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

Maria Alejandra Pinero de Plaza; Claire Hutchinson; Alline Beleigoli; Matthew Tieu; Michael Lawless; Tiffany Conroy; Rebecca Feo; Robyn A. Clark; Hila Dafny; Penelope McMillan; Regina Allande-Cussó; Alison A. Kitson

doi:10.1111/jan.16312

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

Research output: Contribution to journal › Article › peer-review

9 Citations (Scopus)

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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 disparities 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 analysis based on CLCT constructs. Relationships among these constructs were quantitatively assessed using Jaccard coefficients and hierarchical clustering via dendrogram analysis to identify related clusters.

Results: A strong interconnectedness among constructs: ‘care from others’, ‘capability’, ‘care network’ and ‘care provision’ (coefficient = 1) highlights their entangled crucial 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 approaches within CR.

Conclusion: The CLCT provides a comprehensive theoretical and practical framework to address disparities in CR, facilitating a personalized approach to enhance engagement 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 underserved populations, impacting practices and outcomes.

Reporting Method: EQUATOR—MMR-RHS.

Patient Contribution: A consumer co-researcher contributed to all study phases.

Original language	English
Pages (from-to)	5163-5180
Number of pages	18
Journal	Journal of Advanced Nursing
Volume	81
Issue number	8
DOIs	https://doi.org/10.1111/jan.16312
Publication status	Published - Aug 2025

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being
SDG 5 Gender Equality
SDG 10 Reduced Inequalities
SDG 11 Sustainable Cities and Communities
SDG 17 Partnerships for the Goals

Keywords

cardiac rehabilitation
caring life course theory
fundamental care
mixed-methods
rural health

NTRO Type of Output

Major

Access to Document

10.1111/jan.16312Licence: CC BY

Final published versionFinal published version, 2.83 MBLicence: CC BY

Cite this

@article{54218d745b5a4a75b725c00e97fb5eff,

title = "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 disparities 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 analysis based on CLCT constructs. Relationships among these constructs were quantitatively assessed using Jaccard coefficients and hierarchical clustering via dendrogram analysis to identify related clusters. Results: A strong interconnectedness among constructs: {\textquoteleft}care from others{\textquoteright}, {\textquoteleft}capability{\textquoteright}, {\textquoteleft}care network{\textquoteright} and {\textquoteleft}care provision{\textquoteright} (coefficient = 1) highlights their entangled crucial role in CR. However, significant conceptual disparities between {\textquoteleft}care biography{\textquoteright} and {\textquoteleft}fundamental care{\textquoteright} (coefficient = 0.4) and between {\textquoteleft}self-care{\textquoteright} and {\textquoteleft}care biography{\textquoteright} (coefficient = 0.384615) indicate a need for more aligned and personalized care approaches within CR. Conclusion: The CLCT provides a comprehensive theoretical and practical framework to address disparities in CR, facilitating a personalized approach to enhance engagement 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 underserved populations, impacting practices and outcomes. Reporting Method: EQUATOR—MMR-RHS. Patient Contribution: A consumer co-researcher contributed to all study phases.",

keywords = "cardiac rehabilitation, caring life course theory, fundamental care, mixed-methods, rural health",

author = "Pinero de Plaza, \{Maria Alejandra\} and Claire Hutchinson and Alline Beleigoli and Matthew Tieu and Michael Lawless and Tiffany Conroy and Rebecca Feo and Clark, \{Robyn A.\} and Hila Dafny and Penelope McMillan and Regina Allande-Cuss{\'o} and Kitson, \{Alison A.\}",

year = "2025",

month = aug,

doi = "10.1111/jan.16312",

language = "English",

volume = "81",

pages = "5163--5180",

journal = "Journal of Advanced Nursing",

issn = "0309-2402",

publisher = "Wiley-Blackwell Publishing Ltd",

number = "8",

}

TY - JOUR

T1 - The Caring Life Course Theory

T2 - Opening new frontiers in care—A cardiac rehabilitation example

AU - Pinero de Plaza, Maria Alejandra

AU - Hutchinson, Claire

AU - Beleigoli, Alline

AU - Tieu, Matthew

AU - Lawless, Michael

AU - Conroy, Tiffany

AU - Feo, Rebecca

AU - Clark, Robyn A.

AU - Dafny, Hila

AU - McMillan, Penelope

AU - Allande-Cussó, Regina

AU - Kitson, Alison A.

PY - 2025/8

Y1 - 2025/8

N2 - Aim(s): To operationalize the Caring Life Course Theory (CLCT) as a framework for improving cardiac rehabilitation (CR) engagement and informing ways to address disparities 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 analysis based on CLCT constructs. Relationships among these constructs were quantitatively assessed using Jaccard coefficients and hierarchical clustering via dendrogram analysis to identify related clusters. Results: A strong interconnectedness among constructs: ‘care from others’, ‘capability’, ‘care network’ and ‘care provision’ (coefficient = 1) highlights their entangled crucial 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 approaches within CR. Conclusion: The CLCT provides a comprehensive theoretical and practical framework to address disparities in CR, facilitating a personalized approach to enhance engagement 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 underserved populations, impacting practices and outcomes. Reporting Method: EQUATOR—MMR-RHS. Patient Contribution: A consumer co-researcher contributed to all study phases.

AB - Aim(s): To operationalize the Caring Life Course Theory (CLCT) as a framework for improving cardiac rehabilitation (CR) engagement and informing ways to address disparities 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 analysis based on CLCT constructs. Relationships among these constructs were quantitatively assessed using Jaccard coefficients and hierarchical clustering via dendrogram analysis to identify related clusters. Results: A strong interconnectedness among constructs: ‘care from others’, ‘capability’, ‘care network’ and ‘care provision’ (coefficient = 1) highlights their entangled crucial 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 approaches within CR. Conclusion: The CLCT provides a comprehensive theoretical and practical framework to address disparities in CR, facilitating a personalized approach to enhance engagement 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 underserved populations, impacting practices and outcomes. Reporting Method: EQUATOR—MMR-RHS. Patient Contribution: A consumer co-researcher contributed to all study phases.

KW - cardiac rehabilitation

KW - caring life course theory

KW - fundamental care

KW - mixed-methods

KW - rural health

UR - https://www.scopus.com/pages/publications/85198618035

UR - https://www.linkedin.com/pulse/embracing-life-course-perspective-innovations-cardiac-a4iec/?trackingId=VGcPuy5mSXC%2FNLf5Jlfo7g%3D%3D

UR - http://purl.org/au-research/grants/NHMRC/1169893

U2 - 10.1111/jan.16312

DO - 10.1111/jan.16312

M3 - Article

AN - SCOPUS:85198618035

SN - 0309-2402

VL - 81

SP - 5163

EP - 5180

JO - Journal of Advanced Nursing

JF - Journal of Advanced Nursing

IS - 8

ER -

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

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ACvA CV Champion

Awarded the People's Choice Poster Award at the South Australian Cardiovascular Research Network (SA CVRN) Emerging Leaders Symposium 2026.

A winner of the Big Ideas video competition to improve the Australian health system. Consumer Health Forum of Australia, 2021.

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

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