Shocked and guilty, but highly motivated: Younger patients' experience post MI

Abstract

Background: Prevalence of myocardial infarction (MI) is increasing in younger patients. These patients have distinct needs post MI and are also the poorest attenders at cardiac rehabilitation (CR). Little is known about how younger patients come to terms with their diagnosis, evaluate their personal risk and motivate themselves for lifestyle change. Aim: The aim of the study is to explore the issues encountered by younger patients, who have families, as they attempt lifestyle changes post MI. Methods: A Heideggerian phenomenological methodology employing semi-structured interviews was used with participants (n=7), 6–8 weeks following discharge from hospital. All participants were diagnosed with an MI for the first time, were <50 years of age and had dependent children. Framework analysis was used to identify themes within the interviews. Results: Five major themes were identified: guilt, grief, disbelief, motivation for change, and family support and involvement in lifestyle change. Post MI, family responsibilities were a strong motivator for survival and lifestyle change. The participants were keen to live healthier lives, improve their risk profile and encourage others to do the same. Conclusion: This study confirms the importance of considering the patient's age and family responsibilities within the setting of preventative cardiology. A more patient-centred and tailored approach to CR is needed with younger patients to improve uptake owing to their lifestyle and family commitments. There is need for further research in the acceptability of the current provision of CR.

What Do We Know About Young Adult Cardiac Patients' Experience? A Systematic Review

“…Our findings demonstrated the importance of social support for YAC patients, especially from close relatives (Lacharity, 1999;Joubert et al, 2013;Bucholz et al, 2014;Leung Yinko et al, 2014;McAnirn et al, 2015). For YAC patients, a lack of social support was associated with health, emotional, mental, and depressive issues and lower QoL (Joubert et al, 2013;Bucholz et al, 2014;Leung Yinko et al, 2014).…”

“…A focus on emotional distress was found in 34% of the included studies. Anger and irritability were often evoked by patients and seemed to be part of their emotional state from their hospitalization until at least a year later, both in quantitative and qualitative studies (Uusküla, 1996 ; Lacharity, 1999 ; Lavie and Milani, 2006 ; Andersson et al, 2013 ; McAnirn et al, 2015 ). According to Lavie and Milani ( 2006 ), hostility was higher among younger patients (<55) compared to older patients (≥70).…”

“…Worry was part of the young patients' emotional states 1 week after hospitalization in a quantitative study (Uusküla, 1996 ), and up to 6 months later in a qualitative study (Merritt et al, 2017 ). The patients also felt guilt and responsibility with regards to their family and to past bad lifestyle choices (McAnirn et al, 2015 ). These feelings seemed to last up to a year later, according to some high-quality studies (Andersson et al, 2013 ; Merritt et al, 2017 ).…”

A qualitative study of younger men's experience of heart attack (myocardial infarction)

“…Few studies have examined MI experience in younger adults (Table 1). Particular themes for younger MI patients were shock and disbelief that the event could happen at their age (Allison & Campbell, 2009;Lichtman et al, 2015;McAnirn et al, 2015). Most studies describe uncertainty and fear, extending to a new sense of life as fragile after participants' first encounter with their own mortality (Andersson, Borglin, & Willman, 2013).…”

“…Despite these challenges, two studies (Andersson et al ., ; McAnirn et al ., ) noted the potential for personal growth as a result of MI. Post‐MI, participants spoke of helping others to look after their health, while making the most of life by reflecting on their own values and implementing changes in line with them.…”