EXPERIENCES OF MALE ARAB CANADIANS AFTER CARDIAC EVENTS: THE PERCEIVED INFLUENCE OF ACCULTURATION AND RELIGIOUS COPING IN MANAGING LIFESTYLE BEHAVIOURS

H. Baharoon¹, J. King¹

Background: Immigrants’ cultural background, home countries’ lifestyle, and acculturation level in host countries may impact health status and disease prevention. As well, religious coping or using religious beliefs, attitudes or practices to face life challenges can provide a sense of meaning and purpose in life. Religious coping may motivate people to maintain mental and physical health by adopting preventive healthy lifestyle behaviours. However, cardiac rehabilitation secondary prevention programs rarely consider individuals’ cultural and religious backgrounds to support individuals in changing healthy lifestyle behaviours. Up to this point, the influence of acculturation and religious coping has been rarely addressed in cardiac rehabilitation programs from the perspective of Arab individuals having cardiac events while living in Canada.

Purpose: This study aims to understand male Arab individuals’ lived experiences after cardiac events and explore their perceptions regarding the influence of acculturation and religious coping on healthy lifestyle behaviours during recovery.

Methods: The health belief model was used as the framework for interview questions and analysis for this phenomenological qualitative study. Participants were 10 male Arab individuals who identified themselves as having cardiac events while living in Canada Semi-structured in-depth interviews of 40-75 minutes in length, were conducted in January-March 2020, in Ottawa. An inductive content analysis approach was used to identify themes.

Results: All participants were Muslim men born outside Canada, married and living with their families in Ottawa. Five of them came to Canada as refugees, and the other five were immigrants. Most of these participants lived in Canada for more than five years. While eight participants had had heart attacks, and two participants had angina. Results identified five core themes:
1) Stressful challenges in Canadian lifestyle might lead to cardiac events
2) Cardiac events were not hard experiences
3) Participants recognized the risk with low self-efficacy to adopt healthy behaviours
4) Death is coming, but the stressful concern was children future
5) Participants were not motivated to attend cardiac rehabilitation programs.

Conclusion(s): Findings suggest that stress and mental burdens while living in Canada negatively affected Arab male individuals’ experiences following a cardiac event. Regardless of whether stress was acculturative or lifestyle stress, it was perceived as a potential cause of cardiac events and a factor leading to low self-efficacy to change lifestyle behaviours. However, positive religious coping strategies were used as a moderator to manage stress and cardiac events consequences, but not to change physical activity, diet, and smoking behaviours. The importance of adhering to medications was perceived as more important than adopting healthy lifestyle behaviours. For this reason, they expressed less perceived needs for cardiac rehabilitation programs.

Implications: Understanding the influence of acculturation and religious coping in Arab individuals’ experiences with cardiac events is part of a patient-centred healthcare approach in rehabilitation programs that may positively reflect these individuals’ health consequences. As physiotherapists have a central role in cardiac rehabilitation programs, their in-depth understanding of individuals’ perceptions, beliefs, and behaviours after cardiac events may facilitate participation and adherence to physical and mental health components of cardiac rehabilitation programs or community-based health promotion programs.

Funding, acknowledgements: Self-funding

Keywords: Lifestyle behaviours among Arab, Acculturation and Religious coping, Cardiac Rehabilitation

Topic: Health promotion & wellbeing/healthy ageing/physical activity

Did this work require ethics approval? Yes

Institution: University of Ottawa

Committee: Research Ethics Board at the University of Ottawa

Ethics number: H12-17-04