Ethnic differences in illness representations, coping and adjustment in people with coronary heart disease
Background and Aims
There have been few studies examining ethnic differences in people's
illness representations. The aim of this research was to explore the
relationship between ethnicity and illness representations, coping,
perceived health status and psychological adjustment in participants with
coronary heart disease (CHD).Furthermore, within a Punjabi group, it
aimed to explore the relationship between these variables and
acculturation, as well as the relationship between illness representations,
coping and adjustment.
Design and Participants
The study was cross-sectional employing a between and within group
design incorporating comparative and correlational analyses. The sample
included 47 Punjabi participants and 44 Caucasian participants with
diagnosed CHD,recruited from a cardiology clinic and a Gurdwara (Sikh
Variables were measured using a range of quantitative questionnaires,
which were translated into Punjabi.
Ethnic differences were found in participants' illness representations and
in particular causal beliefs. Only one coping strategy was significan tly
different between the two groups and there were no differences on
perceived health status measures or in anxiety levels. However, the Punjabi
group were significantly more depressed. Within the Punjabi group,acculturation was found to be associated with illness representations,
coping and physical functioning. Illness representations were associated
with adjustment measures, however there were few associations between
illness representations and coping, and between coping and adjustment.
Overall, ethnicity did not account for any of the variance in perceived
physical functioning or anxiety levels, but accounted for 11 percent of the
variance in depression levels. Illness representations were more important
than ethnicity and coping in accounting for the variance in perceived
physical functioning and psychological adjustment.
The results are discussed in terms of the self-regulatory model and future
research is suggested. Clinical implications for the undertaking of
culturally sensitive work with Punjabi clients with CHD,are discussed.