Health and Illness Perceptions of Patients suffering their First Acute Myocardial Infarction and Undergoing Primary Percutaneous Coronary Intervention in Queensland: A Qualitative Study

Abstract

As a result of advances in technology and treatment techniques, interventional cardiology has led to significant changes in the treatment of patients suffering a heart attack (or Acute Myocardial Infarction - AMI). The current treatment often involves primary (emergency) Percutaneous Coronary Intervention (angiogram and angioplasty) followed by a rapid recovery. Patients often do not experience significant pain during recovery, have markedly reduced hospital stay and return to work sooner than in the past. Therefore it is plausible that they may dismiss the significance of their cardiac illness and its long-term implications. Therefore the meaning that these patients assign to their experience of having a heart attack and emergency treatment in the form of PCI plays a pivotal role in their subsequent health behaviour, including cardiac rehabilitation attendance, medication adherence and functional status. This qualitative study used hermeneutic phenomenology to explore participants' experiences and gain an understanding of their perceptions of the event and beliefs about their subsequent health and illness. Semi-structured, in-depth interviews were conducted three to six months following discharge with thirteen participants (ten males and three females). Four key themes emerged from the data, illustrating the physiological, emotional and social adjustment experienced by the participants. These included confusion about the expected and experienced symptoms of AMI, a realization of their vulnerability to sudden death, amazement at the speed of intervention and physical recovery and a gradual understanding of the need to modify risk factors and revalue priorities in life. It is anticipated that the findings will contribute to the provision of effective and streamlined cardiac education that are tailored to the needs of this group of patients.