The Caring Life Course Theory: Opening new frontiers in care—A cardiac rehabilitation example

Abstract

Aim(s): To operationalize the Caring Life Course Theory (CLCT) as a framework for improving cardiac rehabilitation (CR) engagement and informing ways to address dis- parities in rural, low socio-economic areas. Methods: A secondary analysis of data collected from 15 CR programmes to identify CR patterns through the CLCT lens using a mixed-methods approach. All analytical processes were conducted in NVivo, coding qualitative data through thematic analy- sis based on CLCT constructs. Relationships among these constructs were quantita- tively assessed using Jaccard coefficients and hierarchical clustering via dendrogram analysis to identify related clusters. Results: A strong interconnectedness among constructs: ‘care from others’, ‘capabil- ity’, ‘care network’ and ‘care provision’ (coefficient = 1) highlights their entangled cru- cial role in CR. However, significant conceptual disparities between ‘care biography’ and ‘fundamental care’ (coefficient = 0.4) and between ‘self-care’ and ‘care biography’ (coefficient = 0.384615) indicate a need for more aligned and personalized care ap- proaches within CR. Conclusion: The CLCT provides a comprehensive theoretical and practical framework to address disparities in CR, facilitating a personalized approach to enhance engage- ment in rural and underserved regions. Implications: Integrating CLCT into CR programme designs could effectively address participation challenges, demonstrating the theory's utility in developing targeted, accessible care interventions/solutions. Impact: • Explored the challenge of low CR engagement in rural, low socio-economic settings. • Uncovered care provision, transitions and individual care biographies' relevance for CR engagement. Demonstrated the potential of CLCT to inform/transform CR services for under- served populations, impacting practices and outcomes. Reporting Method: EQUATOR—MMR-RHS. Patient Contribution: A consumer co-researcher contributed to all study phases