Factors influencing female patients’ recovery after their first myocardial infarction as experienced by cardiac rehabilitation nurses


Background: In the developed part of the world, coronary heart disease is the major cause of death and is one of the leading causes of disease burden. In Sweden, more than 30,000 people per year are affected by myocardial infarction and out of these approximately 40% are women. Nearly 70% of the women survive and after a myocardial infarction a recovery process follows. Today’s health care focuses more on treatment, symptoms and risk factors than on the individuals’ perceptions of the recovery process. Aim: To explore cardiac rehabilitation nurses’ experiences of factors influencing female patients’ recovery after their first myocardial infarction. Methods: Twenty cardiac rehabilitation nurses were interviewed. The study was conducted using qualitative content analysis. Results: The cardiac rehabilitation nurses experienced that women’s recovery after a first myocardial infarction was influenced whether they had a supportive context, their ability to cope with the stresses of life, if they wanted to be involved in their own personal care and how they related to themselves. Conclusions: Women’s recovery after a myocardial infarction was influenced by factors related to surroundings as well as own individual factors. The underlying meaning of women’s recovery can be described as the transition process of a recovery to health. Our findings suggest that a focus on person-centered nursing would be beneficial in order to promote the every woman’s personal and unique recovery after a myocardial infarction. Finally, the cardiac rehabilitation nurses’ experiences of factors influencing male patients’ recovery after their first myocardial infarction should be important to investigate.

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Wieslander, I. , Mårtensson, J. , Fridlund, B. and Svedberg, P. (2013) Factors influencing female patients’ recovery after their first myocardial infarction as experienced by cardiac rehabilitation nurses. Open Journal of Nursing, 3, 230-240. doi: 10.4236/ojn.2013.32032.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Gaziano, T.A., Bitton, A., Anand, S., Abrahams-Gessel, S. and Murphy, A. (2010) Growing epidemic of coronary heart disease in low- and middle-income countries. Current Problems in Cardiology, 35, 72-115. doi:10.1016/j.cpcardiol.2009.10.002
[2] Wenger, N.K. (2003) Coronary heart disease: The female heart is vulnerable. Progress in Cardiovascular Diseases, 46, 199-229. doi:10.1016/j.pcad.2003.08.003
[3] The National Board of Health and Welfare (2008) The National Board of Health and Welfare guidelines for cardiac care. Socialstyrelsen, Stockholm.
[4] Johansson Sundler, A. (2008) Mitt hjärta, mitt liv: Kvinnors osäkra resa mot hälsa efter en hjärtinfarkt. My heart, my life: Women’s uncertain health journey following a myocardial infarction. Växjö University Press, Växjö.
[5] Perk, J., Guy De Backer, G., Gohlke, H., Graham, I., Zeljko Reiner, Z., Verschuren, M., et al. (2012) European guidelines on cardiovascular disease prevention in clinical practice (version 2012). European Heart Journal, 33, 1-77.
[6] SWEDEHEART (2012) SWEDEHEART 2011 annual report. Matador Kommunikation, Uppsala.
[7] World Health Organization (WHO) (2005) Preventing chronic diseases: A vital investment: WHO global report. World Health Organization, Geneva.
[8] World Health Organization (WHO) (1993) Needs and action priorities in cardiac rehabilitation and secondary prevention in patients with coronary heart disease. WHO Regional Office for Europe, Geneva.
