Vivências de mulheres à dor no infarto do miocárdio

Abstract

RESUMENEn el presente estudio se tuvo como objetivo comprender los significados de la experiencia del dolor en mujeres que sufrieron infarto del miocardio e identificar sus acciones inmediatas frente a la misma. En esta investigación cualitativa se utilizó la teoría del Interaccionismo Simbólico y la metodología de la Teoría Fundamentada en los Datos. Fueron entrevistadas cuarenta y tres mujeres del Hospital Universitario. La categoría central que expresó el sentido de la experiencia fue "Teniendo una ruptura con la vida cotidiana". Las categorías que revelaron esa ruptura mostraron que frente al creciente dolor las mujeres se sintieron dominadas y con miedo de morir, pues perdieron el control personal sobre el cuerpo y la vida. No reconocieron el infarto y se resistieron, al principio, a procurar atención, haciendo intentos para aminorar el dolor. Ante el dolor insoportable y la impotencia en su control, pidieron la salvación Divina, ayuda a las personas y recurrieron al tratamiento médico. DESCRIPTORES ABSTRACTThe aim of this study was to understand the meanings of the experience of pain suffered by women during acute myocardial infarction (AMI) and to identify their immediate actions in face of pain. This qualitative research used the Symbolic Interactionism theory and the Grounded Theory methodology. Forty-three women were interviewed at the University Hospital. The central category expressing the pain experience was that it was "a break with day-to-day life". The categories that expressed such break revealed that in face of increasing pain those women felt dominated and afraid of dying because they had lost control over their bodies and their lives. They did not recognize the occurrence of AMI and at first resisted to look for assistance by attempting to alleviate the pain. In face of the unbearable pain and their impotence to control it, they asked for God's salvation and help from surrounding people and finally resorted to medical assistance. KEY WORDS

Pre-hospital delay in acute myocardial infarction: judgement of symptoms and resistance to pain

“…Girls, in turn, are educated in the private space of home and family, they are prepared to be good mothers and wives. 12 From childhood, men learn to make decisions without showing weakness. Furthermore, the position of provider, head of household, protective father and hero are roles constructed according to gender patterns, linking the image of man to the reference of hegemonic masculinity.…”

“…In many cultures, the experience of motherhood associates the image of women to their ability to endure pain. 12 This ability has symbolic relationship to suffering and evolves from a historical past that suffers the interference of modern Western Judeo-Christian culture, which in the Bible highlights the ability of the Virgin Mary to suffer quietly and follow her son until death. 11 Such social constructions can reinforce, among women, the idea that pain should be tolerated, leaving them to moan, to try to relieve it with their own resources, or even to hide it.…”

“…Understanding what happens during this stage can guide actions of the healthcare team resulting in faster service. 12 Based on the above, the study objectives were: to estimate time of decision (TD) for seeking medical care and the time of arrival (TA) at a health facility for men and women with AMI, as well as to analyze the influence of pain interpretation behaviors and pain resistance in these times. methodS This is a cross-sectional study that employed quantitative and qualitative methods of analysis.…”

Time of arrival of patients with acute myocardial infarction to the emergency department

“…[3] According to American research, more than 12 million people have some heart disease and more than one million presents an acute myocardial infarction (AMI) per year, resulting in 466,000 deaths related to coronary artery disease (CAD) [4]. In Brazil, cardiovascular diseases are responsible for 31% of deaths from known causes [5] and in this set, the AMI is worrying society and public health authorities, due to the impact on mortality and the number of hospitalizations in whole country [6,7], being the major cause of attendance in emergency units [4]. Two-thirds of sudden deaths from heart disease occur outside the hospital and only 20% of people who reported acute chest pain to the emergency arrive two hours before the start of these signals [6,8].…”

“…In Brazil, cardiovascular diseases are responsible for 31% of deaths from known causes [5] and in this set, the AMI is worrying society and public health authorities, due to the impact on mortality and the number of hospitalizations in whole country [6,7], being the major cause of attendance in emergency units [4]. Two-thirds of sudden deaths from heart disease occur outside the hospital and only 20% of people who reported acute chest pain to the emergency arrive two hours before the start of these signals [6,8]. One factor that contributes to the reduction of this high mortality from AMI is the rapid treatment of these patients after the onset of symptoms [6].…”