Accepting myocardial infarction diagnosis as an important challenge during the transition process: A qualitative study
-
Roya Khorrami Estakhri
,
Zahra Taheri-Ezbarami
,
Hamid Peyrovi
,
Ehsan Kazemnezhad Leyli
,
Adele Isanazar
,
Seyed Aboozar Fakhrmousavi
,
Fateme Jafaraghaee
Abstract
Background & Aim: Failure to accept the disease can make a person susceptible to negative emotions, maladjustment to the disease, and disruption of the bio-psychosocial balance. This study aimed to investigate factors facilitating and inhibiting acceptance of myocardial infarction in newly diagnosed patients.
Methods & Materials: In this qualitative content analysis study, participants were patients experiencing myocardial infarction for the first time, their caregivers, nurses, and specialist physicians. Data were collected between June 2023 and January 2024 through in-depth, semi-structured individual interviews with 11 participants selected through purposive sampling. Data analysis followed the three-step method proposed by Elo and Kyngäs.
Results: Several key themes were identified as influential factors in the acceptance of disease among newly diagnosed myocardial infarction patients. Facilitators of acceptance included social support, adaptation to new roles, perceived susceptibility to the disease, spirituality, and the role of healthcare providers. Conversely, barriers to acceptance encompassed symptom reduction, unexpected diagnosis of myocardial infarction, and lack of awareness. Understanding these factors is essential for developing targeted interventions to improve patient adjustment and outcomes.
Conclusion: Identifying facilitators and barriers to the acceptance of disease can enhance patient engagement and adherence to treatment plans. Understanding these factors allows healthcare providers to tailor interventions that promote positive coping strategies. Ultimately, fostering acceptance can reduce healthcare costs by minimizing complications.
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https://doi.org/10.1177/1474515114564929
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9. McCracken LM, Eccleston C. Coping or acceptance: what to do about chronic pain? Pain. 2003;105(1-2):197-204. https://doi.org/10.1016/S0304-3959(03)00202-1
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https://doi.org/10.17533/udea.iee.v40n2e08
11. Kowalewska B, Cybulski M, Jankowiak B, Krajewska-Kułak E. Acceptance of illness, satisfaction with life, sense of stigmatization, and quality of life among people with psoriasis: A cross-sectional study. Dermatology and Therapy. 2020;10(3):413-30. https://doi.org/10.1007/s13555-020-00368-w
12. Basińska MA, Woźniewicz A. Emotional intelligence in psoriasis patients as a determinant of acceptance of illness. Dermatology Review/Przegląd Dermatologiczny. 2012;99(3):202-9.
13. Alligood MR. Nursing Theorists and Their Work-E-Book: Nursing Theorists and Their Work-E-Book: Elsevier Health Sciences; 2017.
14. Meleis AI, Sawyer LM, Im E-O, Messias DKH, Schumacher K. Experiencing transitions: an emerging middle-range theory. Advances in Nursing Science. 2000;23(1):12-28. https://doi.org/10.1097/00012272-200009000-00006
15. Ranjandish F, Mahmoodi H, Shaghaghi A. Psychometric responsiveness of the health-related quality of life questionnaire (HeartQoL-P) in the Iranian post-myocardial infarction patients. Health and Quality of Life Outcomes. 2019;17:1-7. https://doi.org/10.1186/s12955-018-1075-8
16. Meleis AI. Transitions theory: Middle range and situation specific theories in nursing research and practice: Springer Publishing Company; 2010.
17. Elo S, Kyngäs H. The qualitative content analysis process. Journal of Advanced Nursing. 2008;62(1):107-15. https://doi.org/10.1111/j.1365-2648.2007.04569.x
18. Hsieh H-F, Shannon SE. Three approaches to qualitative content analysis. Qualitative Health Research. 2005;15(9):1277-88. https://doi.org/10.1177/1049732305276687
19. Zhang Y, Wildemuth BM. Qualitative analysis of content. Applications of social research methods to questions in information and library science. 2009;308(319):1-12.