[9] Piepoli, MF., Corrà, U., Benzer, W., Bjarnason-Wehrens, B., Dendale, P., Gaita D., et al. (2010) Secondary prevention through cardiac rehabilitation: from knowledge to implementation. A position paper from the cardiac rehabilitation section of the European association of cardiovascular prevention and rehabilitation. Cardiac rehabilitation section of the European association of cardiovascular prevention and rehabilitation. European Journal of Cardiovascular Prevention and Rehabilitation, 17, 1-17. doi:10.1097/HJR.0b013e3283313592
[10] Jackson, L., Leclerc, J., Erskine, Y. and Linden, W. (2005) Getting the most out of cardiac rehabilitation: A review of referral and adherence predictors. Heart, 91, 10-14. doi:10.1136/hrt.2004.045559
[11] De Feo, S., Tramarin, R., Ambrosetti, M., Riccio, C., Temporelli, P.L., Favretto, G., et al. (2012) Gender differences in cardiac rehabilitation programs from the Italian survey on cardiac rehabilitation (ISYDE-2008). International Journal of Cardiology, 160, 133-139. doi:10.1016/j.ijcard.2011.04.011
[12] Sjöström-Strand, A., Ivarsson, B. and Sjöberg, T. (2011) Women’s experience of a myocardial infarction: 5 years later. Scandinavian Journal of Caring Sciences, 25, 459- 466. doi:10.1111/j.1471-6712.2010.00849.x
[13] Jackson, J.C., Hart, R.P., Gordon, S.M., Shintani, A., Truman, B., May, L., et al. (2003) Six-month neuropsychological outcome of medical intensive care unit patients. Critical Care Medicine, 31, 1226-1234. doi:10.1097/01.CCM.0000059996.30263.94
[14] Slade, M. and Hayward M. (2007) Recovery, psychosis and psychiatry: Research is better than rhetoric. Acta Psychiatrica Scandinavica, 116, 81-83. doi:10.1111/j.1600-0447.2007.01047.x
[15] Mancini, M.A., Hardiman, E.R. and Lawson, H.A. (2005) Making sense of it all: Consumer providers’ theories about factors facilitating and impeding recovery from psychiatric disabilities. Psychiatric Rehabilitation Journal, 29, 48-55. doi:10.2975/29.2005.48.55
[16] Anthony, W.A. (1993) Recovery from mental illness: The guiding vision of the mental health service system in the 1990s. Innovations & Research, 2, 17-24.
[17] Deegan, P. (1996) Recovery as a journey of the heart. Psychiatric Rehabilitation Journal, 19, 91-97.
[18] Tod, A. (2008) Exploring the meaning of recovery following myocardial infarction. Nursing Standard, 23, 35- 42.
[19] Tobin, B. (2000) Getting back to normal: Women’s recovery after a myocardial infarction. Canadian Journal of Cardiovascular Nursing, 11, 11-19.
[20] Fridlund, B. (2002) The role of the nurse in cardiac rehabilitations programmes. European Journal of Cardiovascular Nursing, 1, 15-18. doi:10.1016/S1474-5151(01)00017-2
[21] Hedback, B., Perk, J. and Wodlin, P. (1993) Long-term reduction of cardiac mortality after myocardial infarction: 10-year results of a comprehensive rehabilitation programme. European Heart Journal, 14, 831-835. doi:10.1093/eurheartj/14.6.831
[22] Kerr, E.E. and Fothergill-Bourbonnais, F. (2002) The recovery mosaic: Older women’s lived experiences after a myocardial infarction. Heart & Lung, 31, 355-367. doi:10.1067/mhl.2002.127939
[23] Rankin, S.H. (2002) Women recovering from acute myocardial infarction: Psychosocial and physical functioning outcomes for 12 months after acute myocardial infarction. Heart & Lung, 31, 399-410. doi:10.1067/mhl.2002.129447
[24] McSweeney, J.C. and Coon, S. (2004) Women’s inhibittors and facilitators associated with making behavioral changes after myocardial infarction. Medical-Surgical Nursing, 13, 49-56.
[25] Svedlund, M. and Danielson, E. (2004) Myocardial infarction: Narrations by afflicted women and their partners of lived experiences in daily life following an acute myocardial infarction. Journal of Clinical Nursing, 13, 438- 446. doi:10.1111/j.1365-2702.2004.00915.x
[26] Worrall-Carter, L., Jones, T. and Driscoll, A. (2005) The experiences and adjustments of women following their first acute myocardial infarction. Contemporary nurse. A Journal for the Australian Nursing Profession, 19, 211- 221.
