The experiences and adjustments of women following their first acute myocardial infarction
Linda Worrall-Carter
Senior Research Fellow, Deakin University; Box Hill Hospital, Burwood VIC
Tamsin Jones
Staff Nurse, Box Hill Hospital, Box Hill VIC
Andrea Driscoll
School of Nursing, Deakin University, Burwood VIC
PP: 211 - 221
Abstract
Very little is known about cardiovascular disease (CVD) in women and their specific needs throughout their recovery process. This study aimed to explore the experiences and adjustments of women following their first AMI. Naturalistic inquiry was used and six women were interviewed post their first AMI. Two major themes were identified: (1) 'the initial experience/event' which identifies events and emotions leading up to, and during, the hospital admission; and (2) 'support: for who and how' exploring the importance of support throughout the recovery process.
The women in this study did not see themselves at risk of an AMI regardless of their lifestyles and when it did occur they adopted a variety of coping mechanisms in order to adjust to their trauma. The findings highlight the need for an increase in community awareness and education surrounding the risk factors of heart disease and its signs and symptoms, to minimize delayed hospital presentations.
Keywords
education; lifestyle modification; myocardial infarction; naturalistic inquiry; women
References
AIHW. Heart, stroke and vascular disease: Australian Facts (2004). Perth, Australian Institute Health and Welfare, the National Heart Foundation, and the National Stroke Foundation of Australia.
Aikman, H.M.(2001). Gender Differences in the Symptoms of Myocardial Infarction. Unpublished doctoral thesis. Latrobe University, Melbourne.
Beery, T.A. (1995) Gender bias in the diagnosis and treatment of coronary artery disease. Heart and Lung: J of Crit Care 24(6): 427-35.
Bittner, V. (1994). Cardiovascular Disease in Women. J Women's Health 3(5): 369-76.
Bogdan, R.C., Biklen, S.K. (1982). Qualitative research for education: An introduction the theory and methods (2nd ed). Allyn & Bacon, Boston.
Burnard, P. (1991). A method of analysing interview transcripts in qualitative research. Nurse Education Today 11:461-6.
Bush, T. and Tonnessen D. (1995). Women and Heart Disease: The Hard Facts & the Good News. Women's Health Digest 1(2):118-27.
Cochrane, B.L. (1992). Acute Myocardial Infarction in Women. Crit Care Nurs Clinics of Nth Am 4(2): 279-89.
Davidson, P.M.., Daly, J., Hancock, K., Moser, D., Chang, E., Cockburn, J. (2003). Perceptions and experiences of heart disease: a literature review and identification of a research agenda in older women. European Journal of Cardiovascular Nursing 2, 255-64.
Dempsey, S.J., Dracup, K., Moser, D.K. (1995). Women's decision to seek care for symptoms of acute myocardial infarction. Heart and Lung: J of Crit Care 24(6): 444-56.
Dixon, J.P., Dixon, J.K., & Spinner, J.C. (1991). Tensions Between Career and Interpersonal Commitments as Risk Factor for Cardiovascular Disease Among Women. Women & Health 17(3): 33-57.
Dracup, K., & Moser, D.K. (1997). Beyond socio-demographics: factors influencing the decision to seek treatment for symptoms of acute myocardial infarction. Heart and Lung: J of Crit Care 26(4): 253-62.
Duvall, W.L. (2003). Cardiovascular Disease in Women, The Mount Sinai Journal of Medicine 70(5): 293-305.
Eaker E.D., Chesebro, H.H., Sacks, F.M., Wenger, N.K., Whisnant, J.P. (1993). Cardiovascular Disease in Women. Circulation 88(4): 1999-2009.
Erhardt, L.R. (2003). Women - a neglected risk group for atherosclerosis and vascular disease. Scandinavian Cardiovascular Journal 37: 3-12.
Erlandson. D.A., Harris, E.L., Skipper B.L., Allen, S.D. (1993). Doing Naturalistic Inquiry: a Guide to Methods. Sage, London.
Fleury, J., Kimbrell, C.L., & Kruszewski, M.A. (1995). Life after a cardiac event: Women's experience in healing. Heart and Lung: J of Crit Care 26(6): 474-82.
Gurwitz, J.H., McLaughlin, T.J., Willison, D.J., Guadagnoli, E., Hauptman, P.J., Gao, X., & Soumerai, S.B. (1997). Delayed hospital presentation in patients who have had acute myocardial infarction. Ann Intern Med 128(8): 593-9.
Hibbard, J.H., & Pope, C.R. (1993). The quality of social roles as predictors of morbidity and mortality. Social Science Medicine 36: 217-25.
