Bhattacharyya Mimi, Stevenson Fiona, Walters Kate
Research Department of Primary Care and Population Health, University College London, London, UK.
BMJ Open. 2016 Jul 8;6(7):e010195. doi: 10.1136/bmjopen-2015-010195.
There is little research on how different ethnic groups adapt after an acute cardiac event. This qualitative study explores between-ethnicity and within-ethnicity variation in adaptation, and the psychological impact of an acute cardiac event among UK South Asian and white British people.
We purposively sampled people by ethnic group from general practices in London who had a new myocardial infarction, angina or acute arrhythmia in the preceding 18 months.
We conducted 28 semistructured interviews for exploring the psychological symptoms, experiences and adaptations following a cardiac event among South Asians (Indian and Bangladeshi) in comparison to white British people. Data were analysed using a thematic 'framework' approach.
Findings showed heterogeneity in experiences of the cardiac event and its subsequent psychological and physical impact. Adaptation to the event related predominantly to life circumstances, personal attitudes and employment status. Anxiety and low mood symptoms were common sequelae, especially in the Bangladeshi group. Indian men tended to normalise symptoms and the cardiac event, and reported less negative mood symptoms than other groups. Fear of physical exertion, particularly heavy lifting, persisted across the groups. Some people across all ethnic groups indicated the need for more psychological therapy postcardiac event. Socioeconomic circumstances, age and prior work status appeared to be more important in relation to adaptation after a cardiac event than ethnic status.
Heterogeneity in views and experiences related to the socioeconomic background, age and work status of the participants along with some cultural influences. Rehabilitation programmes should be flexibly tailored for individuals in particular and where relevant, specific support should be provided for returning to work.
关于不同种族群体在急性心脏事件后如何适应的研究较少。这项定性研究探讨了英国南亚裔和白人在适应方面的种族间和种族内差异,以及急性心脏事件对他们的心理影响。
我们从伦敦的普通诊所中按种族有目的地抽取了在过去18个月内发生新的心肌梗死、心绞痛或急性心律失常的患者。
我们进行了28次半结构化访谈,以探讨南亚裔(印度裔和孟加拉裔)与英国白人在心脏事件后的心理症状、经历和适应情况。采用主题“框架”方法对数据进行分析。
研究结果显示,心脏事件的经历及其随后的心理和生理影响存在异质性。对该事件的适应主要与生活环境、个人态度和就业状况有关。焦虑和情绪低落症状是常见的后遗症,尤其是在孟加拉裔群体中。印度男性倾向于将症状和心脏事件正常化,且报告的负面情绪症状比其他群体少。对体力活动,特别是重物搬运的恐惧在所有群体中都持续存在。所有种族群体中的一些人表示,心脏事件后需要更多的心理治疗。社会经济状况、年龄和先前的工作状态在心脏事件后的适应方面似乎比种族身份更为重要。
与参与者的社会经济背景、年龄和工作状态相关的观点和经历存在异质性,同时也受到一些文化影响。康复计划应根据个人情况灵活制定,在相关情况下,应为重返工作岗位提供具体支持。