[27] Day, W. and Batten, L. (2006) Cardiac rehabilitation for women: One size does not fit all. Australian Journal of Advanced Nursing, 24, 21-26.
[28] Hildingh, C., Fridlund, B. and Lidell, E. (2007) Women’s experiences of recovery after myocardial infarction: A meta-synthesis. Heart & Lung, 36, 410-417.
[29] Eriksson, M., Asplund, K. and Svedlund, M. (2009) Patients’ and their partners’ experiences of returning home after hospital discharge following acute myocardial infarction. Journal of Cardiovascular Nursing, 8, 267-273. doi:10.1016/j.ejcnurse.2009.03.003
[30] Stevens, S. and Thomas, S.P. (2012) Recovery of midlife women from myocardial infarction. Health Care for Women International Health, 33, 1096-1113. doi:10.1080/07399332.2012.684815
[31] Downe-Wamboldt, B. (1992) Content analysis: Method, applications, and issues. Health Care for Women International, 2, 313-321. doi:10.1080/07399339209516006
[32] Graneheim, U.H. and Lundman, B. (2004) Qualitative content analysis in nursing research: Concepts, procedures and measures to achieve trustworthiness. Nurse Education Today, 24, 105-112. doi:10.1016/j.nedt.2003.10.001
[33] World Medical Association (2008) Declaration of Helsinki—Ethical principles for medical research involving human subjects. The World Medical Association (WMA), Seoul.
[34] Schumacher, K.L. and Meleis, A.I. (1994) Transitions: A central concept in nursing. The Journal of Nursing Scholarship, 26, 119-127. doi:10.1111/j.1547-5069.1994.tb00929.x
[35] Meleis, A.I., Sawyer, L.M., Im, E., Messias, D.K. and Shumacher, K. (2000) Experiencing transitions: An emerging middle-range theory. Journal of Advanced Nursing, 23, 12-28.
[36] Ziegert, K. (2011) Maintaining families’ well-being in everyday life. International Journal of Qualitative Studies on Health and Well-Being, 6.
[37] Wieslander, I., Baigi, A., Turesson, C. and Fridlund, B. (2005) Women’s social support and social network after their first myocardial infarction: A 4-year follow-up with focus on cardiac rehabilitation. European Journal of Cardiovascular Nursing, 4, 278-285. doi:10.1016/j.ejcnurse.2005.06.004
[38] Sjöström-Strand, A. and Fridlund, B. (2006) Women’s descriptions of coping with stress at the time of and after a myocardial infarction: A phenomenographic analysis. Canadian Journal of Cardiovascular Nursing, 16, 5-12.
[39] White, J., Hunter, M. and Holttum, S. (2007) How do women experience myocardial infarction? A qualitative exploration of illness perceptions, adjustment and coping. Psychology Health & Medicine, 12, 278-288. doi:10.1080/13548500600971288
[40] Svedlund, M., Danielson, E. and Norberg, A. (2001) Women’s narratives during the acute phase of their myocardial infarction. Journal of Advanced Nursing, 35, 197- 205. doi:10.1046/j.1365-2648.2001.01837.x
[41] Alsén, P., Brink, E., Persson, L.O., Bröndström, Y. and Karlson, B.W. (2010) Illness perceptions after myocardial infarction: Relations to fatigue, emotional distress, and health-related quality of life. Journal of Cardiovascular Nursing, 25, E1-E10.
[42] Arenhall, E., Kristofferzon, M.L., Fridlund, B., Malm, D. and Nilsson, U. (2011) The male partners’ experiences of the intimate relationships after a first myocardial infarction. European Journal of Cardiovascular Nursing, 10, 108-114. doi:10.1016/j.ejcnurse.2010.05.003
[43] Nilsson, U.G., Svedberg, P., Fridlund, B., Alm-Roijer, C., Thylén I. and SAMMI-Study Group (2012) Sex knowledge in males and females recovering from a myocardial infarction: A brief communication. Clinical Nursing Research, 21, 486-494. doi:10.1177/1054773812437241
[44] Jaarsma, T., Strömberg, A., Fridlund, B., De Geest, S., Mårtensson, J., Moons, P., et al. (2010) Sexual counselling of cardiac patients: Nurses’ perception of practice, responsibility and confidence. European Journal of Cardiovascular Nursing, 9, 24-29. doi:10.1016/j.ejcnurse.2009.11.003
[45] Jaarsma, T., Steinke, E.E. and Gianotten, W.L. (2010) Sexual problems in cardiac patients: How to assess, when to refer. Journal of Cardiovascular Nursing, 25, 159-164.
