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Women’s recovery after a first myocardial infarction from an organisational, a relational and an individual perspective
Jönköping University, School of Health Science, HHJ, Quality Improvement and Leadership in Health and Welfare.
2014 (English)Doctoral thesis, comprehensive summary (Other academic)Alternative title
Kvinnors återhämtning efter en första hjärtinfarkt ur ett organisatoriskt, relationellt och individuellt perspektiv (Swedish)
Abstract [en]

The overall aim of this thesis was to explore and describe women’s recovery after a first myocardial infarction (MI) from an organisational, a relational and an individual perspective. In this thesis a longitudinal, explorative and descriptive design combining both quantitative (papers I-II) and qualitative (papers III-IV) methods has been used. Data was collected from healthcare professionals at 18 acute hospitals (paper I), which on two occasions answered a questionnaire dealing with cardiac rehabilitation efforts. From these 18 hospitals, 240 women who had suffereda first MI (paper II) were consecutively chosen to answer a questionnaire on three occasions on the subject of social support and social network. Descriptive and inferential statistics were used to analyse data over time. Paper III and IV had an exploratory and descriptive design based on an inductive, qualitative content analysis approach. Interviews were conducted with 20 cardiac rehabilitation nurses (CRN) (paper III) and with 26 women suffering a first MI (paper IV).

The results showed that patients with MI, and their next of kin, were offered a well-functioning cardiac rehabilitation on both measurement occasions. None of the hospitals offered a CRP that was specifically designed for women (paper I). The women perceived that the extent of general support, support from relatives, and professional support changed positively over time (paper II). The CRNs experienced that women’s recovery was influenced by their ability to cope with the stresses of life, if they wanted to be involved in their own personal care and how they related to themselves, and their opportunities to receive support (paper III). Women experienced that ability to approach the new perspective of life depended on how they embraced the three dimensions; behaviour, i.e. women’s acting and engaging in various activities, social i.e. how women receive and give support in their social environment, and psychological i.e. their way of thinking, reflect and appreciate life (paper IV).

In conclusion, the four studies show that women’s recovery after a first MI is depending on factors emerging from an organisational, a relational and an individual perspective. Using knowledge from these three perspectives the possibility of a holistic approach to women’s recovery process to health will increase and the risk of a reductionist thinking will decrease.

Place, publisher, year, edition, pages
Jönköping: Hälsohögskolan i Jönköping , 2014. , 88 p.
Series
Hälsohögskolans avhandlingsserie, ISSN 1654-3602 ; 54
Keyword [en]
Cardiac rehabilitation, longitudinal, myocardial infarction, nursing, recovery process, secondary prevention, qualitative content analysis, social support, women
National Category
Nursing
Identifiers
URN: urn:nbn:se:hj:diva-24425ISBN: 978-91-85835-53-9 (print)OAI: oai:DiVA.org:hj-24425DiVA: diva2:740577
Public defence
2014-09-19, Forum Humanum, Hälsohögskolan i Jönköping, Jönköping, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2014-08-25 Created: 2014-08-25 Last updated: 2014-08-25Bibliographically approved
List of papers
1. Cardiac rehabilitation efforts for patients with ischaemic heart disease: a 5-year comparative review in five counties in western Sweden
Open this publication in new window or tab >>Cardiac rehabilitation efforts for patients with ischaemic heart disease: a 5-year comparative review in five counties in western Sweden
2001 (English)In: Coronary Health Care, ISSN 1362-3265, Vol. 5, no 1, 16-24 p.Article in journal (Refereed) Published
National Category
Nursing
Identifiers
urn:nbn:se:hj:diva-11823 (URN)10.1054/chec.2000.0106 (DOI)
Available from: 2010-03-23 Created: 2010-03-23 Last updated: 2014-08-25Bibliographically approved
2. Women's social support and social network after their first myocardial infarction: a 4-year follow-up with focus on cardiac rehabilitation
Open this publication in new window or tab >>Women's social support and social network after their first myocardial infarction: a 4-year follow-up with focus on cardiac rehabilitation
2005 (English)In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, Vol. 4, no 4, 278-285 p.Article in journal (Refereed) Published
National Category
Nursing
Identifiers
urn:nbn:se:hj:diva-9898 (URN)10.1016/j.ejcnurse.2005.06.004 (DOI)
Available from: 2009-08-19 Created: 2009-08-19 Last updated: 2014-08-25Bibliographically approved
3. Factors influencing female patients' recovery after their first myocardial infarction as experienced by cardiac rehabilitation nurses
Open this publication in new window or tab >>Factors influencing female patients' recovery after their first myocardial infarction as experienced by cardiac rehabilitation nurses
2013 (English)In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 3, no 2, 230-240 p.Article in journal (Refereed) Published
Abstract [en]

