This case study illustrates the basic life processes, transitions, and meanings of a woman with diagnosed coronary artery disease who participated in an innovative outpatient program of cardiac rehabilitation. Data gathering and analysis were accomplished using the phenomenologic procedures outlined by Spiegelberg and van Manen. A formulated structure, healing through integration, was generated from the interpretation of case study data, as well as the data of 15 other adult patients who participated in a program of outpatient cardiac rehabilitation. This structure provides a framework for nursing assessment and the implementation of relevant mind, body, social, spiritual, and behavioral interventions designed to assist individuals in integrating health-enhancing behaviors and recovery following a cardiac health crisis.
Management of the myocardial infarction patient may extend beyond the physiologic to include psychosocial factors that may adversely affect cardiac health. Psychosocial factors such as depression, coronary-prone behavior, hostility, social isolation, anxiety, anger, and stress are related to increased cardiac death and illness. Various interventions including cognitive-behavioral therapies, techniques that elicit the relaxation response, meditation, exercise, and increasing social networks, may play a role in improving health outcomes. This article explores the relationship of these psychosocial factors to cardiac health and proposes a biopsychosocial model of care.
This study evaluated the efficacy of the relaxation response on the post-operative recovery of 27 cardiac surgery patients randomly assigned to one of two groups. Thirteen experimental group patients received educational information and practiced eliciting the relaxation response before and after surgery. The 14 patients in the control group received only information. Experimental and control groups were compared before and after surgery on both physiological and psychological recovery variables. There were no initial differences between experimental and control groups on demographic, physiological, and most psychological variables. The experimental group had lower incidence of postoperative supraventricular tachycardia (SVT) than the control group (p = .04) despite having had the same occurrence previously. Experimental and control groups did not significantly differ over the course of study on any other physiological variables. Patients practicing the relaxation response had greater decreases in psychological tension (p = .04) and anger (p = .04) than those who received only educational information. The decreases in psychological tension may have been a result of regression to the mean because the experimental group started with elevated tension relative to the control group (p = .04). We conclude that practicing the relaxation response before and after surgery may reduce SVT, tension, and anger.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.