title: It is not just a Minor Thing - A Phenomenological-Hermeneutic Study of Patients' Experiences when afflicted by a Minor Heart Attack and Participating in Cardiac Rehabilitation.
abstract: BACKGROUND
  To improve cardiac care, especially cardiac rehabilitation, patients' perspectives should be better addressed. In Denmark, patients afflicted by a minor heart attack in terms of unstable angina pectoris or non-ST-elevation myocardial infarction are treated in fast-track programmes with subacute treatment in hospital, early discharge and follow-up specialised outpatient cardiac rehabilitation. Knowledge of these patients' experiences of their life situation is essential to develop sufficient care protocols.
  
  
  OBJECTIVE
  To gain in-depth understanding of how patients afflicted by a minor heart attack experience their life situation when following cardiac rehabilitation.
  
  
  METHODS
  Focus group interviews and individual interviews were conducted with 11 patients enrolled in the cardiac rehabilitation programme. Data consisted of text in the form of transcribed interviews. A three-phased interpretation inspired by Paul Ricoeur's theory of interpretation was applied.
  
  
  RESULTS
  As an overall concept, the patients experienced being forced into a demanding life shaking journey. Three themes emerged: Difficulty accepting the disease: facing the disease is a difficult challenge for the patients, leading to vulnerability and helplessness; Understanding that life has become frail: patients feel shaken as they realise that the disease is chronic and life-threatening; and An altered life: patients must adjust to new limitations in their everyday lives.
  
  
  CONCLUSIONS
  Patients experience an overall demanding transition when they are afflicted by a minor heat attack, whereby their lives are sweepingly changed. Supporting patients' integrity, which becomes vulnerable during the various stages of transitions, is essential to ensure a healthy outcome. Being together with fellow patients during cardiac rehabilitation is a facilitating factor in the course of transition.
authors.affiliation: Institute of Health, Section of Nursing Science, Aarhus University, Aarhus, Denmark.|Slagelse Hospital Region Zealand, Slagelse, Denmark.
authors.forename: Charlotte P
authors.initials: CP
authors.lastname: Simonÿ
authors.affiliation: Institute of Health, Section of Nursing Science, 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 M, Denmark.
authors.forename: Birthe D
authors.initials: BD
authors.lastname: Pedersen
authors.affiliation: Section of Health Services Research Lillebaelt Hospital, Denmark/University of Southern Denmark, Vejle, Denmark.
authors.forename: Regner
authors.initials: R
authors.lastname: Birkelund
mesh_terms: D000072038:Cardiac Rehabilitation; D017144:Focus Groups; D066297:Hermeneutics; D006801:Humans; D009203:Myocardial Infarction / Q000503:physiopathology / Q000523:psychology* / Q000534:rehabilitation
keywords: cardiac rehabilitation; chronic illness; existence; integrity; minor heart attack; patients’ experiences; phenomenological-hermeneutic research; transitions