Illness perceptions influence involvement in rehabilitation programs and adoption of lifestyle changes following acute myocardial infarction

Abstract

Synopsis MacInnes, J. D. (2005). The illness perceptions of women following acute myocardial infarction: Implications for behavioural change and attendance at cardiac rehabilitation. Women & Health, 42 (4), 105 -121.Research objective: To explore illness perceptions of women following acute myocardial infarction. Design: Qualitative. Setting: Three district general hospitals in south-east England. Participants: Purposive sample of 10 women who had been admitted and since discharged from one of the three hospitals in the study with acute myocardial infarction (AMI). They participated in the study 3 months after their AMI. Their ages ranged from 30 to 80 years with a mean of 72. Methods: Semistructured interviews were conducted with each participant for approximately 1 h. The structure of the interviews was determined by the Self-Regulatory Model of Illness Behaviour as described by Leventhal and Nerenz (1985). Field notes were taken following each interview. Data were analysed utilising a framework method described by Ritchie and Spencer in Bryman and Burgess (1994). This involved identification of themes in the data, grouping of data together that related to the same theme, and mapping of relationships between and within themes and with the research question and existing literature. Strategies to establish the trustworthiness of the data or the analysis were not reported. Main Findings: Five themes were identified: (i) Stress as the cause of the illness. Participants were somewhat unsure about the cause of their illness, however, perceived both physical and emotional stress to be major contributing factors. (ii) Loss of confidence and inability to complete household chores. For many of the participants, the illness leads to a loss of their independence. (iii) The time line and episodic nature of the illness. Rather than a long-term illness, the participants viewed the myocardial infarction as an acute event or episode that may recur. (iv) Perceived lack of control. Residual symptoms and the need to take medication left many participants feeling powerless to control the illness and prevent it from recurring. (v) Illness perceptions in relation to lifestyle changes and attendance at cardiac rehabilitation. Reducing stress through relaxation and slowing down was adopted over making other lifestyle changes to diet, exercise or smoking because stress was perceived to be the main cause of the illness. Motivation for cardiac rehabilitation was stronger for younger participants, and those that believed it would help increase their independence. CommentaryThere is an increasing recognition of the burden of coronary heart disease (CHD) in women, and as a consequence, the need to describe women's perceptions of the causes of CHD and adjustment following an acute coronary event. The study undertaken by MacInnes (2005) provides an insight into the perceptions of women recovering from an acute myocardial infarction (AMI). The use of the qualitative methodology has provided an understanding of the participants' unique experienc...