title: Empowered to gain a new foothold in life--A study of the meaning of participating in cardiac rehabilitation to patients afflicted by a minor heart attack.
abstract: This study aimed to investigate what it means to patients afflicted by a minor heart attack to participate in cardiac rehabilitation (CR). CR is well-established internationally to support patients towards moving forward in satisfying, healthy, and well-functioning lives. Studies indicate that patients achieve improvement in quality of life when participating in CR. However, knowledge of how patients are supported during CR is sparse. Moreover, knowledge of what participating in CR means to patients afflicted by a minor heart attack is lacking. In-depth knowledge in this area is crucial in order to understand these patients' particular gains and needs. In a phenomenological-hermeneutic frame field observations, focus group interviews, and individual interviews were conducted among 11 patients during and after their participation in CR. Field notes and transcribed interviews underwent three-phased interpretation. It was found that patients were supported to gain renewed balance in their lives during CR. Three themes were identified: (1) receiving a helpful but limited caring hand, (2) being supported to find new values in life, and (3) developing responsibility for the remaining time. The patients were carefully guided through a difficult time and supported to continue in healthy everyday lives. They were given hope which enabled them to find themselves a new foothold in life with respect to their own sense of well-being. This guidance and a sense of hopefulness were provided by heart specialists and more seasoned heart patients. In conclusion, patients were empowered to achieve a healthier lifestyle and improve their personal well-being during CR. However, structural barriers in the programme prevented adequate support regarding the patients' total needs. Knowledge of the benefits of CR emphasizes the significance of the programme and highlights the importance of high inclusion. Efforts should be made to develop more flexible and longer lasting programmes and further involvement of relatives must be considered.
authors.affiliation: Section of Nursing Science, Institute of Health, Aarhus University, Aarhus, Denmark.|Department of quality and education, Slagelse Hospital Region Zealand, Slagelse, Denmark; cpsi@regionsjealland.dk.
authors.forename: Charlotte P
authors.initials: CP
authors.lastname: Simonÿ
authors.affiliation: Section of Nursing Science, Institute of Health, Aarhus University, Aarhus, Denmark.|Department of Anesthesiology, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Pia
authors.initials: P
authors.lastname: Dreyer
authors.affiliation: Research Unit of Nursing, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.
authors.forename: Birthe D
authors.initials: BD
authors.lastname: Pedersen
authors.affiliation: Section of Health Services Research, Lillebaelt Hospital, Vejle, Denmark.|Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark.
authors.forename: Regner
authors.initials: R
authors.lastname: Birkelund
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology*; D000368:Aged; D001294:Attitude to Health; D005260:Female; D017144:Focus Groups; D065026:Hope; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000523:psychology / Q000534:rehabilitation*; D011209:Power, Psychological; D011788:Quality of Life / Q000523:psychology*; D012944:Social Support
keywords: Cardiac rehabilitation; coronary heart disease; empowerment; patients' lived experiences; phenomenological-hermeneutic research; well-being