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Strömbäck, U., Engström, Å. & Wälivaara, B.-M. (2019). Realising the seriousness – the experience of suffering a second myocardial infarction: A qualitative study. Intensive & Critical Care Nursing, 51, 1-6
Open this publication in new window or tab >>Realising the seriousness – the experience of suffering a second myocardial infarction: A qualitative study
2019 (English)In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 51, p. 1-6Article in journal (Refereed) Published
Abstract [en]

Objectives

The aim of this study was to describe people’s experiences of suffering a second myocardial infarction.

Research methodology

A descriptive qualitative design. Interviews were conducted with eight persons afflicted by two myocardial infarctions. Data were analysed with qualitative content analysis.

Findings

The analysis resulted in one theme and four categories. The theme was ‘Realising the seriousness’ and the categories were: 1) Knowledge from previous experience; 2) A wake-up call for lifestyle changes; 3) The future becomes unpredictable; 4) Trying to find balance in life. The participant’s previous experience contributed to a better understanding of the symptoms of myocardial infarction and how to act when suffering a second myocardial infarction. After their second myocardial infarction, the participants became really aware of the need to implement a healthier lifestyle, as doing so might avoid a third myocardial infarction. The risk of suffering or even dying due to yet another myocardial infarction felt more tangible after their second one.

Conclusion

A second myocardial infarction is a different event in comparison to the first one, which makes afflicted people realise the seriousness and importance of making life style changes. They are more affected both physically and psychologically.

Place, publisher, year, edition, pages
Elsevier, 2019
Keywords
Common sense model, Experience, Qualitative content analysis, Second myocardial infarction
National Category
Nursing
Research subject
Nursing
Identifiers
urn:nbn:se:ltu:diva-71445 (URN)10.1016/j.iccn.2018.12.002 (DOI)30579827 (PubMedID)2-s2.0-85058654313 (Scopus ID)
Note

Validerad;2019;Nivå 2;2019-03-12 (inah)

Available from: 2018-11-05 Created: 2018-11-05 Last updated: 2019-03-12Bibliographically approved
Strömbäck, U. (2018). The second myocardial infarction: A known but different experience. (Doctoral dissertation). Luleå: Luleå University of Technology
Open this publication in new window or tab >>The second myocardial infarction: A known but different experience
2018 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall aim of this thesis was to explore the second myocardial infarction (MI) and describe experiences of the second myocardial infarction from the perspectives of patients and personnel in cardiac rehabilitation (CR).

This thesis includes four studies. Studies using quantitative method (I, II) and qualitative method (III, IV) were performed. Studies I and II were retrospective cohort studies based on data from the Northern Sweden’s MONICA myocardial infarction registry. A paired design was used. Study I included 1017 participants, and the corresponding figure for Study II was 820 participants. The participants had at least two MI events recorded in the MONICA MI registry from 1990 – 2009 (I) and 1986 – 2009 (II). The two MI events studied were the first and second events. Study III included eight patients who suffered two MIs. The data were collected through interviews about the experience of suffering a second MI. In Study IV, personnel working with CR were interviewed about the experience of working with patients suffering from a second MI and data from study III were used for describing the patients expressed needs during CR. Data were analysed by descriptive and analytic statistics (I, II) and by qualitative content analysis (III, IV).

Both men and women had higher risk factor burdens when suffering the second MI compared when they suffered the first MI. Women had a higher risk factor burden at both first and second MI compared with men. Women also suffered the second MI with a shorter time interval than men did (I). The most common symptom reported in men and women at both MI events were typical symptoms. In men, 10.6 % reported different types of symptoms at first and second MI, and the corresponding figure for women was 16.2 % (II). The number of patients with a prehospital delay < 2 hours increased at the second MI. Furthermore, the results showed that patients with a prehospital delay ≥ 2 hours at the first MI were more likely to have a prehospital delay ≥ 2 hours at the second MI (II). Suffering a second MI is a known but different event compared to the first MI, it makes afflicted people realise the seriousness and the importance of making lifestyle changes (III). People express they are more affected after having the second MI, both physically and psychologically (III). In the analysis of congruence between the needs patients expressed linked to CR and personnel’s description of how they worked, a theme emerged: “Be seen as a unique person” 2(IV). The patients expressed a need of customised care, and the personnel described that it was important for them to individualise the care given to these patients.

