The influence of country of origin on engagement in self-care behaviours following heart surgery: a descriptive correlational study

J Clin Nurs. 2012 Aug;21(15-16):2202-8. doi: 10.1111/j.1365-2702.2012.04095.x. Epub 2012 May 30.


Aim: The aim of this study was to determine whether an individual's country of origin influenced performance of self-care behaviours after heart surgery.

Background: Patients are required to perform self-care behaviours following cardiovascular surgery. Usual care encompasses a patient education initiative that addresses self-care behaviour performance. Within Canada, current heart surgery patient education efforts have been designed and evaluated using homogenous samples that self-identify their country of origin as England, Ireland or Scotland. However, approximately 42·6% of Canadian cardiovascular surgical patients self-identify their country of origin as India or China. Thus, current cardiovascular surgery patient education initiatives may not be applicable to all patients undergoing heart surgery, which may result in decreased patient outcomes such as performance of self-care behaviours.

Design: This descriptive study.

Methods: A convenience sample of 90 patients who underwent heart surgery at one of two university-affiliated teaching hospitals, representing individuals of diverse backgrounds. Point-biserial correlational analysis was conducted to determine the relationship between country of origin and performance of self-care behaviours.

Results: Findings indicate individuals who self-identified their country of origin as England or Ireland were associated with a higher score on the number of self-care behaviours performed (p < 0·05) than individuals who self-identified other countries of origin. Self-care behaviours were taught using patient education materials that were designed based on feedback obtained from individuals whose country of origin was England or Ireland.

Conclusion: This study provides preliminary evidence to suggest country of origin influences the amount of self-care behaviours individuals will perform.

Relevance to clinical practice: Patient education initiatives should incorporate the values, beliefs, attitudes and customs reflective of an individual's country of origin to enhance the likelihood of producing desired outcomes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Canada
  • Cardiac Rehabilitation*
  • Cardiovascular Diseases / ethnology
  • Cardiovascular Diseases / surgery*
  • China / ethnology
  • Female
  • Humans
  • India / ethnology
  • Male
  • Middle Aged
  • Patient Education as Topic
  • Postoperative Care / rehabilitation*
  • Qualitative Research
  • Self Care*
  • United Kingdom / ethnology