Hostname: page-component-78c5997874-mlc7c Total loading time: 0 Render date: 2024-11-10T12:15:03.348Z Has data issue: false hasContentIssue false
  • English
  • Français

Psychosocial experiences in the context of life-threatening illness: The cardiac rehabilitation patient

Published online by Cambridge University Press:  03 June 2014

Gerard N. Holder ,
William C. Young ,
Sheeba R. Nadarajah  and
Ann M. Berger
Gerard N. Holder
Affiliation:
Pain and Palliative Care Service, National Institutes of Health Clinical Center, Bethesda, Maryland
William C. Young
Affiliation:
Pain and Palliative Care Service, National Institutes of Health Clinical Center, Bethesda, Maryland
Sheeba R. Nadarajah
Affiliation:
Department of Nursing, Bowie State University, Bowie, Maryland
Ann M. Berger*
Affiliation:
Pain and Palliative Care Service, National Institutes of Health Clinical Center, Bethesda, Maryland
*
Address correspondence and reprint requests to: Ann M. Berger, Pain and Palliative Care Service, National Institutes of Health Clinical Center, 10 Center Drive, Building 10, Room 2-1733, Bethesda, Maryland 20892. E-mail: aberger@cc.nih.gov
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

One of the most prevalent life-threatening illnesses is heart disease. The initial trauma of being diagnosed with a life-threatening illness or having a cardiac event can begin a psychosocial chain reaction that results in a transformation of the lives of these patients. The goal of our study was to investigate the lived experiences of psychosocial healing in rehabilitation of cardiac patients using a qualitative written interview.

Method:

A purposive sample of 14 cardiac event survivors was recruited. Participants were interviewed after informed consent and screening. We used a qualitative analysis and model-revision approach similar to the procedure outlined by Charmaz (2006).

Results:

Participants consistently mentioned that a heightened awareness of mortality was a motivating factor that led to participants focusing more on their family and relationships, having an enhanced outlook on life, and making healthy lifestyle changes.

Significance of results:

If clinicians are able to employ a measure to better understand the nature of a patient's progression from cardiac event to successful recovery, interventions such as cardiac rehabilitation can be implemented earlier and more effectively during the course of the illness and recovery phases of treatment. Theoretically, this early detection of a patient's progression could reduce the time spent recovering from a cardiac event, and it would allow treatments for these conditions to better alleviate the psychosocial concerns faced by patients.

