Confronting one's vulnerability – patients with chest pain participating in a high‐intensity exercise programme

Røysland, Ingrid Ølfarnes; Friberg, Febe; Brinchmann, Berit Støre; Svello, Sunniva Nordeide; Valborgland, Torstein; Larsen, Alf Inge

doi:10.1111/jocn.13609

Cited by 7 publications

(30 citation statements)

References 23 publications

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“…Twelve participants agreed to participate in an exercise training program ( Table I ). The results at 12 weeks have been previously reported (Røysland et al, 2017 ). The patients were now interviewed one year after finishing the program to assess the long-term effects ( Figure 1 ).…”

Section: Methodssupporting

confidence: 78%

“…According to Røysland et al ( 2017 ) patients with angina-like chest pain with no obstructive coronary artery disease who participate in a high-intensity exercise training program undergo a transition described as becoming a more capable person. To our knowledge there is no follow-up on the continuation of the process of training from these patients’ perspective.…”

Section: Introductionmentioning

confidence: 99%

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Reassured on a background of vulnerability - people with microvascular angina 12 months after high-intensity physical exercise program

Røysland

Ueland

Larsen

2022

International Journal of Qualitative Studies on Health and Well

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Purpose Physical activity is recommended for patients with coronary microvascular dysfunction, however, avoided due to fear about the heart. The aim is to achieve an understanding of the meaning of physical activity one year after participating in a high-intensity exercise training program. Method Twelve people were interviewed using a phenomenological hermeneutic approach. Results Four themes were formulated and revealed that one year after participating in high-intensity exercise training participants had an awareness of the meaning of the project, their chest pain and daily life: Being reassured, Daily life’s impact on chest pain and continuing doing high-intensity exercise training, A strengthened body and mind, Being part of a group of people with similar problems. Comprehensive understanding was formulated as “Being reassured according being physically active in a background of vulnerability”. Conclusion This study indicates that by going through the high-intensity exercise training program the person regains more unity with the lived body and an unfolding life. A person-centred approach is suggested including an underlying dimension of vulnerability. A lifeworld led care means meeting the patient in their way of relating to the world bodily and existentially. Taking this understanding into consideration will advance the requirements for establishing person-centred care.

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Section: Methodssupporting

confidence: 78%

Section: Introductionmentioning

confidence: 99%

Reassured on a background of vulnerability - people with microvascular angina 12 months after high-intensity physical exercise program

Røysland

Ueland

Larsen

2022

International Journal of Qualitative Studies on Health and Well

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“…Although the term appears in the health research literature and beyond, it often does so without an explicit definition. [5][6][7][8][9] The descriptions that do exist suggest that different researchers have different conceptualisations in mind: it is described variously as "that form of uncertainty which is experienced privately by the individual patient upon the realisation that the future life of his or her mind, body, and self is in jeopardy," 10(p134) "uncertainty about the availability of a relational exchange necessary for psychological survival," 11(p502) and "the varieties of uncertainty that are entailed by the finite limitations of our epistemic standpoint." 12(p383) A lack of consistency in the meaning of basic concepts within the taxonomy may hobble future research in this field.…”

Section: Introductionmentioning

confidence: 99%

Existential uncertainty in health care: A concept analysis

Dwan

Willig

2021

Evaluation Clinical Practice

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Rationale, aims and objectives: According to an influential taxonomy of varieties of uncertainty in health care, existential uncertainty is a key aspect of uncertainty for patients.Although the term "existential uncertainty" appears across a number of disciplines in the research literature, its use is diffuse and inconsistent. To date there has not been a systematic attempt to define it. The aim of this study is to generate a theoretically-informed conceptualisation of existential uncertainty within the context of an established taxonomy.Method: Existential uncertainty was subjected to a concept analysis, which drew on existing uses of the term across multiple disciplines as well as insights from uncertainty theory more broadly and from the existential therapy literature to generate a tentative definition of the concept. Antecedents, consequences, and empirical referents of existential uncertainty were also identified. A model case was described as well as a borderline case and a related case in order to illustrate and delineate the concept.Results: Existential uncertainty is conceptualised as an awareness of the undetermined but finite nature of one's own being-in-the-world, concerned primarily with identity, meaning, and choice. This awareness is fundamental and ineradicable, and manifests at different levels of consciousness. Conclusion:Humans rely on identity, worldview, and a sense of meaning in life as ways of managing the ineradicable uncertainty of our being-in-the-world, and these can be challenged by a serious diagnosis. It is important that medical professionals acknowledge issues around existential uncertainty as well as issues around scientific uncertainty, and recognise when patients might be struggling with these. Further research is required to identify ways of measuring existential uncertainty and to develop appropriate interventions, but it is hoped that this conceptualisation provides a useful first step towards that goal.

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“…This is probably related to the sense of confidence and being able to master the training as revealed in a sub study on quality of life in this population. 14 Participants in the current study did physical exercise on a treadmill overseen by experienced physiotherapists giving guidance and emotional support to obtain adequate heart rate during the HIT sessions ( Figure 2 ). The participants valued being tested, as well as the possibility of getting a diagnosis, and they talked about being “seen” and “selected” when they were asked to participate in the project, which implied testing and training.…”

Section: Discussionmentioning

confidence: 99%

Aerobic high-intensity interval exercise training in patients with angina and no obstructive coronary artery disease: feasibility and physiological effects

Larsen

Sæland

Vegsundvåg

et al. 2023

European Heart Journal Open

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Aims Patients with chest pain and normal coronary angiogram [angina with normal coronary arteries (ANOCA)] constitute a therapeutic problem with considerable functional limitation and reduced quality of life. The aims of the current pilot study were to (i) explore if a structured aerobic high-intensity interval training (HIT) program for 12 weeks was feasible in patients with ANOCA, and (ii) to assess mechanisms related to symptoms in this population. Methods and results Sixteen patients with ANOCA underwent a 3-month aerobic HIT program with one-to-one monitored exercise sessions on treadmill in a 4 min × 4 manner, three times a week. Four patients served as controls. Coronary flow velocity reserve (CFVR) transthoracic Doppler, flow-mediated vasodilation (FMD) and VO 2max was measured at baseline and after 12 weeks. The average attendance to training sessions was 82.3% ± 10.1 (56–94). CFVR in the training group increased from 2.50 ± 0.48 to 3.04 ± 0.71 ( P < 0.001) whereas FMD increased from 4.19 ± 2.42% to 8.28 ± 2.85% ( P < 0.001). Improvement in CFVR correlated with the relative improvement in FMD ( R = 0.45, P = 0.047). This was associated with an increase in VO 2max from 28.75 ± 6.51 mL/kg/min to 31.93 ± 6.46 mL/kg/min ( P < 0.001). Conclusion A 3-month program of monitored HIT was feasible, with high adherence resulting in improved functional capacity in patients with ANOCA. CFVR improved and this improvement was associated with improved FMD. ClinicalTrials.gov Identifier NCT02905630

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Confronting one's vulnerability – patients with chest pain participating in a high‐intensity exercise programme

Cited by 7 publications

References 23 publications

Reassured on a background of vulnerability - people with microvascular angina 12 months after high-intensity physical exercise program

Reassured on a background of vulnerability - people with microvascular angina 12 months after high-intensity physical exercise program

Existential uncertainty in health care: A concept analysis

Aerobic high-intensity interval exercise training in patients with angina and no obstructive coronary artery disease: feasibility and physiological effects

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