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Bernt Jørgensen SM, Johnsen NF, Maribo T, Brøndum S, Gislason G, Kristiansen M. Factors shaping return to work: a qualitative study among heart failure patients in Denmark. Disabil Rehabil 2023:1-11. [PMID: 37818938 DOI: 10.1080/09638288.2023.2266998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 09/30/2023] [Indexed: 10/13/2023]
Abstract
PURPOSE For people of working-age diagnosed with heart failure, return to work (RTW) is often a significant rehabilitation goal. To inform vocational rehabilitation strategies, we conducted a qualitative study aiming at exploring patient experienced support needs, and barriers and facilitators to RTW. MATERIALS AND METHODS Ten men and eight women with heart failure (48-60 years) were interviewed in Denmark during 2022. A thematic analysis was conducted using the Sherbrooke model as framework. RESULTS Multiple factors operating at different levels shaped participants' RTW processes. Personal factors included motivation, mental and physical health, social relations, and financial concerns. Factors in the health care system shaping RTW included access to medical treatment, mental health care, and cardiac rehabilitation. Factors in workplace system shaping RTW included job type, employer support, and social relations. Factors in the legislative and insurance system shaping RTW included authorities' administration of sickness benefits, professional assistance, vocational counselling, and interdisciplinary cooperation. CONCLUSION Findings illustrate a need to include vocational rehabilitation within comprehensive cardiac rehabilitation programmes, to identify people in need of support, to improve the coordination of care across the health and social care sectors, and to involve employers, health care professionals, and social workers in individualised RTW strategies.IMPLICATIONS FOR REHABILITATIONVocational re-integration is shaped by multiple factors operating at different levels (including personal factors, work-related factors, factors in the health care system, and factors in the legislative and insurance system).To improve return to work following heart failure, there is a need for multi-level initiatives, including policy measures and efforts to enhance continuity and coordination of care.People with heart failure in need of vocational support should be identified early within comprehensive cardiac rehabilitation programmes.Health care professionals should address work-related issues and provide individualised information and clear advice regarding timely and safe return to work.Individualised return-to-work plans should be developed within interdisciplinary teams across health and social care sectors and involve employers to ensure that they are aware of relevant work accommodations.
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Affiliation(s)
- Sidsel Marie Bernt Jørgensen
- The Danish Heart Foundation, Section of Cardiovascular Research, Copenhagen, Denmark
- Department of Public Health & Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark
| | - Nina Føns Johnsen
- The Danish Heart Foundation, Section of Cardiovascular Research, Copenhagen, Denmark
| | - Thomas Maribo
- Department of Public Health, Aarhus University, Aarhus, Denmark
- Central Denmark Region, DEFACTUM, Aarhus, Denmark
| | - Stig Brøndum
- The Danish Heart Foundation, Section of Cardiovascular Research, Copenhagen, Denmark
| | - Gunnar Gislason
- The Danish Heart Foundation, Section of Cardiovascular Research, Copenhagen, Denmark
- Department of Cardiology, Copenhagen University Hospital Herlev and Gentofte, Hellerup, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Maria Kristiansen
- Department of Public Health & Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark
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Hasan EM, Calma CL, Tudor A, Oancea C, Tudorache V, Petrache IA, Tudorache E, Papava I. Coping, Anxiety, and Pain Intensity in Patients Requiring Thoracic Surgery. J Pers Med 2021; 11:1221. [PMID: 34834573 PMCID: PMC8620564 DOI: 10.3390/jpm11111221] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 11/09/2021] [Accepted: 11/16/2021] [Indexed: 12/04/2022] Open
Abstract
Stress, anxiety, and post-surgical chest pain are common problems among patients with thoracic surgical pathology. The way in which psychological distress is managed-the coping style-can influence the postsurgical evolution and quality of life of patients. In our study, we monitored the influence of coping style on patients' anxiety and the intensity of post-operative chest pain. We conducted a cross-sectional study on 90 subjects with thoracic surgical pathology. One month after their surgeries, patients completed the following scales and questionnaires, translated, adapted, and validated for the Romanian population: COPE scale inventory, Generalized Anxiety Disorder-7 Questionnaire, McGill Pain Questionnaire, and Numeric Pain Rating Scale. Anxiety (evaluated using the Generalized Anxiety Disorder-7 Questionnaire) and postoperative thoracic pain intensity (evaluated by means of the Numeric Pain Rating Scale, Number of Words Chosen, and McGill Pain Questionnaire) were significantly higher in patients exhibiting social-focused coping than in patients presenting emotion-focused or problem-focused coping as their main coping style (Kruskal-Wallis, p = 0.028, p = 0.022, p = 0.042, p = 0.007). In our study, there were no differences observed in pain intensity relative to level of anxiety. Coping style is an important concept in the management of anxiety and pain experienced by patients undergoing chest surgery. Therefore, a multidisciplinary approach should be considered in clinical practice.
