Empowered to gain a new foothold in life—A study of the meaning of participating in cardiac rehabilitation to patients afflicted by a minor heart attack

Abstract

This study aimed to investigate what it means to patients afflicted by a minor heart attack to participate in cardiac rehabilitation (CR). CR is well-established internationally to support patients towards moving forward in satisfying, healthy, and well-functioning lives. Studies indicate that patients achieve improvement in quality of life when participating in CR. However, knowledge of how patients are supported during CR is sparse. Moreover, knowledge of what participating in CR means to patients afflicted by a minor heart attack is lacking. In-depth knowledge in this area is crucial in order to understand these patients’ particular gains and needs. In a phenomenological-hermeneutic frame field observations, focus group interviews, and individual interviews were conducted among 11 patients during and after their participation in CR. Field notes and transcribed interviews underwent three-phased interpretation. It was found that patients were supported to gain renewed balance in their lives during CR. Three themes were identified: (1) receiving a helpful but limited caring hand, (2) being supported to find new values in life, and (3) developing responsibility for the remaining time. The patients were carefully guided through a difficult time and supported to continue in healthy everyday lives. They were given hope which enabled them to find themselves a new foothold in life with respect to their own sense of well-being. This guidance and a sense of hopefulness were provided by heart specialists and more seasoned heart patients. In conclusion, patients were empowered to achieve a healthier lifestyle and improve their personal well-being during CR. However, structural barriers in the programme prevented adequate support regarding the patients’ total needs. Knowledge of the benefits of CR emphasizes the significance of the programme and highlights the importance of high inclusion. Efforts should be made to develop more flexible and longer lasting programmes and further involvement of relatives must be considered.

Women's experiences of how their recovery process is promoted after a first myocardial infarction: Implications for cardiac rehabilitation care

“…From the findings in our study, nurses ought to work with a more recovery-oriented holistic approach (Davidson, 2008 ; WHO, 1986 ) where behavioural, social, and psychological dimensions are taken into account. This is in line with a recent study (Simony et al, 2015 ) that showed that recovery after an MI, for both women and men, is a matter of finding new values in lives through focusing on individual needs and subjective well-being.…”

“…Research has also shown that women value the emotional support and social interaction during CRP more than men and men appreciate the opportunity for information exchange more than women (Barlow, Turner, & Gilchrist, 2009 ). However, in more recent studies both women and men describe that they want to be supported in finding new values in life (Kazimiera Andersson, Borglin, & Willman, 2013 ; Pryor et al, 2014 ; Simony et al, 2015 ), which is also in line with our women's descriptions. In our study, we have not investigated differences between genders, but our result does not confirm the traditional gender-role patterns because the women also described values that seem to be more suitable for males.…”

“…A longer CRP with extended support could improve women's chances of recovery. Patients, both women and men, describe that the supportive care is too limited, because it is sometimes hard to participate in every meeting during the CRP (Simony et al, 2015 ). Since CRP usually have a predetermined time frame and follow a set structure that is similar for all patients, this could entail that women are unnecessarily passive in their personal recovery.…”

“…Research into women's experiences after an MI has had a specific focus on the difficulties in their daily lives and the interruptions and limitations that occur (Johansson, Dahlberg, & Ekebergh, 2003 ; Sjöström-Strand, Ivarsson, & Sjöberg, 2011 ; Stevens & Thomas, 2012 ; Svedlund & Danielson, 2004 ). Other studies have primarily focused on health care interventions such as CRPs (Day & Batten, 2006 ; Simony, Dreyer, Pedersen, & Birkelund, 2015 ) and patient education (Perry & Rosenfeld, 2005 ) as well as how MI affects patients’ health behaviours (McSweeney & Coon, 2004 ) and intimate relations (Arenhall, Kristofferzon, Fridlund, Malm, & Nilsson, 2011 ). Several studies have also shown that fewer women than men actually participate in CRPs (Daniels, Arena, Lavie, & Forman, 2012 ; Grace, Racco, Chessex, Rivera, & Oh, 2010 ).…”

Patients’ Experiences of Cardiovascular Health Education and Risk Communication: A Qualitative Synthesis

“…Secondly they viewed it as an important factor to help them make a positive recovery. An empathic approach from health professionals combined with the provision of support helped to build a strong professional-patient relationship which in turn increased patients' receptivity to lifestyle changes (Hansen & Nelson, 2011;Kristofferzon et al, 2007;Simony et al, 2015;Treloar, 1997;White et al, 2010;Woodard et al, 2005;Wright et al, 2001; (Simony et al, 2015) Patient participants described the positive aspects of consultations in which health professionals communicated that they understood the patient's perspective and why they might behave in a particular way. The provision of individualized support and reassurance, active listening, positive facial expressions (smiling) and physical contact (e.g.…”