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女性如何经历心肌梗死?对疾病认知、适应与应对的质性探索。

How do women experience myocardial infarction? A qualitative exploration of illness perceptions, adjustment and coping.

作者信息

White Joanna, Hunter Myra, Holttum Sue

机构信息

Cardiac Health and Rehabilitation Team, Kings College Hospital, Denmark Hill, London, UK.

出版信息

Psychol Health Med. 2007 May;12(3):278-88. doi: 10.1080/13548500600971288.

Abstract

While UK Department of Health policy recognizes the importance of secondary prevention and rehabilitation following a cardiac event, there still appears a dearth of research addressing women's needs. This study aimed to explore adjustment in terms of women's perception of their cardiac event, impact on relationships and coping strategies employed. Five women suffering first time MI were interviewed, using a semi-structured format and were telephoned 2 months later. Data were analysed using Interpretative Phenomenological Analysis. Perceptions included: Making Sense of the Event, Cognitive and Emotional Responses and Self-beliefs. Relationships issues were: Others' Reactions and Change in Relationships and Roles. Cognitive and Behavioural strategies and Support from others (including cardiac rehabilitation) formed coping strategies. For most participants, the event was unexpected evoking uncertainty and later, emotions extending beyond the more widely accepted depression and anxiety. Women tended to minimize severity of symptoms and impact of event (perhaps as a way of coping and protecting others), displaying a strong sense of optimism and hope that life would soon return to "normal". However, it appeared this was difficult to maintain and the experience seemed to challenge relationships and roles. The findings suggest recommendations for further research with possible implications for clinical practice.

摘要

虽然英国卫生部的政策认识到心脏事件后二级预防和康复的重要性,但针对女性需求的研究似乎仍然匮乏。本研究旨在从女性对心脏事件的认知、对人际关系的影响以及所采用的应对策略等方面探讨适应情况。对五名首次发生心肌梗死的女性进行了访谈,采用半结构化形式,并在两个月后给她们打电话。使用解释现象学分析法对数据进行了分析。认知包括:理解事件、认知和情感反应以及自我信念。人际关系问题包括:他人的反应以及人际关系和角色的变化。认知和行为策略以及他人的支持(包括心脏康复)构成了应对策略。对大多数参与者来说,该事件是意想不到的,引发了不确定性,后来情绪超出了更广泛认可的抑郁和焦虑。女性倾向于淡化症状的严重程度和事件的影响(可能是一种应对和保护他人的方式),表现出强烈的乐观情绪,并希望生活很快恢复“正常”。然而,似乎这很难维持,而且这种经历似乎对人际关系和角色构成了挑战。研究结果为进一步研究提出了建议,可能对临床实践产生影响。

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