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Affiliation(s)
- Elisei Moise Hasan
- Clinic of Thoracic Surgery, Emergency Clinical Municipal Hospital Timișoara, Gheorghe Dima Street No. 5, 300079 Timișoara, Romania; (E.M.H.); (I.A.P.)
- University of Medicine and Pharmacy Timișoara, Eftimie Murgu Square No. 2, 300041 Timișoara, Romania
| | - Crenguta Livia Calma
- Discipline of Physiology, Department of Functional Sciences, Center of Immuno-Physiology (CIFBIOTEH), “Victor Babeș” University of Medicine and Pharmacy Timișoara, Eftimie Murgu Square No. 2, 300041 Timișoara, Romania
| | - Anca Tudor
- Discipline of Biostatistics and Medical Informatics, Department of Functional Sciences, “Victor Babeș” University of Medicine and Pharmacy Timișoara, Eftimie Murgu Square No. 2, 300041 Timișoara, Romania;
| | - Cristian Oancea
- Discipline of Pneumology, Department of Infectious Diseases, “Victor Babeș” University of Medicine and Pharmacy Timișoara, Eftimie Murgu Square No. 2, 300041 Timișoara, Romania; (C.O.); (V.T.); (E.T.)
| | - Voicu Tudorache
- Discipline of Pneumology, Department of Infectious Diseases, “Victor Babeș” University of Medicine and Pharmacy Timișoara, Eftimie Murgu Square No. 2, 300041 Timișoara, Romania; (C.O.); (V.T.); (E.T.)
| | - Ioan Adrian Petrache
- Clinic of Thoracic Surgery, Emergency Clinical Municipal Hospital Timișoara, Gheorghe Dima Street No. 5, 300079 Timișoara, Romania; (E.M.H.); (I.A.P.)
- First Discipline of Surgical Semiology, First Department of Surgery, “Victor Babeș” University of Medicine and Pharmacy Timișoara, Eftimie Murgu Square No. 2, 300041 Timișoara, Romania
| | - Emanuela Tudorache
- Discipline of Pneumology, Department of Infectious Diseases, “Victor Babeș” University of Medicine and Pharmacy Timișoara, Eftimie Murgu Square No. 2, 300041 Timișoara, Romania; (C.O.); (V.T.); (E.T.)
| | - Ion Papava
- Discipline of Psychiatry, Department of Neuroscence, NEUROPSY-COG Center for Cognitive Research in Neuropsychiatric Pathology, “Victor Babeș” University of Medicine and Pharmacy Timișoara, Eftimie Murgu Square No. 2, 300041 Timișoara, Romania;
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Solano-Ruiz MC, de Freitas GF, Ugarte-Gurrutxaga MI, Gómez-Cantarino S, Siles-González J. Men's Positive and Negative Experiences Following Acute Myocardial Infarction. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:1053. [PMID: 33504041 PMCID: PMC7908433 DOI: 10.3390/ijerph18031053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 01/21/2021] [Accepted: 01/22/2021] [Indexed: 11/16/2022]
Abstract
(1) Objective: To describe men's experiences as acute myocardial infarction sufferers from a social phenomenological perspective, a year after the event (2) Methods: The phenomenological interview was used to capture the participants' discourse. The data were analyzed according to the theoretical methodological approach of social phenomenology. (3) Results: The discourse analysis of the content produced the following categories, set out according reasons "why": personal biography, knowledge set, warning signs prior to the illness, experience at the intensive care unit, and rehabilitation process; and reasons "for": expectations as regards the illness, health professionals, and future social life and work prospects. (4) Conclusions: Participants had not established a healthy condition one year after myocardial infarction, perceiving a very thin line between life and death. Personal biography influences the coping of the disease. They feel like the illness helped them to create new meanings and value of life. They envisage a future full of great restrictions and uncertainty. The results of this study have underlined the need to involve care at all stages of the illness: the physical and emotional dependence upon admittance at the intensive care unit, the need to be cured, the constant demand for information about the illness, the difficulties encountered upon returning home, uncertainty about the future, etc. All these moments indicate that proper nursing care adapted to the specific needs of each individual and their family members must be provided in order to help them to overcome all the stages involved in this process. It is necessary to individualize care because the sense of reality is common and universal, but the ways of expressing are subjective, and it depended on the totality of experiences accumulated throughout life.
