Getting back to normal : women's recovery after a myocardial infarction : a grounded theory study

Abstract

Despite the fact that many women survive a myocardial infarction and are able to resume their roles and responsibilities, with perhaps some modification after their heart attack, little is known about their recovery from this event. Thus, the purpose of this study was to use a grounded theory approach to examine the recovery process for women who experienced an acute myocardial infarction. Interviews conducted with 12 women, who ranged in age from 60 - 80 years and who had experienced a myocardial infarction, provided the major sources of data. The findings of this study indicate that the recovery process is variable and encompasses four stages. In each of these stages the individual focuses on the basic social psychological process of 'getting back to normal'. In the first stage of the process, 'accepting what has happened', the woman attempts to come to terms with the event by confronting mortality and looking for causes. Encountering limitations, accepting limitations, and reducing insecurities are hallmarks of the second stage, 'establishing boundaries'. Throughout the third stage, 'making adjustments', strategies such as testing the waters, monitoring self, and weighing costs and benefits are employed to assist the individual in her attempt to get back to normal. If the first three stages are successfully mastered, the individual progresses to the fourth stage, 're-establishing normality'. This final stage is characterized by the redefining of normal and the resumption of independence. Findings from this investigation may give new insights into developing guidelines for a cardiac rehabilitation regime that is grounded in a sound scientific rationale and is gender sensitive, addressing women's unique experiences and concerns. Included in this study are implications for nursing practice, nursing education, and nursing research.