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``It's up to me with a little support'' - Adherence after myocardial infarction: A qualitative study
Admi Hanna1, Eilon-Moshe Yael2, Levy Hadassa2
1Nursing Department, Yezreel Valley College, Israel; Rambam Health Care Campus, Haifa, Israel.
Insights
Patient willpower is key for adherence post heart attack, but needs self-competence and tailored changes. Family and healthcare professionals can bolster motivation for better adherence to treatment and lifestyle changes.
Area of Science:
- Cardiology
- Behavioral Science
- Health Psychology
Background:
- Ischemic heart disease and stroke are leading global causes of death.
- Poor treatment adherence in chronic conditions is a significant challenge.
- Few studies explore patient motivational perspectives on adherence post myocardial infarction.
Purpose of the Study:
- To understand patient perceptions of health-related adherence behaviors after a heart attack.
- To identify motivational factors influencing adherence from the patient's viewpoint.
Main Methods:
- Phenomenological approach utilizing content analysis.
- Qualitative interviews with 22 participants post myocardial infarction.
- Participants recruited from cardiac rehabilitation and community settings in Northern Israel.
Main Results:
- Two main categories and six sub-categories emerged, aligned with Self-Determination Theory.
- Inner willpower is crucial but insufficient; self-competence and personalized lifestyle adjustments are vital.
- Extrinsic motivators (family, healthcare professionals) enhance intrinsic motivation; caring attitudes and autonomy are beneficial.
Conclusions:
- Adherence is a complex, holistic phenomenon.
- Findings can advance self-care for chronic conditions and inform professional interventions.
- Improved adherence can increase life expectancy, enhance quality of life, and reduce healthcare costs.
Background:
Ischemic heart disease and stroke remain the leading causes of death globally. Poor adherence to treatment amongst patients with chronic health conditions is a global unresolved problem of enormous magnitude. Despite extensive research in the field of adherence behaviors, few studies have focused on motivational aspects that can enhance adherence from the patients' points of view post myocardial infarction.
Aim:
To gain insights into the perceptions that underline health-related adherence behaviors, from the perspective of patients who experienced a heart attack.
Design:
A phenomenological approach.
Methods:
The study used a content analysis method, with qualitative criteria to establish trustworthiness. Interviews were conducted with a purposive sample of 22 participants post myocardial infarction, recruited from a hospital cardiac rehabilitation program and communities in Northern Israel.
Results:
The abstraction process generated two main categories and six sub-categories imbedded in the Self Determination Theory framework. While inner self determination or willpower, as expressed by the participants, was perceived as the most crucial motivator, it was insufficient. A sense of self competency and the ability to tailor life changes, according to personal preferences, is needed to turn willpower into practice. Extrinsic motivators such as family members, especially spouses and health professionals, are important to strengthen intrinsic motivation. Attitudes of caring, respect for values, and autonomy as opposed to patronization were perceived as helpful. The benefits of a cardiac rehabilitation program were articulated by attendees of the program in contrast to excuses by non-attendees CONCLUSION: Understanding adherence as a complex holistic phenomenon could advance theoretical insights and enhance adherence to therapies and healthy lifestyle among people post myocardial infarction.
Impact:
Study findings may advance the self-care of people with long-term health conditions, and assist professionals to conduct interventions that strengthen adherence. Increased adherence can impact life expectancy, quality of life, and reduce the economic burden on health care systems and societies.
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