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Affiliation(s)
| | | | - M. Idoia Ugarte-Gurrutxaga
- Department of Nursing, Physiotherapy and Occupational Therapy, University of Castilla-La Mancha Campus, 45004 Toledo, Spain; (M.I.U.-G.); (S.G.-C.)
| | - Sagrario Gómez-Cantarino
- Department of Nursing, Physiotherapy and Occupational Therapy, University of Castilla-La Mancha Campus, 45004 Toledo, Spain; (M.I.U.-G.); (S.G.-C.)
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Turan Kavradim S, Canli Özer Z. The effect of education and telephone follow-up intervention based on the Roy Adaptation Model after myocardial infarction: randomised controlled trial. Scand J Caring Sci 2019; 34:247-260. [PMID: 31769891 DOI: 10.1111/scs.12793] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 10/17/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Patients' lifestyle changes after myocardial infarction reduce the risk of infarction. Nursing interventions are important for the initiation and maintenance of lifestyle adaptation. AIM The aim of this study was to evaluate the effect of education and telephone follow-up intervention based on the Roy Adaptation Model for improving myocardial infarction patients' self-efficacy, quality of life and lifestyle adaptation. METHOD In this parallel, randomised controlled trial, patients were randomly allocated to a control group or an intervention group (n = 33/group). The control group received routine care, while the intervention group received routine care plus a telephone follow-up intervention, which consisted of a predischarge education programme and three telephone follow-up sessions. Data were collected before discharge, in the 12th week after discharge between April 2016 and August 2017. All outcomes were assessed at baseline and at 12 weeks, and included quality of life, coping adaptation process, self-efficacy and lifestyle changes. The CONSORT checklist was used in the study. RESULTS In the 12th week after discharge, patients in the intervention group had significant improvements in self-efficacy, quality of life and coping adaptation process compared with the control group. The intervention group also had more adaptation lifestyle changes concerning patients nutrition and physical activity in the 12-week follow-up. CONCLUSION This study demonstrated that education and telephone follow-up intervention based on Roy Adaptation Model was had positive and significant results after 12 weeks compared with usual care. The findings of this study are important for supporting nursing practice and health professionals who care for individuals with myocardial infarction to develop nursing care.
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Affiliation(s)
- Selma Turan Kavradim
- Department of Internal Medicine Nursing, Faculty of Nursing, Akdeniz University, Antalya, Turkey
| | - Zeynep Canli Özer
- Department of Internal Medicine Nursing, Faculty of Nursing, Akdeniz University, Antalya, Turkey
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Bårdsgjerde EK, Kvangarsnes M, Landstad B, Nylenna M, Hole T. Patients' narratives of their patient participation in the myocardial infarction pathway. J Adv Nurs 2018; 75:1063-1073. [PMID: 30549312 DOI: 10.1111/jan.13931] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 10/18/2018] [Accepted: 11/13/2018] [Indexed: 11/29/2022]
Abstract
AIM To explore how patients in areas without local percutaneous coronary intervention (PCI) facilities experience patient participation in different phases of the myocardial infarction pathway. BACKGROUND Acute treatment of myocardial infarction often involves PCI. In Norway, this treatment is centralized at certain hospitals; thus, patients often require long-distance transportation and experience frequent hospital transfers. Short hospital stays, transfers between hospitals and the patient's emotional state pose challenges to promoting patient participation. DESIGN A qualitative design with a narrative approach. METHODS Participants were recruited through purposive sampling. Eight men and two women were interviewed in 2016. FINDINGS Four themes related to the patients' experiences at the beginning, middle and end of the pathway were identified: (a) Lack of verbal communication in the acute phase; (b) trust in healthcare professionals and treatment; (c) lack of participation and coordination at discharge; and (d) shared decision-making in rehabilitation. The findings showed how the patients moved from a low level of patient participation in the acute phase to a high level of patient participation in the rehabilitation phase. CONCLUSION This is the first study to explore patient participation in different phases of the myocardial infarction pathway. We argue that individual plans for information and patient participation are important to improve patient involvement in an earlier stage of the pathway. Further research from a healthcare professional perspective can be valuable to understand this topic. IMPACT This study gives new insight that can be valuable for healthcare professionals in implementing patient participation throughout the pathway.