Suffering a second MI is experienced as a different and more serious event that the first one. The patients had gained valuable knowledge due to their previous experience and the second MI was a wake-up call for life style changes. A majority of the patients had typical symptoms at both MI events and an increased number of patients had a prehospital delay < 2 hours at the second MI. We suggest that the personnel in CR pay attention to first-time MI patients’ illness representation to enhance the patient’s awareness of the seriousness of the illness and the fact that they suffer from a chronic illness. The care given after an MI, including cardiac rehabilitation should be person-centred to involve the patient as an active participator in the care and were the patient’s resources and needs are in focus.

Place, publisher, year, edition, pages
Luleå: Luleå University of Technology, 2018
Series
Doctoral thesis / Luleå University of Technology 1 jan 1997 → …, ISSN 1402-1544
National Category
Nursing
Research subject
Nursing
Identifiers
urn:nbn:se:ltu:diva-71447 (URN)978-91-7790-254-6 (ISBN)978-91-7790-255-3 (ISBN)
Public defence
2018-12-07, D770, Luleå, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2018-11-06 Created: 2018-11-05 Last updated: 2019-07-12Bibliographically approved
Strömbäck, U., Engström, Å., Lundqvist, R., Lundblad, D. & Vikman, I. (2018). The second myocardial infarction: Is there any difference in symptoms and prehospital delay compared to the first myocardial infarction?. European Journal of Cardiovascular Nursing, 17(7), 652-659
Open this publication in new window or tab >>The second myocardial infarction: Is there any difference in symptoms and prehospital delay compared to the first myocardial infarction?
Show others...
2018 (English)In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 17, no 7, p. 652-659Article in journal (Refereed) Published
Abstract [en]

BACKGROUND:

Knowledge is limited concerning the type of symptoms and the time from onset of symptoms to first medical contact at first and second myocardial infarction in the same patient.

AIM:

This study aimed to describe the type of symptoms and the time from onset of symptoms to first medical contact in first and second myocardial infarctions in men and women affected by two myocardial infarctions. Furthermore, the aim was to identify factors associated with prehospital delays ≥2 h at second myocardial infarction.

METHODS:

A retrospective cohort study with 820 patients aged 31-74 years with a first and a second myocardial infarction from 1986 through 2009 registered in the Northern Sweden MONICA registry.

RESULTS:

The most common symptoms reported among patients affected by two myocardial infarctions are typical symptoms at both myocardial infarction events. Significantly more women reported atypical symptoms at the second myocardial infarction compared to the first. Ten per cent of the men did not report the same type of symptoms at the first and second myocardial infarctions; the corresponding figure for women was 16.2%. The time from onset of symptoms to first medical contact was shorter at the second myocardial infarction compared to the first myocardial infarction. Patients with prehospital delay ≥2 h at the first myocardial infarction were more likely to have a prehospital delay ≥2 h at the second myocardial infarction.

CONCLUSIONS:

Symptoms of second myocardial infarctions are not necessarily the same as those of first myocardial infarctions. A patient's behaviour at the first myocardial infarction could predict how he or she would behave at a second myocardial infarction.