Jackson, D., Daly, J., Davidson, P., Elliott, D., Cameron-Traub, E., Wade V., Chin, C., Salamonsen, Y. (2000).Women recovering from first-time myocardial infarction (MI): a feminist qualitative study. J Adv Nurs 32(6): 1403-11.
Jensen, L., King K.M.(1997). Women and Heart Disease: The Issues. Crit Care Nurse 17(2): 45-52.
Kannel, W., Sorlie, P., McNamara, P. (1979). Prognosis after initial myocardial infarction: the Framingham study. Am J Cardiol 44: 53-9.
Kaplan, A. (2004). Coronary Artery Disease: What's Different for Women?, Geriatric Times March/April.
Kerr, E. E. & Fothergill-Bourbonnais, F. (2002). The recovery mosaic: Older women's lived experience after a myocardial infarction. Heart and Lung: J of Crit Care 31 (5): 355-367.
Lincoln, Y.S., Guba E.G. (1985). Naturalistic Inquiry. Sage, Beverley Hills.
McKinley, S., Moser, D.K., & Dracup K. (2000). Treatment-seeking behaviour for acute myocardial infarction symptoms in north America and Australia. Heart and Lung: J of Crit Care 29(4): 237-47.
Mosca, L., Appel, L.J., Benjamin, E.J., Berra, K., Chandra-Strobos, N., Fabunmi, R.P., Grady, D., Haan, C.K., Hayes, S.N., Judelson, D.R., Keenan, N.L., McBride, P., Oparil, S., Ouyang, P., Oz, M.C., Mendelsohn, M.E., Pasternak, R.C., Pinn, V.W., Robertson, R.M., Schenck-Gustafsson, K., Sila, C.A., Smith, S.C., Sopko, G., Taylor, A.J., Walsh, B.W., Wenger, N.K., Williams, C.L. (2004). AHA Guidelines Evidence Based Guidelines for Cardiovascular Disease Prevention in Women, Circulation, 109: 672-693.
National Heart Foundation of Australia (2002). Women and Heart Disease, http://www.heartfoundation.com.au/downloads/Women_and_HD_April_2002.PDF last accessed 29/09/04.
Neuman. W.L.(2000). Social Research Methods: Qualitative and Quantitative Approaches (4th ed). Allyn & Bacon, Boston.
Oliver-McNeil, S. & Artinian, N.T. (2002). Women's Perceptions of Personal Cardiovascular Risk and Their Risk-Reducing Behaviours. American Journal of Critical Care 11(3): 221-227.
Polit, D.F., Hungler, B.P. (1997). Essentials of Nursing Research: Methods, Appraisal and Utilization (4th ed). Lippincott-Raven Publishers, Philadelphia.
Rosenfeld, A.G., & Gilkeson, J.(2000). Meaning of illness for women with coronary heart disease. Heart and Lung: J of Crit Care 29(2): 105-112.
Sheifer, S.E., Rathore, S.S., Gersh, B.J., Weinfurt, K.P., William, J., Breall, J.A., & Schulman, K.A. (2000). Time to presentation with acute myocardial infarction in the elderly: Associations With Race, Sex and Socioeconomic Characteristics. Circulation 12(14): 1651-6.
Streubert, H.J., & Carpenter, D.R. (1995). Qualitative Research in Nursing: Advancing the humanistic Imperative. J.B. Lippincott Company, Philadelphia.
Stewart M, D, K., Meade, D., Hirth, A., Makrides, L. (2000). Myocardial Infarction: survivors and spouses stress, coping and support. J Adv Nursing 31(6): 1351-60.
Svedlund, M., Danielson, E., Norberg, A. (2001). Women's narratives during the acute phase of their myocardial infarction. J Adv Nurs 35(2): 197-205.
Taylor, S.J., Bodgan, R. (1984). Introduction to Research Methods: The search for Meanings (2nd ed).Wiley, New York.
Tecce, M.A., Dasgupta, I., Doherty, J.U. (2003). Heart disease in older women. Gender differences affect diagnosis and treatment. Geriatrics 58(12): 33-39.
Welin, C., Lappas, G., Wilhelmsen, L. (2000). Independent importance of psychosocial factors for prognosis after myocardial infarction. Journal of Internal Medicine 247(6): 629-640.
Westin, L., Carlsson, R., Erhardt, L., Cantor-Graae, E. & McNeil (1999). Differences in Quality of Life in Men and Women with Ischemic Heart Disease. Scandinavian Cardiovascular Journal 33: 160-165.
Wingate, S. (1995). Quality of life for women after a myocardial infarction. Heart and Lung: J of Crit Care 24(6): 467-73.
eContent Home
