Sociocultural and structural factors shaping self-management in chronic cardiovascular conditions: a qualitative descriptive inquiry

Chronic cardiovascular conditions, such as heart failure, coronary artery disease, hypertension, and peripheral arterial disease, are major causes of illness and death. Self-management is key to improving outcomes for those with these conditions. However, self-management practices are influenced not only by individual knowledge and motivation but also by broader sociocultural and structural factors. Limited attention has been given to how these contextual elements affect self-management experiences.

This study explores the role of sociocultural and structural factors in self-management among individuals with chronic cardiovascular conditions.

A qualitative descriptive design was used. By employing a maximum variation sampling technique, a total of 19 individuals were recruited. A semi-structured interview guide was used to complete in-depth interviews, which were audio-recorded. Data were analyzed using Braun and Clarke’s reflexive thematic analysis. MAXQDA was used to facilitate the analysis process.

Findings: Participants‘ ages ranged from 22 to 82 years, and of the 19 participants, 13 were male. The key cardiovascular conditions were coronary heart disease, valvular heart disease, heart failure, and hypertension. Analysis of qualitative data revealed four broader themes: (a) labour of re-navigating social roles; (b) depletion of collective family resources; (c) healthcare system failure or systemic failure as driver of mistrust; (d) healthcare access as an enduring struggle.

Living with chronic cardiovascular conditions involved ongoing adaptation, financial strain, and navigation of systemic barriers, particularly for individuals from low- and middle-income countries. Findings highlight the need for culturally responsive, affordable, and system-level interventions that support sustained self-management and equitable access to care.