20. Cipora E, Konieczny M, Sobieszczanski J. Acceptance of illness by women with breast cancer. Annals of Agricultural and Environmental Medicine. 2018;25(1). https://doi.org/10.26444/aaem/75876
21. Azimian J, Negarandeh R, Fakhr-Movahedi A. Factors affecting nurses' coping with transition: an exploratory qualitative study. Global Journal of Health Science. 2014;6(6):88. https://doi.org/10.5539/gjhs.v6n6p88
22. Richardson A, Adner N, Nordström G. Persons with insulin‐dependent diabetes mellitus: acceptance and coping ability. Journal of Advanced Nursing. 2001;33(6):758-63. https://doi.org/10.1046/j.1365-2648.2001.01717.x
23. Smoleń E, Jarema M, Hombek K, Słysz M, Kalita K. Acceptance and adaptation to the disease in patients treated oncologically. Nursing Problems/Problemy Pielęgniarstwa. 2018;26(1):37-43. https://doi.org/10.26444/monz/86142
24. Uchmanowicz I, Jankowska-Polanska B, Motowidlo U, Uchmanowicz B, Chabowski M. Assessment of illness acceptance by patients with COPD and the prevalence of depression and anxiety in COPD. International Journal of Chronic Obstructive Pulmonary Disease. 2016:963-70. https://doi.org/10.2147/COPD.S102754
25. Dugunchi F, Mudgal SK, Marznaki ZH, Shirafkan H, Abrotan S, Jafarian F, et al. Levels of adherence to treatment, illness perception and acceptance of illness in patients with coronary artery disease-descriptive and correlational study. BMC Cardiovascular Disorders. 2024;24(1):171. https://doi.org/10.1186/s12872-024-03827-w
26. Koenig HG. Religion, spirituality, and health: The research and clinical implications. International Scholarly Research Notices. 2012;2012(1):278730. https://doi.org/10.5402/2012/278730
27. Atsira OP, Yuliati E, Atika A, Abdurachman A, Maramis MM. Relationship between spirituality and acceptance of illness level in bipolar patients. Kesmas: Jurnal Kesehatan Masyarakat Nasional (National Public Health Journal). 2020;15(3). https://doi.org/10.21109/kesmas.v15i3.3432
28. Kołpa M, Wywrot-Kozłowska B, Jurkiewicz B, Grochowska A. The factors determining acceptance and adjustment to cancer. Pielęgniarstwo Chirurgiczne i Angiologiczne/Surgical and Vascular Nursing. 2015;9(3):165-9.
29. Yang Y, Gong J, Yang B, Chen C, Deng X, Chen K, et al. Post-discharge nutritional management for patients with coronary heart disease and frailty: a qualitative study. BMC Geriatrics. 2024;24(1):268. https://doi.org/10.1186/s12877-024-04885-7
30. Bårdsgjerde EK, Kvangarsnes M, Landstad B, Nylenna M, Hole T. Patients' narratives of their patient participation in the myocardial infarction pathway. Journal of Advanced Nursing. 2019;75(5):1063-73. https://doi.org/10.1111/jan.13931
31. Łuczyk M, Pietraszek A, Łuczyk R, Stanisławek A, Szadowska-Szlachetka Z, Charzyńska-Gula M. Akceptacja choroby w grupie kobiet leczonych chirurgicznie z powodu nowotworu piersi. Journal of Education, Health and Sport. 2015;5(9).
32. Pluta A, Sulikowska B, Manitius J, Posieczek Z, Marzec A, Morisky DE. Acceptance of illness and compliance with therapeutic recommendations in patients with hypertension. International Journal of Environmental Research and Public Health. 2020;17(18):6789. https://doi.org/10.3390/ijerph17186789
33. Kurpas D, Mroczek B, Brodowski J, Urban M, Nitsch-Osuch A. Does health status influence acceptance of illness in patients with chronic respiratory diseases? Neurotransmitter Interactions and Cognitive Function. 2015:57-66. https://doi.org/10.1007/5584_2014_47
34. Ockleford E, Shaw RL, Willars J, Dixon-Woods M. Education and self-management for people newly diagnosed with type 2 diabetes: A qualitative study of patients' views. Chronic illness. 2008;4(1):28-37. https://doi.org/10.1177/1742395307086673
35. AlArab N, Antoun J. Patients' acceptance of obesity as a chronic disease: A qualitative study in Lebanon. BMJ Open. 2022;12(3):e059366. https://doi.org/10.1136/bmjopen-2021-059366
2. Virani SS, Alonso A, Benjamin EJ, Bittencourt MS, Callaway CW, Carson AP, Chamberlain AM, Chang AR, Cheng S, Delling FN, Djousse L. Heart disease and stroke statistics-2020 update: a report from the American Heart Association. Circulation. 2020 Mar 3;141(9):e139-596. https://doi.org/10.1161/CIR.0000000000000757
3. Talaei M, Sarrafzadegan N, Sadeghi M, Oveisgharan S, Marshall T, Thomas GN, et al. Incidence of cardiovascular diseases in an Iranian population: the Isfahan Cohort Study. Archives of Iranian Medicine. 2013;16(3):138-44.
