Recovery patterns and lifestyle changes after coronary angioplasty: the patient's perspective

Progression of coronary atherosclerosis remains a significant problem after percutaneous transluminal coronary angioplasty (PTCA), requiring patients to make ongoing modifications in their coronary risk factors and lifestyle.

To examine patients' reactions to suggested lifestyle changes, to identify barriers and facilitators to risk reduction, to identify sources of health information, and to elicit suggestions for nursing interventions to aid in long-term recovery.

Qualitative study using 2-hour, tape-recorded focus group sessions. Participants were enrolled in one of seven groups (4 to 9 members each).

Forty-five patients (26 men, 19 women) who had undergone PTCA 3 to 18 months earlier were recruited from a university-affiliated midwestern medical center.

Using a constant-comparative method for data analysis, six major themes emerged. Positive themes included seeking control from successful changes made; compromise with medical recommendations to maintain quality of life; and acceptance of the uncertain nature of their disease. Negative themes included powerlessness to stop disease progression; frustration with enacting lifestyle changes; and concerns about the uncertainty of the future. Specific barriers and facilitators for risk reduction were readily identified. Though patients had few suggestions for nursing interventions, the most predominant requests were for newsletters, "hot lines," and a video library.

These results provide insight into the experiences of the relatively understudied PTCA population. Patients were making at least some of their necessary lifestyle changes, though often with some difficulty. Nurses have an excellent opportunity to expand their focus and provide guidance and support to patients as they adopt a heart-healthy lifestyle.