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Affiliation(s)
- Elise Kvalsund Bårdsgjerde
- Department of Health Sciences in Ålesund, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Ålesund, Norway
| | - Marit Kvangarsnes
- Department of Health Sciences in Ålesund, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Ålesund, Norway.,Møre og Romsdal Hospital Trust, Ålesund, Norway
| | - Bodil Landstad
- Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden.,Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Magne Nylenna
- Institute of Health and Society, University of Oslo, Oslo, Norway.,Norwegian Institute of Public Health, Oslo, Norway
| | - Torstein Hole
- Clinic of Medicine and Rehabilitation, Møre og Romsdal Hospital Trust, Ålesund, Norway.,Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
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Investigation about the Impact of Tourism Development on a Water Conservation Area in Taiwan. SUSTAINABILITY 2018. [DOI: 10.3390/su10072328] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Bahall M, Khan K. Quality of life of patients with first-time AMI: a descriptive study. Health Qual Life Outcomes 2018; 16:32. [PMID: 29433517 PMCID: PMC5810028 DOI: 10.1186/s12955-018-0860-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Accepted: 02/07/2018] [Indexed: 03/01/2023] Open
Abstract
Background Outcomes following acute myocardial infarction (AMI) may result in death, increased morbidity, and change in quality of life (QOL). This study explores health-related QOL of first-time patients following AMI. Methods This cross-sectional study used a sample of patients with first-time AMI experienced between April 2011 and March 2015 at a tertiary health institution. Recruited patients belonged to different post-AMI periods: 2–10 weeks, 5–22 months, and > 22 months to 4 years post AMI. Inclusion criteria were not confused and communicating freely. Exclusion criteria were non-contactable, refusing to participate, and deceased. One-on-one interviews were conducted using the validated and pre-tested Quality of Life after Myocardial Infarction (QLMI) questionnaire. QOL of patients after AMI was evaluated at each period. Descriptive, Mann–Whitney U, Kruskal–Wallis, and regression analyses were conducted using SPSS version 24. Results A total of 534 participant interviews (overall response rate 65.4%) were conducted. Interviewees were predominantly male (67%), aged 51–65 years (45%), Indo-Trinidadian (81.2%), NSTEMI (64.4%), and hypertensive (72.4%). Overall QOL improved over time and in all domains: Emotional, Physical, and Social. Lower QOL was found among women, patients with NSTEMI, and diabetics in all domains; in patients with hypertension and renal disease in the Physical and Social domains only; and in patients with ischaemic heart disease (IHD) in the Physical domain only. Self-reported stress and lack of exercise were associated with lower QOL while drinking alcohol and eating out were related to better QOL. Hypercholesterolemia, smoking, and ethnicity showed no association with QOL. Declining QOL in the Physical domain with age was also found. The leading components of QOL were self-confidence and social exclusion (early post AMI), lack of self-confidence (intermediate post AMI), and tearfulness (late post AMI). Conclusions QOL in AMI survivors improves over time. Female gender, NSTEMI, diabetes, hypertension, renal disease, stress, and lack of exercise were associated with lower QOL while hypercholesterolemia, smoking, and ethnicity showed no association with QOL. Cardiac rehabilitation and psychological support may enhance earlier increased QOL among survivors, particularly among vulnerable groups.
