Brink Eva, Karlson Bjorn W, Hallberg Lillemor R-M
Nursing, Health and Culture, West University, Vänersborg, Sweden.
J Adv Nurs. 2006 Feb;53(4):403-11. doi: 10.1111/j.1365-2648.2006.03737.x.
This paper reports on an interview study exploring the self-regulation process in women and men, 5 months after a first-time myocardial infarction.
Somatic, psychological and social factors affect readjustment after a first-time myocardial infarction, and studies have demonstrated substantial rates of depression in patients after myocardial infarction Women report poorer mental health and physical condition than do men. Reconstruction of the self begins when disease poses novel problems and is more likely to occur in cases of long-lasting and disruptive illnesses. Experiencing myocardial infarction is likely to alter a person's mental representation of self. However, the self-regulation process following first-time myocardial infarction is not yet fully understood.
Twenty-one people (11 women, 10 men) were interviewed 5 months after first-time myocardial infarction. The grounded theory method provided the strategies for data collection and analysis.
Interviewees' definition of themselves as active was threatened by fatigue and other health problems that kept them from taking part in activities as they had done before the heart attack. Although reorienting the active self was central to the process of recovery from myocardial infarction, reorienting was restricted by illness perception and coping.
Participants had not established a stable health condition 5 months after first-time myocardial infarction. They mainly preferred to moderate rather than radically change their daily life activities. They needed more knowledge and support. Nurses can help with information and advice on managing daily life activities, including dialogue about lifestyle changes at this phase of readjustment.
本文报告一项访谈研究,该研究探讨了首次心肌梗死后5个月男性和女性的自我调节过程。
躯体、心理和社会因素会影响首次心肌梗死后的重新适应,并且研究表明心肌梗死后患者的抑郁症发病率很高。女性报告的心理健康和身体状况比男性差。当疾病带来新问题时,自我重建就开始了,并且在长期和破坏性疾病的情况下更有可能发生。经历心肌梗死可能会改变一个人对自我的心理表征。然而,首次心肌梗死后的自我调节过程尚未完全被理解。
对21人(11名女性,10名男性)在首次心肌梗死后5个月进行了访谈。扎根理论方法为数据收集和分析提供了策略。
受访者将自己定义为活跃的自我受到疲劳和其他健康问题的威胁,这些问题使他们无法像心脏病发作前那样参与活动。尽管重新定位活跃的自我是心肌梗死恢复过程的核心,但重新定位受到疾病认知和应对方式的限制。
首次心肌梗死后5个月,参与者尚未建立稳定的健康状况。他们主要倾向于适度调整而非彻底改变日常生活活动。他们需要更多的知识和支持。护士可以在管理日常生活活动方面提供信息和建议,包括在这个重新适应阶段就生活方式改变进行对话。