S.L., Abbey, S.E., Shnek, Z.M., Irvine, J., Franche, R.L. et Stewart, D.E. (2002). Cardiac rehabilitation I : Review of psychosocial factors. General Hospital Psychiatry. 24:3.121-126.
- Hanna, I.R. et Wenger, N.K. (2005). Secondary prevention of coronary heart disease in Elderly patients. American Family Physician. 71:12.2289-96.
- Jones, M., Jolly, K., Raftery, J., Lip, G.Y., Greenfield, S. and on behalf of the BRUM Steering Committee (2007). ‘DNA’ may not mean ‘did not participate’ : A qualitative study of reasons for non-adherence at home- and centre-based cardiac rehabilitation. Family Practice. 24:4.343-357.
- Keaton, A.K. et Pierce, L.L. (2000). Cardiac therapy for men with coronary artery disease. Journal of holistic nursing. 18:1.63-85.
- King, R. (2002). Illness attributions and myocardial infarction: The influence of gender and socio-economic circumstances on illness beliefs. Journal of Advanced Nursing. 37:5.431-438.
- Marmot, M.G. (2004). The status syndrome, How social standing affects our health and longevity. New York : Holt Paperbacks, Henry Holt and company, LCC.
- Oldridge, N.B. (1991). Cardiac rehabilitation services : what are they and are they worth it. Comprehensive therapy. 17.59-66.
- Pampalon, R., Hamel, D. et Gamache P. (2008). Évolution de la mortalité prématurée au Québec, In Frohlich, K., De Koninck, Demers, M. et Bernard, P. (dir.). Les inégalités sociales de santé au Québec. Montréal : Les presses de l’Université de Montréal. 13-35.
- Pope, C. et Mays, N. (2006). Qualitative research in health care. Blackwell Publishing.Raphael, D. (2002). Social justice is good for our hearts: Why societal factors – Not lifestyles – Are major causes of heart disease in Canada and Elsewhere. Toronto : CSJ Foundation for Research Education.
- Suaya, J.A., Shepard, D.S., Normand S-L. T, Ades P.A., Prottas, J. et Stason, W.B. (2007). Use of cardiac rehabilitation by medicare beneficiaries after myocardial infarction or coronary bypass surgery. Circulation. 116.1653-1662.
- Wheatley, E.E. (2006). Bodies at risk : An ethnography of heart disease. Burlington : Ashgate Publishing.
- Williams, S.J. (1995). Theorising class, health and lifestyles : Can Bourdieu help us? Sociology of Health & Illness (Print). 17:5.577-604.
- Willich, S.N., Müller-Nordhorn, J., Kulig, M., Bonting, M., Gohlke, H., Hahmann, H., Besterhorn, K., Krobot, K. et Völler, H. (2001). Cardiac risk Factors, medication, and recurrent clinical events after acute coronary disease: a prospective cohort study. European Heart Journal. 22:4.307-313.