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Affiliation(s)
- Mandreker Bahall
- Department of Clinical Medical Sciences, University of the West Indies, St. Augustine, Trinidad, Trinidad and Tobago.
| | - Katija Khan
- Department of Clinical Medical Sciences, University of the West Indies, St. Augustine, Trinidad, Trinidad and Tobago
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Ammouri AA, Kamanyire JK, Abu Raddaha AH, Achora S, Obeidat AA. Another Chance at Life: Jordanian Patients' Experience of Going Through a Myocardial Infarction. Res Theory Nurs Pract 2017; 31:334-348. [PMID: 29137693 DOI: 10.1891/1541-6577.31.4.334] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND PURPOSE Myocardial infarction (MI) is a life-threatening health condition that has physical, spiritual, emotional, and social changes. Understanding feelings and thoughts of patients who suffered MI attacks is essential to recovery. Among Jordanian patients who suffered an acute attack of MI, the aim of the study was to describe the experiences and the varied meanings that they assign to their experiences. METHODS A qualitative hermeneutic phenomenological research design was used. Five participants were engaged in in-depth semistructured interviews. The participants were identified using a purposeful sampling technique, after being admitted at a coronary care unit in a university hospital located in Amman, the capital city of Jordan. The hospital provides a full range of cardiovascular medical and surgical care for patients admitted from different socioeconomic levels. Transcribed data were analyzed following inductive qualitative content analysis method. RESULTS The experience of MI was a traumatizing event characterized by life-threatening symptoms, and participants feared they would not come back home. However, cultural values and religiosity among the Jordanian patients played a major role in facilitating their positive coping during and after the MI attack. The participants' recount of their experience was summed-up into 5 major themes: frightening experience, needed support, religiosity, experiencing changes, and lifestyle modifications. After the MI attack, most of the participants felt that they had given another chance to live, showing a pressing need to make healthier lifestyle modifications to avoid another MI attack. IMPLICATIONS FOR PRACTICE Health care workers should need not only pay attention on physical and physiological caring aspects but should also consider other patients' needs, while supporting the patients and their family members.
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Langdridge D. Recovery From Heart Attack, Biomedicalization, and the Production of a Contingent Health Citizenship. QUALITATIVE HEALTH RESEARCH 2017; 27:1391-1401. [PMID: 27634296 DOI: 10.1177/1049732316668818] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
In this article, I explore the experience of recovery from a heart attack through an analytic autoethnography. I discuss the tensions inherent in biomedical subjectivities of health and ill-health during cardiac recovery through three key themes: (a) the transfer of responsibility and becoming a subject "at risk," (b) technologies of biomedicine and the disciplining of subjectivities, and (c) the transformation of a body toward a new pharmaceuticalized bodily normal. Through an analysis driven by the biomedicalization thesis of Clarke, alongside work on biopower and the governmentality of health by Foucault, Rose, and Rabinow, I seek to provide new insights into the process of cardiac recovery and the relationship between individual experience and broader socio-political processes. Key to this analysis is a focus on the contingent subjectivities brought into being through biomedicalization that constitute a new form of health citizenship that is otherwise not accounted for in narratives of recovery.
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Ganasegeran K, Rashid A. The prevalence of medication nonadherence in post-myocardial infarction survivors and its perceived barriers and psychological correlates: a cross-sectional study in a cardiac health facility in Malaysia. Patient Prefer Adherence 2017; 11:1975-1985. [PMID: 29263654 PMCID: PMC5726356 DOI: 10.2147/ppa.s151053] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Although evidence-based practice has shown the benefits of prescribed cardioprotective drugs in post-myocardial infarction (MI) survivors, adherence rates remain suboptimal. The aim of this study was to determine the prevalence and factors associated with medication nonadherence among post-MI survivors in Malaysia. MATERIALS AND METHODS This cross-sectional study was conducted from February to September 2016 among 242 post-MI survivors aged 24-96 years at the cardiology outpatient clinic in a Malaysian cardiac specialist center. The study utilized an interviewer-administered questionnaire that consisted of items adapted and modified from the validated Simplified Medication Adherence Questionnaire, sociodemographics, health factors, perceived barriers, and novel psychological attributes, which employed the modified Confusion, Hubbub, and Order Scale and the Verbal Denial in Myocardial Infarction questionnaire. RESULTS The prevalence of medication nonadherence was 74%. In the multivariable model, denial of illness (AOR 1.2, 95% CI 0.9-1.8; P=0.032), preference to traditional medicine (AOR 8.7, 95% CI 1.1-31.7; P=0.044), lack of information about illness (AOR 3.3, 95% CI 1.1-10.6; P=0.045), fear of side effects (AOR 6.4, 95% CI 2.5-16.6; P<0.001), and complex regimen (AOR 5.2, 95% CI 1.9-14.2; P=0.001) were statistically significant variables associated with medication nonadherence. CONCLUSION The relatively higher medication-nonadherence rate in this study was associated with patient-, provider-, and therapy-related factors and the novel psychological attribute denial of illness. Future research should explore these factors using robust methodological techniques to determine temporality among these factors.