Keywords

MortalityLife-threatening illnessCardiac illnessQualitative research
Type
Original Articles
Information
Palliative & Supportive Care , Volume 13 , Issue 3 , June 2015 , pp. 749 - 756
Copyright
Copyright © Cambridge University Press 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Adejumo, P.O. (2009). Psychosocial support, nursing challenges and collaborative research in cancer. African Journal of Medicine and Medicinal Sciences, 38, 75–79.Google Scholar
Binik, Y.M. & Devins, G.M. (1986). Quality of life. In Renal transplantation. Garovoy, M. & Guttmann, R.D. (eds.), pp. 341–353. New York: Churchill Livingstone.Google Scholar
Binik, Y.M., Chowanec, G.D. & Devins, G.M. (1990). Marital role strain, illness intrusiveness, and their impact on marital and individual adjustment in end-stage renal disease. Psychology & Health, 4, 245–257.10.1080/08870449008400394Google Scholar
Blagg, C.R. (1978). Objective quantification of rehabilitation in dialysis and transplantation. In Strategy in renal failure. Friedman, E.A. (ed), pp. 415–443. New York: Wiley.Google Scholar
Brennan, J. (2001). Adjustment to cancer: Coping or personal transition. Psycho-Oncology, 10, 1–18.Google Scholar
Burgess, A.W., Lerner, D.J., D'Agostino, R.B., et al. (1987). A randomized control trial of cardiac rehabilitation. Social Science & Medicine, 24, 359–370.10.1016/0277-9536(87)90154-7Google Scholar
Carver, C.S., Scheier, M.F. & Weintraub, J.K. (1989). Assessing coping strategies: A theoretically based approach. Journal of Personality and Social Psychology, 56, 267–283.Google Scholar
Carver, C.S., Pozo, C., Harris, S.D., et al. (1993). How coping mediates the effect of optimism on distress: A study of women with early stages of breast cancer. Journal of Personality and Social Psychology, 65, 375–390.10.1037/0022-3514.65.2.375Google Scholar
Chang, B.H., Casey, A., Dusek, J.A., et al. (2010). Relaxation response and spirituality: Pathways to improve psychological outcomes in cardiac rehabilitation. Journal of Psychosomatic Research, 69, 93–100.10.1016/j.jpsychores.2010.01.007Google Scholar
Charmaz, K. (2006). Constructing grounded theory: A practical guide through qualitative analysis. Los Angeles: Sage.Google Scholar
Clark, A.M., Hartling, L., Vandermeer, B., et al. (2005). Metaanalysis: Secondary prevention programs for patients with coronary artery disease. Annals of Internal Medicine, 143, 659–672.Google Scholar
Coyne, J.C. & Tennen, H. (2010). Positive psychology in cancer care: Bad science, exaggerated claims, and unproven medicine. Annals of Behavioral Medicine, 39, 16–26.Google Scholar
Czaczkes, J.W. & De-Nour, A.K. (1978). Chronic hemodialysis as a way of life. New York: Brunner/Mazel.Google Scholar
Devins, G.M. (1989). Enhancing personal control and minimizing illness intrusiveness. In Maximizing rehabilitation in chronic renal disease. Kutner, N.G. et al. (eds.), pp. 109–136. New York: PMA.Google Scholar
Devins, G.M. (1991). Illness intrusiveness and the psychosocial impact of end-stage renal disease. In Psychosocial aspects of end-stage renal disease: issues of our times. Hardy, M.A. et al. (eds.), pp. 83–102. New York: Haworth.Google Scholar
Devins, G.M., Binik, Y.M., Hollomby, D.J., et al. (1981). Helplessness and depression in end-stage renal disease. Canadian Journal of Behavioural Science, 15, 373–391.Google Scholar
Devins, G.M., Binik, Y.M., Hutchinson, T.A., et al. (1983). The emotional impact of end-stage renal disease: Importance of patient's perceptions of intrusiveness and control. The International Journal of Psychiatry in Medicine, 13, 327–343.Google Scholar
Devins, G.M., Mandin, H., Hons, R.B., et al. (1990). Illness intrusiveness and quality of life in end-stage renal disease: Comparison and stability across treatment modalities. Psychology & Health, 9, 117–142.10.1037/0278-6133.9.2.117Google Scholar
Ell, K. (1996). Social networks, social support and coping with serious illness: The family connection. Social Science & Medicine, 42, 173–183.10.1016/0277-9536(95)00100-XGoogle Scholar
Fann, J.R., Ell, K. & Sharpe, M. (2012). Integrating psychosocial care into cancer services. Journal of Clinical Oncology, 30, 1178–1186.10.1200/JCO.2011.39.7398Google Scholar
Go, A.S., Mozaffarian, D., Roger, V.L., et al. (2013). Heart disease and stroke statistics—2013 update: A report from the American Heart Association [review]. Circulation, 127, e6–e245.Google Scholar
Grace, S.L., Abbey, S.E., Shnek, Z.M., et al. (2002). Cardiac rehabilitation, I: Review of psychosocial factors. General Hospital Psychiatry, 24, 121–126.10.1016/S0163-8343(02)00178-0Google Scholar
Griffin, I.S. & Fentiman, M. (2002). Psychosocial problems following a diagnosis of breast cancer. International Journal of Clinical Practice, 56, 672–675.Google Scholar
Henderson, P.A. (1997). Psychosocial adjustment of adult cancer survivors: Their needs and counselor interventions. Journal of Consulting and Development, 75, 188–194.10.1002/j.1556-6676.1997.tb02332.xGoogle Scholar
Hamalainen, H., Smith, R., Puukka, P., et al. (2000). Social support and physical and psychological recovery one year after myocardial infarction or coronary artery bypass surgery. Scandinavian Journal of Public Health, 28, 62–70.Google Scholar
Hanssen, M.M., Peters, M.L., Vlaeyen, J.W., et al. (2013). Optimism lowers pain: Evidence of the causal status and underlying mechanisms. Pain, 154, 53–58.Google Scholar