Place, publisher, year, edition, pages
Sage Publications, 2018
Keywords
First and second myocardial infarction, prehospital delay, typical and atypical symptoms
National Category
Nursing Physiotherapy
Research subject
Nursing; Physiotherapy
Identifiers
urn:nbn:se:ltu:diva-68457 (URN)10.1177/1474515118777391 (DOI)000446099600011 ()29749753 (PubMedID)2-s2.0-85046824489 (Scopus ID)
Note

Validerad;2018;Nivå 2;2018-10-03 (marisr)

Available from: 2018-04-23 Created: 2018-04-23 Last updated: 2018-11-05Bibliographically approved
Strömbäck, U., Vikman, I., Lundblad, D., Lundqvist, R. & Engström, Å. (2017). The second myocardial infarction: Higher risk factor burden and earlier second myocardial infarction in women compared to men : The Northern Sweden MONICA study. European Journal of Cardiovascular Nursing, 16(5), 418-424
Open this publication in new window or tab >>The second myocardial infarction: Higher risk factor burden and earlier second myocardial infarction in women compared to men : The Northern Sweden MONICA study
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2017 (English)In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 16, no 5, p. 418-424Article in journal (Refereed) Published
Abstract [en]

BACKGROUND:

Several studies have examined various parameters and experiences when patients suffer their first myocardial infarction (MI), but knowledge about when they suffer their second MI is limited.

AIM:

To compare risk factors for MI, that is, diabetes, hypertension and smoking, for the first and second MI events in men and women affected by two MIs and to analyse the time intervals between the first and second MIs.

METHODS:

A retrospective cohort study of 1017 patients aged 25-74 years with first and second MIs from 1990 through 2009 registered in the Northern Sweden MONICA registry.

RESULTS:

More women than men have diabetes and hypertension and are smokers at the first MI. Similar differences between the genders remain at the time of the second MI for diabetes and hypertension, although both risk factors have increased. Smoking decreased at the second MI without any remaining difference between genders. Women suffer their second MI within a shorter time interval than men do. Within 16 months of their first MI, 50% of women had a second MI. The corresponding time interval for men was 33 months.

CONCLUSION:

Patients affected by an MI should be made aware of their risk of recurrent MI and that the risk of recurrence is highest during the first few years after an MI. In patients affected by two MIs, women have a higher risk factor burden and suffer their second MI earlier than men do and thus may need more aggressive and more prompt secondary prevention.

Place, publisher, year, edition, pages
Sage Publications, 2017
National Category
Other Health Sciences Physiotherapy Nursing
Research subject
Health Science; Physiotherapy; Nursing
Identifiers
urn:nbn:se:ltu:diva-61085 (URN)10.1177/1474515116686229 (DOI)000402662800008 ()28029268 (PubMedID)2-s2.0-85020204387 (Scopus ID)
Note

Validerad;2017;Nivå 2;2017-06-05 (andbra)

Available from: 2016-12-15 Created: 2016-12-15 Last updated: 2018-11-05Bibliographically approved
Strömbäck, U., Lundblad, D., Vikman, I. & Engström, Å. (2017). The second myocardial infarction: Higher risk factor burden and earlier second myocardial infarction in women compared with men. In: EuroHeartCare 2017: . Paper presented at EuroHeartCare 2017, Jonkoping, Sweden, 18 - 20 May 2017.
Open this publication in new window or tab >>The second myocardial infarction: Higher risk factor burden and earlier second myocardial infarction in women compared with men
2017 (English)In: EuroHeartCare 2017, 2017Conference paper, Oral presentation with published abstract (Other academic)
National Category
Nursing Physiotherapy
Research subject
Nursing; Physiotherapy
Identifiers
urn:nbn:se:ltu:diva-61963 (URN)
Conference
EuroHeartCare 2017, Jonkoping, Sweden, 18 - 20 May 2017
Available from: 2017-02-13 Created: 2017-02-13 Last updated: 2018-05-31Bibliographically approved
Strömbäck, U., Vikman, I., Lundblad, D., Lundqvist, R. & Engström, Å. (2017). The second myocardial infarction: Women have a higher risk factor burden and suffer a second myocardial infarction earlier than men do. The Northern Sweden MONICA study. Paper presented at EuroHeartCare 2017, Jonkoping, Sweden, 18 - 20 May 2017. European Journal of Cardiovascular Nursing, 16(Suppl. 1), S62-S63, Article ID 165.
Open this publication in new window or tab >>The second myocardial infarction: Women have a higher risk factor burden and suffer a second myocardial infarction earlier than men do. The Northern Sweden MONICA study
Show others...
2017 (English)In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 16, no Suppl. 1, p. S62-S63, article id 165Article in journal, Meeting abstract (Refereed) Published
Place, publisher, year, edition, pages
Sage Publications, 2017
National Category
Other Health Sciences Physiotherapy Nursing
Research subject
Health Science; Physiotherapy; Nursing
Identifiers
urn:nbn:se:ltu:diva-63793 (URN)10.1177/1474515117700580 (DOI)000401775600104 ()28530115 (PubMedID)
Conference
EuroHeartCare 2017, Jonkoping, Sweden, 18 - 20 May 2017
Available from: 2017-06-08 Created: 2017-06-08 Last updated: 2018-10-03Bibliographically approved
Engström, Å., Johansson, M., Mattsson, M. & Strömbäck, U. (2016). Nursing Care of ICU Patients Lightly Sedated with Dexmedetomidine. Journal of Clinical Intensive Care and Medicine, 1, 5-13
Open this publication in new window or tab >>Nursing Care of ICU Patients Lightly Sedated with Dexmedetomidine
2016 (English)In: Journal of Clinical Intensive Care and Medicine, Vol. 1, p. 5-13Article in journal (Refereed) Published
Abstract [en]

