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"It is up to me with a little support" - adherence after myocardial infarction: a qualitative study

Session ACNAP Essentials 4 You - ePosters

Speaker Dassy Levy

Event : ACNAP Essentials 4 You 2020

  • Topic : cardiovascular nursing and allied professions
  • Sub-topic : Chronic Nursing Care
  • Session type : ePosters

Authors : D Levy (Haifa,IL), H Admi (Haifa,IL), Y Eilon-Moshe (Haifa,IL), I Eisen (Haifa,IL), E Nikolsky (Haifa,IL), L Gepstein (Haifa,IL), C Satran (Yezreel Valley,IL), L Ore (Yezreel Valley,IL)

Authors:
D Levy1 , H Admi1 , Y Eilon-Moshe1 , I Eisen1 , E Nikolsky1 , L Gepstein2 , C Satran3 , L Ore4 , 1Rambam Health Care Campus - Haifa - Israel , 2Technion - Israel Institute of Technology - Haifa - Israel , 3Yezreel Valley College, Nursing Department - Yezreel Valley - Israel , 4Yezreel Valley College, Health Systems Management - Yezreel Valley - Israel ,

On behalf: Not relevant

Topic(s):
Chronic Nursing Care

Background: Ischaemic heart disease and stroke remain the leading causes of death globally. Poor keeping-to-treatment regimens amongst patients with chronic health conditions is a global problem of enormous magnitude. Despite extensive research in the field of compliance behaviours, 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 have 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 22 participants post myocardial infarction, recruited from a hospital cardiac rehabilitation programme and communities in Northern Israel. 

Results: Analysis of the results 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 not sufficient. 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 patronisation were perceived as helpful.

Conclusion: Understanding adherence as a complex holistic phenomenon could advance theoretical insights and enhance adherence to therapies and healthy lifestyle amongst patients 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 have impact on life expectancy and quality of life whilst reducing the economic burden on health care systems and societies.

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