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Conceptual Framework for Personal Recovery in Patients With Acute Myocardial Infarction

BACKGROUND: Although there has been movement in cardiology to advance patient‐centered approaches to postacute myocardial infarction (AMI) care, work remains to be done in aligning patient preferences with clinical care. Our objective was to characterize patients’ experience of AMI and treatment to...

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Autores principales: Dreyer, Rachel P., Pavlo, Anthony J., Horne, Anna, Dunn, Robert, Danvers, Karina, Brush, John, Slade, Mike, Davidson, Larry
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8649153/
https://www.ncbi.nlm.nih.gov/pubmed/34581198
http://dx.doi.org/10.1161/JAHA.121.022354
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author Dreyer, Rachel P.
Pavlo, Anthony J.
Horne, Anna
Dunn, Robert
Danvers, Karina
Brush, John
Slade, Mike
Davidson, Larry
author_facet Dreyer, Rachel P.
Pavlo, Anthony J.
Horne, Anna
Dunn, Robert
Danvers, Karina
Brush, John
Slade, Mike
Davidson, Larry
author_sort Dreyer, Rachel P.
collection PubMed
description BACKGROUND: Although there has been movement in cardiology to advance patient‐centered approaches to postacute myocardial infarction (AMI) care, work remains to be done in aligning patient preferences with clinical care. Our objective was to characterize patients’ experience of AMI and treatment to develop a new conceptual framework of patient‐centered recovery in cardiology. METHODS AND RESULTS: We conducted in‐depth interviews with people who previously experienced an AMI (2016–2019). The interview focused on participants’ experiences of their recovery, which were audio‐recorded, transcribed verbatim, and analyzed using a phenomenological framework. The overarching theme described by the 42 participants was feeling like a “different person” after the AMI. This shift manifested itself in both losses and gains, each of which posed new challenges to everyday life. The experience appeared to be an active process requiring people to take responsibility for their health. In terms of loss, participants describe how the AMI threatened their sense of safety and security and led to social isolation, fragility, uncertainty about the future, and difficulty expressing emotions accompanied this new fear. A conceptual framework describing the relationship between AMI, identity change, and functioning was developed. CONCLUSIONS: Participants experienced the AMI as an unexpected disruption in their lives that had far‐reaching effects on their daily functioning, and were resolved in numerous ways. The conceptual framework may assist in providing a theoretical basis for future interventions in cardiology that not only engage and retain patients in care but also improve long‐term adherence to secondary prevention and other aspects of self‐care.
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spelling pubmed-86491532022-03-21 Conceptual Framework for Personal Recovery in Patients With Acute Myocardial Infarction Dreyer, Rachel P. Pavlo, Anthony J. Horne, Anna Dunn, Robert Danvers, Karina Brush, John Slade, Mike Davidson, Larry J Am Heart Assoc Original Research BACKGROUND: Although there has been movement in cardiology to advance patient‐centered approaches to postacute myocardial infarction (AMI) care, work remains to be done in aligning patient preferences with clinical care. Our objective was to characterize patients’ experience of AMI and treatment to develop a new conceptual framework of patient‐centered recovery in cardiology. METHODS AND RESULTS: We conducted in‐depth interviews with people who previously experienced an AMI (2016–2019). The interview focused on participants’ experiences of their recovery, which were audio‐recorded, transcribed verbatim, and analyzed using a phenomenological framework. The overarching theme described by the 42 participants was feeling like a “different person” after the AMI. This shift manifested itself in both losses and gains, each of which posed new challenges to everyday life. The experience appeared to be an active process requiring people to take responsibility for their health. In terms of loss, participants describe how the AMI threatened their sense of safety and security and led to social isolation, fragility, uncertainty about the future, and difficulty expressing emotions accompanied this new fear. A conceptual framework describing the relationship between AMI, identity change, and functioning was developed. CONCLUSIONS: Participants experienced the AMI as an unexpected disruption in their lives that had far‐reaching effects on their daily functioning, and were resolved in numerous ways. The conceptual framework may assist in providing a theoretical basis for future interventions in cardiology that not only engage and retain patients in care but also improve long‐term adherence to secondary prevention and other aspects of self‐care. John Wiley and Sons Inc. 2021-09-28 /pmc/articles/PMC8649153/ /pubmed/34581198 http://dx.doi.org/10.1161/JAHA.121.022354 Text en © 2021 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Research
Dreyer, Rachel P.
Pavlo, Anthony J.
Horne, Anna
Dunn, Robert
Danvers, Karina
Brush, John
Slade, Mike
Davidson, Larry
Conceptual Framework for Personal Recovery in Patients With Acute Myocardial Infarction
title Conceptual Framework for Personal Recovery in Patients With Acute Myocardial Infarction
title_full Conceptual Framework for Personal Recovery in Patients With Acute Myocardial Infarction
title_fullStr Conceptual Framework for Personal Recovery in Patients With Acute Myocardial Infarction
title_full_unstemmed Conceptual Framework for Personal Recovery in Patients With Acute Myocardial Infarction
title_short Conceptual Framework for Personal Recovery in Patients With Acute Myocardial Infarction
title_sort conceptual framework for personal recovery in patients with acute myocardial infarction
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8649153/
https://www.ncbi.nlm.nih.gov/pubmed/34581198
http://dx.doi.org/10.1161/JAHA.121.022354
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