An investigation into risky health behaviours within adult cystic fibrosis patients

Introduction: Smoking, excessive alcohol consumption and illicit drug use are prevalent within the CF population, with these behaviours having adverse health effects upon patients regardless of their treatment adherence. In an attempt to prevent the initiation and aid the cessation of risky behaviours within the CF population, factors associated with these behaviours firstly need to be identified. We therefore investigated beliefs associated with these behaviours within adult CF patients. Method: Twenty-four adult participants were recruited (16 male, age range 19-66 years) from two UK regional CF centres, with a median FEV1 61.77% predicted. Qualitative semi-structured interviews provided an interpretive perspective when investigating patients' beliefs towards their CF and the impact their CF has upon their life, exploring rationales for why some patients engage in risky behaviours. Results: Thematic analysis identified five themes within the data set: “Identity,” “The reality of living with CF and the impact CF can have upon an individual living within a social world,” “Patients' attitudes, beliefs and coping mechanisms in response to living with CF,” “Support from others” and “Acceptance and Awareness.” These findings illustrate that the factors associated with risky behaviours within the CF population are multifactorial. A desire for normalcy was seen to be important to many, with literature acknowledging that this desire for normalcy can be accompanied with the engagement of normalised risky behaviours as a retaliation against the illness identity. Evidence of a life orientated perspective was also prevalent, with participants reporting that they engaged in risky behaviours for fun. Overall there was a reported lack of knowledge concerning consequences of risky behaviours, with many participants stating they had not been informed of these by their clinicians. This was in line with a transition evaluation conducted by the researcher, which indicated that many UK CF units do not integrate a discussion on risky behaviours into a patient's transition to adult care. However, the results of the current research highlight the importance of awareness, with patients who had good awareness of the consequences of risky behaviours often accepting that they cannot engage in such behaviours. Conclusions: This research highlights the need for more effective health promotion measures to reduce and prevent risky behaviours within the CF population. We are now conducting semi-structured interviews with paediatric CF patients to investigate their awareness and beliefs towards risky behaviours, at an age commonly associated with the initiation of such behaviours; the results of which will also be discussed at the NACFC. Overall this research will highlight why some CF patients engage in risky behaviours, to inform interventions to prevent the initiation and aid the cessation of risky behaviours by increasing patient awareness of the consequences of such behaviours, specific to CF.