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Affiliation(s)
- Kurubaran Ganasegeran
- Department of Public Health Medicine, Penang Medical College, George Town, Malaysia
- Correspondence: Kurubaran Ganasegeran, Department of Public Health Medicine, Penang Medical College, Sepoy Lines, George Town, Penang 10450, Malaysia, Tel +60 19 371 1268, Email
| | - Abdul Rashid
- Department of Public Health Medicine, Penang Medical College, George Town, Malaysia
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Malinauskaite I, Slapikas R, Courvoisier D, Mach F, Gencer B. The fear of dying and occurrence of posttraumatic stress symptoms after an acute coronary syndrome: A prospective observational study. J Health Psychol 2016; 22:208-217. [PMID: 26311815 DOI: 10.1177/1359105315600233] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The purpose of the study was to investigate whether experiencing fear of dying after acute coronary syndrome predicts later posttraumatic stress symptoms. We enrolled 90 patients hospitalized with main diagnosis of acute coronary syndrome and assessed baseline characteristics. One month after discharge, we collected the Posttraumatic Stress Scale. A total of 24 patients (26.7%) developed posttraumatic stress symptoms 1 month after the acute coronary syndrome event. Patients with posttraumatic stress symptoms reported significantly greater fear of dying, helplessness, avoidance-focused coping, and severe anxiety. In our prospective study, fear of dying was associated with occurrence of posttraumatic stress symptoms in patients hospitalized with acute coronary syndrome.
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Affiliation(s)
- Ieva Malinauskaite
- 1 Geneva University Hospital, Switzerland.,2 Lithuanian University of Health Sciences Hospital, Lithuania
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Fredriksson-Larsson U, Alsen P, Brink E. I've lost the person I used to be--experiences of the consequences of fatigue following myocardial infarction. Int J Qual Stud Health Well-being 2013; 8:20836. [PMID: 23769653 PMCID: PMC3683631 DOI: 10.3402/qhw.v8i0.20836] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/21/2013] [Indexed: 11/23/2022] Open
Abstract
Fatigue has been found to be the most frequent and bothersome symptom after myocardial infarction (MI), influencing health-related quality of life negatively. Moreover, fatigue after MI has been described as incomprehensible due to its unpredictable occurrence and lack of relationship to physical effort. The aim of this study is therefore to explore persons’ experiences of consequences of fatigue and their strategies for dealing with it 2 months after MI. In total, 18 informants, aged 42–75 years, participated in the study. Interviews were conducted and analysed using constructivist grounded theory methodology. Grounded in the data, the main consequence of fatigue, as illustrated in the core category, was: I’ve lost the person I used to be. It indicates a sense of reduced ability to manage daily life due to experiences of fatigue. The core category was developed from the four categories: involuntary thoughts, certainties replaced with question marks, driving with the handbrake on and just being is enough. Furthermore, attempts to relieve fatigue were limited. These findings indicate that patients with symptoms of fatigue should be supported in developing relief strategies, for example, rest and sleep hygiene as well as physical activity. In conclusion, the results show that fatigue can be understood in light of the concepts “comprehensibility” and “manageability.” They also indicate that, working from a person-centered perspective, health-care professionals can support patients experiencing post-MI fatigue by giving them opportunities to straighten out the question marks and by inviting them to discuss involuntary thoughts and feelings of being restricted in their daily life functioning.
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