Background: In the developed part of the world, coronary heart disease is the major cause of death and is one of the leading causes of disease burden. In Sweden, more than 30,000 people per year are affected by myocardial infarction and out of these approximately 40% are women. Nearly 70% of the women survive and after a myocardial infarction a recovery process follows. Today’s health care focuses more on treatment, symptoms and risk factors than on the individuals’ perceptions of the recovery process. Aim: To explore cardiac rehabilitation nurses’ experiences of factors influencing female patients’ recovery after their first myocardial infarction. Methods: Twenty cardiac rehabilitation nurses were interviewed. The study was conducted using qualitative content analysis. Results: The cardiac rehabilitation nurses experienced that women’s recovery after a first myocardial infarction was influenced whether they had a supportive context, their ability to cope with the stresses of life, if they wanted to be involved in their own personal care and how they related to themselves. Conclusions: Women’s recovery after a myocardial infarction was influenced by factors related to surroundings as well as own individual factors. The underlying meaning of women’s recovery can be described as the transition process of a recovery to health. Our findings suggest that a focus on person-centered nursing would be beneficial in order to promote the every woman’s personal and unique recovery after a myocardial infarction. Finally, the cardiac rehabilitation nurses’ experiences of factors influencing male patients’ recovery after their first myocardial infarction should be important to investigate.

Keyword
Cardiac Rehabilitation Nurses; Myocardial Infarction; Recovery; Transition Process; Women
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:hj:diva-23130 (URN)10.4236/ojn.2013.32032 (DOI)
Available from: 2014-01-16 Created: 2014-01-16 Last updated: 2017-02-09Bibliographically approved
4. Women's experiences of how their recovery process is promoted after a first myocardial infarction: Implications for cardiac rehabilitation care
Open this publication in new window or tab >>Women's experiences of how their recovery process is promoted after a first myocardial infarction: Implications for cardiac rehabilitation care
2016 (English)In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 11, 30633Article in journal (Refereed) Published
Abstract [en]

Background: After a myocardial infarction and discharge from the hospital a recovery process follows for the women. In order to facilitate their recovery, both a preventive and promotive perspective should be taken into consideration. Despite this, today´s healthcare focuses more on prevention and thus research into the promotion of women’s recovery process is needed.

Aim: To explore how women’s recovery processes are promoted after a first myocardial infarction

Methods: The study had an explorative and descriptive design based on qualitative content analysis.

Findings: The women’s recovery process was promoted through using external and internal resources as well as embracing behaviour, social and psychological dimensions. The women embraced these dimensions to a varying extent and this process led to them being able to take in a new perspective on life.

Conclusions: The women’s personal recovery is a multidirectional process with a desire to develop and approach a new perspective on life. It is important for cardiac rehabilitation nurses to not only focus on lifestyle changes and social support, but also on working actively with the women’s inner strength in order to promote the personal recovery of the women. Furthermore, it would be interesting to investigate men’s experiences of how their recovery process after a first Myocardial infarction is promoted.

Place, publisher, year, edition, pages
Taylor & Francis, 2016
Keyword
myocardial infarction, promote, qualitative content analysis, recovery process, women
National Category
Nursing
Identifiers
urn:nbn:se:hj:diva-24426 (URN)10.3402/qhw.v11.30633 (DOI)000396164600001 ()27172514 (PubMedID)2-s2.0-84980662316 (Scopus ID)
Funder
Swedish Heart Lung Foundation
Note

Included in thesis in manuscript (preprint) version.

Available from: 2014-08-25 Created: 2014-08-25 Last updated: 2017-05-03Bibliographically approved

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