This study used the research method of phenomenology to elicit the patient's perspective of the illness experience following a myocardial infarction (MI). The purpose of studying this experience was to gain an understanding of what it meant to men and women to have a MI, what the learning needs were following a MI, and how these learning needs were met. It was proposed that patients would view the illness experience differently from health professionals, thus the patients would identify different learning needs. Anderson's (1985) adaptation of Kleinman's health care system framework was used to conceptualize this problem. Three males and two females, ranging in age from 42 to 77 years, participated in the study. Data were collected through 11 in-depth interviews. From analysis of this data significant statements were extracted to provide a description of the phenomenon under study. The findings of this study suggest that health professionals and patients do view the MI experience from different perspectives. The emphasis of the patients on understanding the MI experience from the reality of their world is reflected in their attempts to rationalize the occurrence of the MI and their desires to know more about their own MI, prognosis, and treatment. In order to plan patient education that will assist post-MI patients in their recovery health professionals must assess patients individually for their: (1) beliefs regarding risk factors and causes of MI; (2) desire for Information; (3) preference for method of instruction; and, (4) preference for timing of education. / Applied Science, Faculty of / Nursing, School of / Graduate

Posttraumatic Growth (PTG), known as antithesis of Post Traumatic Stress Disorder (PTSD) (Tedeschi, Park, &amp / Calhoun, 1998, p.3), has been highlighted in the literature as a positive outcome of the trauma.In the literature, environmental resources (e.g., social and familial support), individual resources (e.g., personality traits, socio-demographic variables), perception of the event (e.g., type of trauma, duration of trauma), cognitive processing (e.g. impact of event, religious participation), and coping (e.g. problem focused coping, emotion focused coping) were found as possible factors on the development of PTG. In the present study, a model to predict PTG in the patients suffering from myocardial infarction (MI / heart attack) and their spouses was tested on the basis of environmental and personal resources, the perception of the event and cognitive processing as latent variables. The model, developed by Schaefer and Moos (1998), was empirically analyzed for the first time with patients suffered from myocardial infarction and their spouses by structural equation model (SEM) using AMOS program. MI patients getting the treatment in various hospitals in the city of Bolu (N=151) and their spouses (N=137) completed the measures in 1.5-2 hours sessions. The analysis of the model with the MI patients&amp / #8217 / data revealed that both environmental resources and individual resources demonstrated indirect effects on PTG via the effect of the perception of the event, cognitive processing and coping. On the other hand, the analysis of the model for the spouses revealed that individual resources demonstrated indirect effects on PTG through the effect of the perception of the event, cognitive processing and coping while environmental resources did not show significant indirect effects on PTG.The findings were discussed in the context of recent theoretical models of PTG, shortcomings of the current study, clinical implications, and suggestions for future research.

D.Litt. et Phil. (Psychology) / It has long been known that South Africans are a high risk population for the development of coronary heart disease. Cardiovascular diseases accounted for 8,7% of all deaths in this country in 1988. Despite this distressing situation, rehabilitation facilities for people who have suffered a myocardial infarction or heart attack are relatively scarce. The facilities that exist tend to focus on the biomedical aspects of cardiac rehabilitation such as exercise and diet, and tend to neglect the psychosocial factors. A review of the literature shows, however, that psychosocial factors, and in particular the Type A coronary-prone behaviour pattern are significantly related not only to the development of coronary heart disease, but also to the probability of sUffering and surviving a heart attack. In addition, Type A.behaviour has been shown to be predictive of the risk of a second infarction after an initial attack. For this reason, the proven technology of a treatment programme developed under the auspices of the Recurrent Coronary Prevention Project (Powell & Thoresen, 1986) was applied in an attempt to adapt the programme for the" South African context. The study was aimed at establishing whether the RCPP programme could successfully be employed in this country, and whether the duration could be shortened so as to be more economically viable given the limited economic resources that characterise health care in South Africa. The modified programme was administered to a group of 13 post-myocardial patients at a local cardiac rehabilitation centre. A second group of 11 patients at the same centre served as a no-treatment waiting list control group, but simultaneously underwent an aerobic exercise and cardiovascular counselling programme. Results of the study indicate that 'the modified programme is highly successful in modifying Type A behaviour and its components in South African sUbjects. Comparisons of the experimental and control groups after the intervention showed statistically significant differences on the majority of measures. It was therefore concluded that the modified programme can be used fruitfully in the local context, but it was cautioned that the present sample needs to be followed up over time to ensure that the treatment gains are maintained.