Gender differences in motivations and perceived effects of Mind–Body Therapy (MBT) practice and views on integrative cardiac rehabilitation among acute coronary syndrome patients: Why do women use MBT?

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Summary

Background

Over one-third of cardiac patients practice Mind–Body Therapy (MBT), particularly women. Considering women are less likely to engage in conventional physical activity, few studies have examined why MBT is well-accepted by women.

Objectives

To qualitatively explore gender differences in the motivations for, and perceived effects of MBT, and the inter-relationships among alternative and conventional physical activities and secondary prevention programs.

Methods

A random subsample of 16 participants (8 female) who reported practicing MBT in a larger study of 661 cardiac patients was interviewed until theme saturation was achieved. Audiotapes were transcribed and coded based on interpretive–descriptive technique within Nvivo-7 software. An audit trail and second coder were utilized to ensure the transparency and validity of results. After main themes emerged, the data were split by gender to identify differences for each theme.

Results

Five themes emerged: (1) promotes positive well-being, (2) physical health benefits, (3) intrinsic and extrinsic motivations, (4) proactive health orientation, and (5) MBT as a preferred complementary and/or alternative physical activity. Men more often expressed preference for MBT for increased positive mood and cardiac-specific benefits, whereas women emphasized stress reduction, increasing self-efficacy, and physical activity, and were eager to see MBT offered in cardiac rehabilitation (CR).

Conclusions

Both male and female users perceived substantial psychosocial and physical benefits of MBT practice. MBT addresses some of women's common barriers to CR.

Introduction

Mind–Body Therapies (MBTs) are defined as “techniques designed to enhance the mind's capacity to affect bodily function and symptoms”.1 There are two main types of MBT: relaxation techniques which include meditation and deep breathing, and somatic techniques (i.e., exercise with relaxation) such as Yoga and Tai Chi.2 Empirical evidence suggests that somatic forms of MBT in particular may ease the burden of cardiovascular disease by improving physiological function and reducing emotional distress.3, 4, 5 MBTs have been commonly practiced by both healthy and patient populations, particularly women.6, 7, 8, 9

A previous study reported that 36% of cardiac patients used complementary and alternative medicine, among which 17% used MBTs.10 Epidemiologic evidence shows increased MBT participation among patient populations, including cardiac patients,8, 11, 12, 13 however, these studies do not explain the motivations these cardiac patients held or the perceived effects associated with MBT use.

Our previous work examined the prevalence and correlates of MBT practice among 465 acute coronary syndrome (ACS) patients.7 Results showed that one-third of participants self-reported using MBTs. Adjusted analyses revealed that females who are less likely to participate in cardiac rehabilitation (CR)14, 15 were more likely to use MBTs. The current study was undertaken to investigate: (1) gender differences in the motivations and perceived effects of MBT practice among ACS patients, and (2) the inter-relationship among alternative and conventional physical activities and cardiovascular secondary prevention.

Section snippets

Participants

This current qualitative study was conducted within a larger prospective study. Ethics approval was obtained from all participating institutions. A sample of 661 ACS in-patients was recruited from 3 hospitals in Ontario. A survey was mailed to participants 18 months post-discharge and included questions regarding MBT practice. As outlined in a previous paper,7 165 (34%) ACS patients self-reported using MBTs in their lifetime, and over half reported using more than one type of MBT. Using a

Results

Sixteen patients who practiced MBTs (8 females) were interviewed. Table 1 displays the descriptive characteristics of participants. Females were generally older, and had a lower family income and education level than males. Through qualitative analysis of transcripts, five themes were identified: (1) MBTs promote positive well-being, (2) physical health benefits, (3) intrinsic and extrinsic motivations, (4) proactive health orientation, and (5) MBT as a preferred complementary and/or

Discussion

This study was designed to qualitatively explore the motivations and perceived effects of MBT practice among male and female ACS patients, and to examine gender differences in these perceptions. Essentially, our findings show that both female and male respondents perceived substantial physical and psychosocial benefits from MBT practice, citing improvements in angina symptoms, breathing, relaxation and positive mood, which consequently foster a greater sense of control during recovery. While

Acknowledgements

This research was funded by the Canadian Health Services Research Foundation and Ontario Ministry of Health and Long-Term Care and administered by the Canadian Institutes of Health Research. The first author is supported by the GENESIS Team– Gender and Sex Determinants of Circulatory and Respiratory Diseases: Interdisciplinary Enhancement Teams Grant Program, Canadian Institutes of Health Research and the Heart and Stroke Foundation of Canada. The last author is supported by the Canadian

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