The lived experience of individuals in cardiac rehabilitation who have a positive outlook on their cardiac recovery: A phenomenological inquiry.

BACKGROUND: Cardiac rehabilitation is often under-utilized despite its well-known benefits. Individuals with cardiac disease who exhibit a positive outlook often experience improved health outcomes. This study tried to explore the question: "What are the lived experiences of cardiac recovery in cardiac rehabilitation individuals with a predominantly positive outlook in the context of an acute cardiac event?" AIMS: Our primary aim explored the experiences of cardiac recovery in cardiac rehabilitation participants with a predominantly positive outlook, within the context of an acute cardiac event, including exploring barriers and facilitators of cardiac recovery. Our secondary aim explored how a positive outlook impacted completion of phase two of the cardiac rehabilitation program. METHODS: Husserlian phenomenology guided this study. A purposive sample of 10 individuals who had experienced an acute cardiac event and had a predominantly positive outlook were interviewed. Data were analyzed using Colaizzi's method. RESULTS: Three themes emerged from the data. The first was "choosing life over death," where participants discussed how they made a decision to improve their health. The second theme was "learning to live a new self," where participants described the changes they had to make in order to improve their health. The third theme was "a life-transforming cardiac event" where participants shared how the cardiac event had changed their life. CONCLUSION: The participants' decisions to choose to live, led them to embrace their cardiac recovery. It is important for nurses to identify individuals in cardiac rehabilitation that need additional support. In addition, alternative models of cardiac rehabilitation programs need to be explored.

Supportive medical care in life-threatening illness: A pilot study.

OBJECTIVE: The goal of this pilot study was to identify the processes by which healing occurs in patients who experience a life-threatening illness. METHOD: Healing was examined by using two qualitative studies that employed a semistructured interview process (interviews lasted between 30 and 115 minutes). There were 10 cardiac event survivors and 9 cancer survivors. These participants came from a community hospital setting (cardiac), nonmedical holistic services organization (cancer), and a research hospital (cancer). Before participants could take part in the study, they were administered preliminary screening measurements, the first of which was an instrument similar to the Distress Thermometer. Participants then self-reported their positive life-transforming changes. If one to three changes were reported six months after onset of the illness, participants were deemed to have passed the screening. Finally, participants were tested for speaking volume and clarity. RESULTS: An overall theme that was prevalent throughout the interviews was medical support. Participants found that their positive, life-transforming changes were typically connected with supportive caregivers who helped to create a culture of care. They also indicated that an absence of this medical supportive care hindered development of such life-transforming changes. SIGNIFICANCE OF RESULTS: Our results indicate that a medical care team will be more effective if a positive culture of care is created. This can be implemented if the team provides comfort, which involves being more engaged in the treatment of patients as well as being more attentive to their psychosocial needs.

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

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.

Spirituality in the context of life-threatening illness and life-transforming change.

OBJECTIVE: Individuals with life-threatening illness often engage in some form of spirituality to meet increased needs for meaning and purpose. This study aimed to identify the role of spirituality in persons who had reported positive, life-transforming change in relation to life-threatening cancer or cardiac events, and to connect these roles to palliative and supportive care. METHOD: A purposive sample of 10 cardiac survivors and 9 cancer survivors was recruited. Once the participants had given informed consent and passed screening in relation to life-transforming change and distress, they engaged in a semistructured one-hour qualitative interview on the theme of how their life-transforming change occurred in the context of their life-threatening illness. In the present article, our phenomenological analysis focuses on participants' references to purpose and meaning in their lives, with particular attention to the role and context of participants' spirituality. RESULTS: Participants mentioned spirituality, meaning, and purpose in many contexts, including connecting with family and friends, nature, art, music, and sometimes creating a relationship with God. Participants often accessed spirituality by enhancing connections in their own lives: with a higher power, people, their work, or themselves. These enhanced connections gave participants greater meaning and purpose in their lives, and substantially helped participants to adjust to their life-threatening illnesses. SIGNIFICANCE OF RESULTS: Understanding the roles and contexts of spirituality among patients with a life-threatening illness allows us to develop better palliative and supportive care plans. Spiritually oriented supportive care may include support groups, yoga, meditation, nature, music, prayer, or referral to spiritual or religious counselors. A quantitative scale is needed to help healthcare clinicians assess the spiritual and coping needs of individuals with life-threatening illness.