“Is My Heart Healing?” A Meta-synthesis of Patients' Experiences After Acute Myocardial Infarction

Abstract

BackgroundRecovery from acute myocardial infarction (AMI) has been primarily understood in a narrow medical sense. For patients who survive, secondary prevention focuses largely on enhancing clinical outcomes. As a result, there is a lack of descriptive accounts of patients' experiences after AMI and little is known about how people go about the challenge of recovering from such an event.ObjectiveWe conducted a meta-synthesis of the available literature on qualitative accounts of patients' experiences after AMI.MethodsWe searched for relevant papers that were descriptive, qualitative accounts of participants' experiences after AMI across 4 electronic databases (April 2016). Using an adapted meta-ethnography approach, we analyzed the findings by translating studies into one another and synthesizing the findings from the studies.ResultsAfter a review of titles/abstracts, reading each article twice in full, and cross-referencing articles, this process resulted in 17 studies with 224 participants (48% women) aged 23 to 90 years. All participants provided a first-person account of an AMI within the 3-day to 25-year time frame. Two major themes emerged that characterized patients' experiences: navigating lifestyle changes and navigating the emotional reaction to the event—consisting of various subthemes.ConclusionAlthough AMI tends to be seen as a discrete event, participants are left with little professional guidance as to how to negotiate significant, and often discordant, psychosocial changes that have long-lasting effects on their lives, similar to persons with chronic illnesses but without research in place to figure out how to best support them.

Men’s Positive and Negative Experiences Following Acute Myocardial Infarction

“…Just like those who had previous heart problems, attributed the appearance of the illness to the fact that they had not looked after themselves properly. This generated a sense of guilt [6,25].…”

“…The global fatigue was associated with concurrent symptoms, such as breathlessness and stress, and coping strategies such as changes in values, intrusion, and isolation. The patients felt emotionally and physically powerless and described their life as "transfixed" [6,7].…”

“…Individuals suffering from a heart disease, such as myocardial infarction (MI), may undergo major changes in their lives. Several research works have involved longitudinal studies about the perception of the illness over time [6][7][8]. Many men described a series of losses after the cardiac diagnosis; these include loss of physical strength, emotional health, depression, fatigue, and problems with physical functioning [9,10].…”

The Canadian Women’s Heart Health Alliance Atlas on the Epidemiology, Diagnosis, and Management of Cardiovascular Disease in Women—Chapter 3: Patient Perspectives

“…Not only the acute experience, but also recovery from a cardiac event can be associated with insecurity, fear, and considerable emotional and physical burdens for men and women. 6 However, women's experiences and personal recovery remain poorly described in the literature. [7][8][9] Women's experiences of CVD diagnosis, treatment, and rehabilitation have largely been shaped by social constructs of gender that historically have emphasized the portrayal of CVD as a "man's disease."…”

Eliciting Patient Experiences About Their Care After Cardiac Surgery

“…A recent review showed that those who experience a cardiac event have informational and care needs that extend far beyond the inpatient setting. 9 These can include navigating lifestyle changes, as well as the emotional reactions post event.…”