MacDermott A F N
Cardiology Department, Royal Victoria Infirmary, NE1 4LP, Newcastle upon Tyne, UK.
Eur J Cardiovasc Nurs. 2002 Dec;1(4):265-72. doi: 10.1016/s1474-5151(02)00047-6.
Angina pectoris is a common medical condition with a high mortality and morbidity rate and normally requires medical therapy to control symptoms. The impact of angina and treatment strategies are gauged almost solely on clinical measurements. This approach does not provide insight into the effects of the disease from the patients' perspectives. Understanding these effects enables a patient centred approach to care, which may facilitate adherence to treatment strategies. Previous studies examining heart disease from the patients' perspective have tended to focus on myocardial infarction or coronary surgery and not, as this study does, on angina per se. Unstructured interviews of seven patients with clinically stable angina pectoris were carried out and analysed using a phenomenological approach. Seven themes were identified: limitation and adjustment; resignation; indignation; caution; reluctant compliance; surprise; and the unknown. Patients made adjustments to their lifestyles because of the limitations imposed on them by angina. These changes were accepted reluctantly, initially with annoyance, but ultimately with resignation. They were cautious in everyday activities to avoid something 'worse' happening. On the whole, they were surprised that they had developed the disease despite little understanding of risk factors. They had not considered the long-term effects of the disease. Angina patients need to have access to information sources to understand the disease and to make adjustments to their lives. An opportunity to discuss the disease with a specialist health care professional is essential. The study showed that phenomenology has a contribution to make in areas such as cardiology where the research agenda is predominantly positivistic.
心绞痛是一种常见的病症，死亡率和发病率都很高，通常需要药物治疗来控制症状。心绞痛的影响和治疗策略几乎完全是通过临床测量来评估的。这种方法无法从患者的角度深入了解该疾病的影响。了解这些影响有助于采取以患者为中心的护理方法，这可能会促进患者对治疗策略的依从性。以往从患者角度研究心脏病的研究往往侧重于心肌梗死或冠状动脉手术，而不像本研究这样关注心绞痛本身。我们对7名临床症状稳定的心绞痛患者进行了非结构化访谈，并采用现象学方法进行分析。确定了七个主题：限制与调整；顺从；愤怒；谨慎；勉强依从；惊讶；以及未知。由于心绞痛给他们带来的限制，患者对自己的生活方式进行了调整。这些改变起初是带着恼怒勉强接受的，但最终还是顺从了。他们在日常活动中小心翼翼，以避免“更糟”的事情发生。总体而言，他们很惊讶自己患上了这种疾病，尽管对危险因素了解甚少。他们没有考虑到这种疾病的长期影响。心绞痛患者需要有获取信息的渠道，以便了解这种疾病并对自己的生活做出调整。与专业医护人员讨论这种疾病的机会至关重要。该研究表明，现象学在心脏病学等研究议程主要为实证主义的领域能发挥作用。