4. Sarrafzadegan N, Mohammadifard N. Cardiovascular disease in Iran in the last 40 years: prevalence, mortality, morbidity, challenges, and strategies for cardiovascular prevention. Archives of Iranian Medicine. 2019 Apr 1;22(4):204-10.
5. Mohseni J, Kazemi T, Maleki MH, Beydokhti H. A systematic review on the prevalence of acute myocardial infarction in Iran. Heart Views. 2017;18(4):125-32. https://doi.org/10.4103/HEARTVIEWS.HEARTVIEWS_71_17
6. Obiegło M, Uchmanowicz I, Wleklik M, Jankowska-Polańska B, Kuśmierz M. The effect of acceptance of illness on the quality of life in patients with chronic heart failure. European Journal of Cardiovascular Nursing. 2016;15(4):241-7.
https://doi.org/10.1177/1474515114564929
7. Kurpas D, Mroczek B, Knap-Czechowska H, Bielska D, Nitsch-Osuch A, Kassolik K, Andrzejewski W, Gryko A, Steciwko A. Quality of life and acceptance of illness among patients with chronic respiratory diseases. Respiratory Physiology & Neurobiology. 2013 Jun 1;187(1):114-7. https://doi.org/10.1016/j.resp.2013.02.009
8. Zheng K, Bruzzese JM, Smaldone A, editors. Illness acceptance in adolescents: a concept analysis. Nursing Forum; 2019: Wiley Online Library. https://doi.org/10.1111/nuf.12368
9. McCracken LM, Eccleston C. Coping or acceptance: what to do about chronic pain? Pain. 2003;105(1-2):197-204. https://doi.org/10.1016/S0304-3959(03)00202-1
10. Rahpeima E, Bijani M, Karimi S, Alkamel A, Dehghan A. Effect of the Implementation of Interdisciplinary Discharge Planning on Treatment Adherence and Readmission in Patients Undergoing Coronary Artery Angioplasty. Investigacion y Educacion en Enfermeria. 2022 Jun;40(2):e08.
https://doi.org/10.17533/udea.iee.v40n2e08
11. Kowalewska B, Cybulski M, Jankowiak B, Krajewska-Kułak E. Acceptance of illness, satisfaction with life, sense of stigmatization, and quality of life among people with psoriasis: A cross-sectional study. Dermatology and Therapy. 2020;10(3):413-30. https://doi.org/10.1007/s13555-020-00368-w
12. Basińska MA, Woźniewicz A. Emotional intelligence in psoriasis patients as a determinant of acceptance of illness. Dermatology Review/Przegląd Dermatologiczny. 2012;99(3):202-9.
13. Alligood MR. Nursing Theorists and Their Work-E-Book: Nursing Theorists and Their Work-E-Book: Elsevier Health Sciences; 2017.
14. Meleis AI, Sawyer LM, Im E-O, Messias DKH, Schumacher K. Experiencing transitions: an emerging middle-range theory. Advances in Nursing Science. 2000;23(1):12-28. https://doi.org/10.1097/00012272-200009000-00006
15. Ranjandish F, Mahmoodi H, Shaghaghi A. Psychometric responsiveness of the health-related quality of life questionnaire (HeartQoL-P) in the Iranian post-myocardial infarction patients. Health and Quality of Life Outcomes. 2019;17:1-7. https://doi.org/10.1186/s12955-018-1075-8
16. Meleis AI. Transitions theory: Middle range and situation specific theories in nursing research and practice: Springer Publishing Company; 2010.
17. Elo S, Kyngäs H. The qualitative content analysis process. Journal of Advanced Nursing. 2008;62(1):107-15. https://doi.org/10.1111/j.1365-2648.2007.04569.x
18. Hsieh H-F, Shannon SE. Three approaches to qualitative content analysis. Qualitative Health Research. 2005;15(9):1277-88. https://doi.org/10.1177/1049732305276687
19. Zhang Y, Wildemuth BM. Qualitative analysis of content. Applications of social research methods to questions in information and library science. 2009;308(319):1-12.
