The Process of Adaptation to Heart Disease after Coronary Angioplasty.

Abstract

Abstract: Background and Aim: Suffering coronary artery disease and applying angioplasty as a treatment is a major vicissitude through which the patient will experience a transition from a healthy person to a sick one. This situation has the potential to cause a disruption in the pattern of life and to lead to great physical, emotional and social tensions for the patients. Therefore, patients need to change their physical, psychosocial and social functioning in order to comply with the conditions stated above. Thus, the approach to adapt the disease and its treatment is a major challenges for patients and researchers. Therefore, the aim of this study is to understand the process of adaptation to heart disease after coronary angioplasty. Methods: Qualitative study and grounded theory methods were selected for achieving the goals of the study. Purposeful sampling was used at the beginning and then theoretical sampling based on derived codes and categories was applied as sampling method. 21 patients as main participants and 6 from the health care system and family members were selected based on purposeful and theoretical sampling method. Data were first collected through unstructured and deep interviews and then interviewing continued in semi –structures from based on theoretical sampling method. Data were analyzed using the approach of Strauss and Corbin simultaneous with data collection. Results: In open coding, data analysis resulted in the discovery of 23 categories and in axial coding, 7 major categories as “living in threatening and relief cycle”, “the turning point of life”, “vulnerability, fear and uncertainly (tinkered”, “acceptance of illness and coming to terms”, “reliance and use of the available supportive resources” and “living in the shadow of the limitations and flaws” derived from data analysis. Finally, data analysis on selective coding led to recognition of “transition to recovery of life” as the core variable. The concept showed the way participants face with their main concern. i.e. “threat to life”, and determined how patients pass the process of adaptation with the disease through three phases “threaten life and identity”, “acceptance of illness and coming to terms”, and “combining illness with life”. Conclusion: This study showed that the process of adaptation to heart disease after coronary angioplasty has a positive evolution during which patients overcome the limitations caused by the disease by improving their understanding on the disease and treatment and by applying their own adaptation strategies and accept it as part of their lives. Understanding the process will help health care staff to identify the unique needs of patients at different stages of the adaptive process strengthening their adaptive strategies and supportive them to overcome facing challenges.