[46] Steinke, E.E. (2010) Sexual dysfunction in women with cardiovascular disease: What do we know? Journal of Cardiovascular Nursing, 25, 151-158.
[47] Rosvall, M., Chaix, B., Lynch, J., Lindstråm, M. and Merlo, J. (2008) The association between socioeconomic position, use of revascularization procedures and five- year survival after recovery from acute myocardial infarction. BMC Public Health, 1, 44. doi:10.1186/1471-2458-8-44
[48] Haglund, B., Köster, M., Nilsson, T. and Rosén, M. (2004) Inequality in access to coronary revascularization in Sweden. Scandinavian Cardiovascular Journal, 38, 334-339. doi:10.1080/14017430410021516
[49] Varnfield, M., Karunanithi, M.K., Särelä, A., Garcia, E., Fairfull, A., Oldenburg, B.F., et al. (2011) Uptake of a technology-assisted home-care cardiac rehabilitation program. The Medical Journal of Australia, 194, S15-S19.
[50] Pfaeffli, L., Maddison, R., Whittaker, R., Stewart, R., Kerr, A., Jiang, Y., et al. (2012) A Health cardiac rehabilitation exercise intervention: findings from content development studies. BMC Cardiovascular Disorders, 12, 36. doi:10.1186/1471-2261-12-36
[51] Parry, M.J., Watt-Watson, J., Hodnett, E., Tranmer, J., Dennis, C.L. and Brooks, D. (2009) Cardiac Home Education and Support Trial (CHEST): A pilot study. Canadian Journal of Cardiology, 25, 393-398. doi:10.1016/S0828-282X(09)70531-8
[52] Vandelanotte, C., Dwyer, T., Van Itallie, A., Hanley, C. and Mummery, W.K. (2010) The development of an internet-based outpatient cardiac rehabilitation intervenetion: A Delphi study. BMC Cardiovascular Disorders, 10, 27. doi:10.1186/1471-2261-10-27
[53] Pollitt, R.A., Rose, K.M. and Kaufman, J.S. (2005) Evaluating the evidence for models of life course socioeconomic factors and cardiovascular outcomes: A systematic review. BMC Public Health, 5, 7-13.
[54] Williams, G.C., Freedman, Z.R. and Deci, E.L. (1998) Supporting autonomy to motivate patients with diabetes for glucose control. Diabetes Care, 21, 1644-1651. doi:10.2337/diacare.21.10.1644
[55] Sahlsten, M.J., Larsson, I.E., Sjöström, B., Lindencrona, C.S. and Plos, K.A. (2007) Patient participation in nursing care: Towards a concept clarification from a nurse perspective. Journal of Clinical Nursing, 16, 630-637. doi:10.1111/j.1365-2702.2006.01660.x
[56] Arnetz, J.E. and Arnetz, B.B. (2009) Gender differences in patient perceptions of involvement in myocardial infarction care. European Journal of Cardiovascular Nursing, 8, 174-181. doi:10.1016/j.ejcnurse.2008.11.002
[57] Young, L.E. and Murray, J. (2011) Patients’ perception of their experience of primary percutaneous intervention for ST segment elevation myocardial infarction. Canadian Journal of Cardiovascular Nursing, 21, 20-30.
[58] Sherrod, M., McIntire Sherrod, N., Tate Spitzer, M. and Cheek, D. (2012) Prevention of heart disease in women: Considerable challenges remain. Open Journal of Nursing, 2, 176-180. doi:10.4236/ojn.2012.23027

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