Salminen-Tuomaala Mari, Astedt-Kurki Päivi, Rekiaro Matti, Paavilainen Eija
Department of Nursing Science, University of Tampere, Pirkanmaa Hospital District, Science Center, Finland ; Mari Salminen-Tuomaala, School of Health Care and Social Work, Seinäjoki University of Applied Sciences, Koskenalantie 17, 60220 Seinäjoki, Finland.
Nurs Res Pract. 2012;2012:674783. doi: 10.1155/2012/674783. Epub 2012 Dec 9.
Background. Patients recovering from a myocardial infarction (MI) are faced with a number of serious challenges. Aim. To create a substantive theory on myocardial infarction patients' coping as a continuum. Methods. Grounded theory method was used. Data were collected by using individual interviews. The informants were 28 MI patients. Results. The core category "coping experiences-a pathway towards different coping orientations" includes 2 main categories: "positive and negative coping experiences" (4 months after MI) and "different coping orientations" (12 months after MI). Conclusion. Coping with a myocardial infarction is a long-term dynamic process of dealing with varied emotions and adjustment needs. Coping is threatened, if the patient denies the seriousness of the situation, suffers from depression and emotional exhaustion, or if there are serious problems in the interaction with family members. This study stresses the importance of recognizing the patient's depressive state of mind and the psychological aspects which affect family dynamics. A more family-centered approach involving a posthospital counseling intervention is recommended. Relevance to Clinical Practice. The results of this study can be used in nursing care practice when organizing support interventions for myocardial infarction patients.
背景。心肌梗死（MI）康复患者面临诸多严峻挑战。目的。构建关于心肌梗死患者应对方式作为一个连续体的实质性理论。方法。采用扎根理论方法。通过个体访谈收集数据。研究对象为28名心肌梗死患者。结果。核心类别“应对经历——通向不同应对取向的路径”包括2个主要类别：“积极和消极应对经历”（心肌梗死后4个月）以及“不同应对取向”（心肌梗死后12个月）。结论。应对心肌梗死是一个应对各种情绪和调整需求的长期动态过程。如果患者否认病情的严重性、患有抑郁症和情绪衰竭，或者在与家庭成员的互动中存在严重问题，应对就会受到威胁。本研究强调认识患者抑郁心境以及影响家庭动态的心理因素的重要性。建议采用更以家庭为中心的方法，包括出院后咨询干预。与临床实践的相关性。本研究结果可用于护理实践中为心肌梗死患者组织支持性干预措施。