20. Cipora E, Konieczny M, Sobieszczanski J. Acceptance of illness by women with breast cancer. Annals of Agricultural and Environmental Medicine. 2018;25(1). https://doi.org/10.26444/aaem/75876
21. Azimian J, Negarandeh R, Fakhr-Movahedi A. Factors affecting nurses' coping with transition: an exploratory qualitative study. Global Journal of Health Science. 2014;6(6):88. https://doi.org/10.5539/gjhs.v6n6p88
22. Richardson A, Adner N, Nordström G. Persons with insulin‐dependent diabetes mellitus: acceptance and coping ability. Journal of Advanced Nursing. 2001;33(6):758-63. https://doi.org/10.1046/j.1365-2648.2001.01717.x
23. Smoleń E, Jarema M, Hombek K, Słysz M, Kalita K. Acceptance and adaptation to the disease in patients treated oncologically. Nursing Problems/Problemy Pielęgniarstwa. 2018;26(1):37-43. https://doi.org/10.26444/monz/86142
24. Uchmanowicz I, Jankowska-Polanska B, Motowidlo U, Uchmanowicz B, Chabowski M. Assessment of illness acceptance by patients with COPD and the prevalence of depression and anxiety in COPD. International Journal of Chronic Obstructive Pulmonary Disease. 2016:963-70. https://doi.org/10.2147/COPD.S102754
25. Dugunchi F, Mudgal SK, Marznaki ZH, Shirafkan H, Abrotan S, Jafarian F, et al. Levels of adherence to treatment, illness perception and acceptance of illness in patients with coronary artery disease-descriptive and correlational study. BMC Cardiovascular Disorders. 2024;24(1):171. https://doi.org/10.1186/s12872-024-03827-w
26. Koenig HG. Religion, spirituality, and health: The research and clinical implications. International Scholarly Research Notices. 2012;2012(1):278730. https://doi.org/10.5402/2012/278730
27. Atsira OP, Yuliati E, Atika A, Abdurachman A, Maramis MM. Relationship between spirituality and acceptance of illness level in bipolar patients. Kesmas: Jurnal Kesehatan Masyarakat Nasional (National Public Health Journal). 2020;15(3). https://doi.org/10.21109/kesmas.v15i3.3432
28. Kołpa M, Wywrot-Kozłowska B, Jurkiewicz B, Grochowska A. The factors determining acceptance and adjustment to cancer. Pielęgniarstwo Chirurgiczne i Angiologiczne/Surgical and Vascular Nursing. 2015;9(3):165-9.
29. Yang Y, Gong J, Yang B, Chen C, Deng X, Chen K, et al. Post-discharge nutritional management for patients with coronary heart disease and frailty: a qualitative study. BMC Geriatrics. 2024;24(1):268. https://doi.org/10.1186/s12877-024-04885-7
30. Bårdsgjerde EK, Kvangarsnes M, Landstad B, Nylenna M, Hole T. Patients' narratives of their patient participation in the myocardial infarction pathway. Journal of Advanced Nursing. 2019;75(5):1063-73. https://doi.org/10.1111/jan.13931
31. Łuczyk M, Pietraszek A, Łuczyk R, Stanisławek A, Szadowska-Szlachetka Z, Charzyńska-Gula M. Akceptacja choroby w grupie kobiet leczonych chirurgicznie z powodu nowotworu piersi. Journal of Education, Health and Sport. 2015;5(9).
32. Pluta A, Sulikowska B, Manitius J, Posieczek Z, Marzec A, Morisky DE. Acceptance of illness and compliance with therapeutic recommendations in patients with hypertension. International Journal of Environmental Research and Public Health. 2020;17(18):6789. https://doi.org/10.3390/ijerph17186789
33. Kurpas D, Mroczek B, Brodowski J, Urban M, Nitsch-Osuch A. Does health status influence acceptance of illness in patients with chronic respiratory diseases? Neurotransmitter Interactions and Cognitive Function. 2015:57-66. https://doi.org/10.1007/5584_2014_47
34. Ockleford E, Shaw RL, Willars J, Dixon-Woods M. Education and self-management for people newly diagnosed with type 2 diabetes: A qualitative study of patients' views. Chronic illness. 2008;4(1):28-37. https://doi.org/10.1177/1742395307086673
35. AlArab N, Antoun J. Patients' acceptance of obesity as a chronic disease: A qualitative study in Lebanon. BMJ Open. 2022;12(3):e059366. https://doi.org/10.1136/bmjopen-2021-059366
| Files | ||
| Issue | Vol 12 No 4 (2025): Autumn | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/npt.v12i4.19651 | |
| Keywords | ||
| myocardial infarction; transition; acceptance of disease; qualitative research | ||
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How to Cite
1.
Khorrami Estakhri R, Taheri-Ezbarami Z, Peyrovi H, Kazemnezhad Leyli E, Isanazar A, Fakhrmousavi SA, Jafaraghaee F. Accepting myocardial infarction diagnosis as an important challenge during the transition process: A qualitative study. NPT. 2025;12(4):381-392.
