Experiences of guilt and shame in patients with familial hypercholesterolemia: a qualitative interview study

Patient Educ Couns. 2007 Dec;69(1-3):108-13. doi: 10.1016/j.pec.2007.08.001. Epub 2007 Sep 21.

Abstract

Objective: To explore patients' experiences of guilt and shame with regard to how they manage familial hypercholesterolemia.

Methods: We interviewed 40 men and women diagnosed with heterozygous familial hypercholesterolemia. Data were analyzed by systematic text condensation inspired by Giorgi's phenomenological method.

Results: Participants disclosed their condition as inherited and not caused by an unhealthy lifestyle. They could experience guilt or shame if they violated their own standards for dietary management, or if a cholesterol test was not favorable. Participants had experienced health professionals who they felt had a moralizing attitude when counseling on lifestyle and diets. One group took this as a sign of care. Another group conveyed experiences of being humiliated in consultations.

Conclusion: Patients with familial hypercholesterolemia may experience guilt and shame related to how they manage their condition. Health professionals' counseling about lifestyle and diet may induce guilt and shame in patients.

Practice implications: Health professionals should be sensitive to a patient's readiness for counseling in order to diminish the risk of unintentionally inducing guilt and shame in patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adaptation, Psychological*
  • Adolescent
  • Adult
  • Attitude of Health Personnel
  • Attitude to Health*
  • Counseling
  • Diet, Fat-Restricted / psychology
  • Feeding Behavior / psychology
  • Female
  • Guilt*
  • Humans
  • Hyperlipoproteinemia Type II / genetics
  • Hyperlipoproteinemia Type II / prevention & control
  • Hyperlipoproteinemia Type II / psychology*
  • Life Style
  • Male
  • Middle Aged
  • Norway
  • Nursing Methodology Research
  • Occupations
  • Qualitative Research
  • Self Care / methods
  • Self Care / psychology*
  • Shame*
  • Stereotyping
  • Surveys and Questionnaires