Rehabilitation after myocardial infarction: experiences and perspectives of people who do not use cardiac rehabilitation and / or CHD 'self-help' groups and their ‘significant others’
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Date
2009Author
Jackson, Angela Mary
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Abstract
Background and goals:
This thesis explores the experience of rehabilitaion following myocardial infarction
(MI) from the perspective of people who did not attend either a cardiac rehabilitation
programme (CR) or a CHD 'self-help' group and their ‘significant others’. These
resources are intended to support post-MI rehabilitation and readjustment and
research identifies various benefits, yet many people do not use them. Given the
scale of the population affected by CHD, the issues of why people do not use the
resources, their experience and that of their family members, and the kinds of support
people need and want, are of public health importance. These issues formed my
investigative goals.
Methods:
The study used a qualitative methodology, informed by ‘grounded theory’. A
screening questionnaire identified non-participants from the post-MI population in
Lothian, from which a sample of ‘maximum diversity’ was selected. In-depth
interviews were conducted with twenty-seven post-MI people and seventeen
‘significant others’. The analysis combined identifying emergent themes and
searching the data for key issues relating to study objectives.
Findings:
Additional to the barrier of non-invitation, a spectrum of factors relating to people’s
‘lifeworld’ circumstances, beliefs, and identity could either encourage or discourage
participation. Factors were highly similar for both resources. Reasons for, and the
process of non-participation could be grouped into three categories: “No need / no
point”, “Not worth it”, or “Not possible”. These were based on the way the factors
that influenced individuals related to three key issues. Shifts between categories
were also possible. A link between non-participation and a range of rehabilitation
difficulties among post-MI people and family members is also demonstrated.
Conclusions and implications:
The study addresses a gap in understanding post-MI non-participation and its
significance, providing insight into the process by which CR and CHD Group nonuse
occurs and the impacts for people who have had MI and family members.
Recommendations are made, identifying realistic ways rehabilitation support might
be improved, barriers and opportunities, and areas for further investigation.