Holland, J.C. & Bultz, B.D. (2007). The NCCN guideline for distress management: A case for making distress the sixth vital sign. Journal of the National Comprehensive Cancer Network, 5, 3–7.Google Scholar
Holland, J.C., Andersen, B., Breitbart, W.S., et al. (2007). Distress management. Journal of the National Comprehensive Cancer Network, 5, 66–98.Google Scholar
Jacobsen, P.B., Donovan, K.A., Trask, P.C., et al. (2005). Screening for psychological distress in ambulatory cancer patients. Cancer, 103, 1494–1502.Google Scholar
Kahane, D.H. (1993). The management of the psychosocial impact of breast cancer. Nurse Practitioner Forum, 4, 105–109.Google Scholar
Kreikebaum, S., Guarneri, E., Talavera, G., et al. (2011). Evaluation of a holistic cardiac rehabilitation in the reduction of biopsychosocial risk factors among patients with coronary heart disease. Psychology, Health & Medicine, 16, 276–290.Google Scholar
Lidell, E. & Fridlund, B. (1996). Long-term effects of a comprehensive rehabilitation programme after myocardial infarction. Scandinavian Journal of Caring Science, 10, 67–74.10.1111/j.1471-6712.1996.tb00314.xGoogle Scholar
McGrady, A., McGinnis, R., Badenhop, D., et al. (2009). Effects of depression and anxiety on adherence to cardiac rehabilitation. Journal of Cardiopulmonary Rehabilitation and Prevention, 29, 358–364.10.1097/HCR.0b013e3181be7a8fGoogle Scholar
Mehnert, A., Lehmann, C., Graefen, M., et al. (2010). Depression, anxiety, post-traumatic stress disorder and health-related quality of life and its association with social support in ambulatory prostate cancer patients. European Journal of Cancer Care, 19, 736–745.10.1111/j.1365-2354.2009.01117.xGoogle Scholar
Miller, D.L., Manne, S.L., Taylor, K., et al. (1996). Psychological distress and well-being in advanced cancer: The effects of optimism and coping. Journal of Clinical Psychology in Medical Settings, 3, 115–130.Google Scholar
Mishel, M.H., Hostetter, T., King, B., et al. (1984). Predictors of psychosocial adjustment in patients newly diagnosed with gynecological cancer. Cancer Nursing, 7, 291–299.Google Scholar
Molloy, G.J., Hamer, M., Randall, G., et al. (2008 a). Marital status and cardiac rehabilitation attendance: a meta-analysis. European Journal of Cardiovascular Prevention and Rehabilitation, 15, 557–561.Google Scholar
Molloy, G.J., Perkins-Porras, L., Bhattacharyya, M.R., et al. (2008 b). Practical support predicts medication adherence and attendance at cardiac rehabilitation following acute coronary syndrome. Journal of Psychosomatic Research, 65, 581–586.Google Scholar
Nadarajah, S., Berger, A.M. & Thomas, S.A. (2013). Current status of spirituality in cardiac rehabilitation programs: A review of literature. Journal of Cardiopulmonary Rehabilitation and Prevention, 33(3), 135–143.Google Scholar
Seki, E., Watanabe, Y., Sunayama, S., et al. (2003). Effects of phase III cardiac rehabilitation programs on health-related quality of life in elderly patients with coronary artery disease: Juntendo Cardiac Rehabilitation Program (J-CARP). Circulation, 67, 73–77.10.1253/circj.67.73Google Scholar
Sheikh, A.I. (2004). Posttraumatic growth in the context of heart disease. Journal of Clinical Psychology in Medical Settings, 11, 265–273.10.1023/B:JOCS.0000045346.76242.73Google Scholar
Skeath, P., Norris, S., Katheria, V., et al. (2013). The nature of life-transforming changes among cancer survivors. Qualitative Health Research, 23, 1155–1167.Google Scholar
Staniute, M., Brozaitiene, J. & Bunevicius, R. (2013). Effects of social support and stressful life events on health-related quality of life in coronary artery disease patients. Journal of Cardiovascular Nursing, 28, 83–89.10.1097/JCN.0b013e318233e69dGoogle Scholar
Stanton, A.L. & Snider, P.R. (1993). Coping with a breast cancer diagnosis: A prospective study. Health Psychology, 12, 16–23.Google Scholar
Stauber, S., Guera, V., Barth, J., et al. (2013). Psychosocial outcome in cardiovascular rehabilitation of peripheral artery disease and coronary artery disease patients. Vascular Medicine, 18, 257–262.10.1177/1358863X13505861Google Scholar
Weis, J. & Boehncke, A. (2011). Psychological comorbidity in patients with cancer. Bundesgesundheitsblatt–Gesundheitsforchung–Gesundheitsschutz, 54, 46–51.10.1007/s00103-010-1184-yGoogle Scholar
Wertz, F.J. (2005). Phenomenological research methods for counseling psychology. Journal of Counseling Psychology, 52, 167–177.Google Scholar
Wojnar, D.M. & Swanson, K.M. (2007). Phenomenology: An exploration. Journal of Holistic Nursing, 25, 172–180.10.1177/0898010106295172Google Scholar
Yates, B.C., Kosloski, K., Kercher, K., et al. (2010). Testing a model of physical and psychological recovery after a cardiac event. Western Journal of Nursing Research, 32, 871–893.Google Scholar
Yohannes, A.M., Doherty, P., Bundy, C., et al. (2010). The long-term benefits of cardiac rehabilitation on depression, anxiety, physical activity and quality of life. Journal of Clinical Nursing, 19(19–20), 2806–2813.Google Scholar
Yoshida, T., Kohzuki, M., Yoshida, K., et al. (1999). Physical and psychological improvements after phase II cardiac rehabilitation in patients with myocardial infarction. Nursing & Health Sciences, 1, 163–170.10.1046/j.1442-2018.1999.00021.xGoogle Scholar