Background: Intensive care patients are often in need of sedation to endure being intubated. Lightsedation is increasingly common since it has been proved to offer benefi ts such as faster recovery to patients.Aim: The aim of this study was to describe critical care nurses’ experiences of nursing patients lightlysedated with dexmedetomidine.Research Methodology: Qualitative personal interviews were conducted during 2015 with 10 critical carenurses in Sweden. Interview transcripts were analysed using inductive qualitative thematic analysis.Results: Light sedation of the patient facilitated communication and interaction with him or her, and therelationship between the patient and his or her family members. Dexmedetomidine was described as a fairlynew drug, and the critical care nurses stated that they needed more knowledge about it and about sedationscales in order to learn more about the drug’s mechanism of action and its potential side effects on patients.Conclusion: It is important to critical care nurses to learn more about dexmedetomidine and about sedationscales to assess levels of sedation, as light sedation has been shown to benefi t the patient as opposed to deepsedation that can increase recovery time.

National Category
Nursing Other Health Sciences
Research subject
Health Science; Nursing
Identifiers
urn:nbn:se:ltu:diva-61280 (URN)
Available from: 2016-12-29 Created: 2016-12-29 Last updated: 2018-05-31Bibliographically approved
Strömbäck, U., Lundblad, D., Vikman, I. & Engström, Å. (2013). Time from onset of symptoms to medical presence at the first and at the second myocardial infarction: a comparative study (ed.). Paper presented at SSAI Congress : Focusing on the brain 26/08/2013 - 29/08/2013. Acta Anaesthesiologica Scandinavica, 57(Suppl. 120), 27
Open this publication in new window or tab >>Time from onset of symptoms to medical presence at the first and at the second myocardial infarction: a comparative study
2013 (English)In: Acta Anaesthesiologica Scandinavica, ISSN 0001-5172, E-ISSN 1399-6576, Vol. 57, no Suppl. 120, p. 27-Article in journal, Meeting abstract (Other academic) Published
National Category
Other Health Sciences Physiotherapy Nursing
Research subject
Health Science; Physiotherapy; Nursing
Identifiers
urn:nbn:se:ltu:diva-38166 (URN)c7ad4ca7-5418-4c58-a9f9-6fa32967e757 (Local ID)c7ad4ca7-5418-4c58-a9f9-6fa32967e757 (Archive number)c7ad4ca7-5418-4c58-a9f9-6fa32967e757 (OAI)
Conference
SSAI Congress : Focusing on the brain 26/08/2013 - 29/08/2013
Note
Godkänd; 2013; 20131007 (andbra)Available from: 2016-10-03 Created: 2016-10-03 Last updated: 2018-05-31Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-8842-7759

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