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 temple). Measures:Variables were measured using a range of quantitative questionnaires, which were translated into Punjabi. Results:Ethnic differences were found in participants' illness representations and in particular causal beliefs. Only one coping strategy was significantly 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. Implications 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