Date of Award

Fall 1982

Document Type

Thesis - Restricted

Degree Name

Master of Science (MS)

Department

Nursing

Abstract

Eleven male myocardial infarction patients and spouses were interviewed on three occasions during the first three months of posthospital convalescence to investigate occurrence, emotional effect, and reporting of signs and symptoms of cardiac dysfunction. A structured interview guide, developed by the researcher, and a tape recorder were used. Criteria developed by the researcher and validated by four cardiovascular nurse-experts were used to evaluate symptom severity and appropriateness of reporting. Of 11 subjects, 9 experienced at least one symptom of cardiac dysfunction during convalescence. Symptom frequency increased as patients progressed through convalescence. Chest discomfort occurred in 9 subjects; 5 experienced palpitations or irregular pulse, 3 dizziness, 2 gradual marked changes in pulse rate, 1 shortness of breath, and none sudden marked changes in pulse rate. Of 35 instances of reported symptoms, overall severity of 17 was mild, of 11 moderate, and of 7 severe . High levels of anxiety, determined by subjects' expression of major felt-concern or investigator impression of denial, occurred in 57.1% of symptom instances discussed by wives, and 54.5% of symptom instances discussed by husbands. Two-thirds of the instances of symptoms were not reported appropriately to physicians. Factors associated with inappropriate reporting of symptoms included increased symptom severity, high levels of expressed concern, denial, avoidance of anticipated consequences of reporting, and problems with physicians. The researcher concluded that nurses must search for more effective ways to help postinfarction patients cope with symptoms .

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