Coping with ischaemic heart disease : views and experiences of key participants, their partners and medical practitioners.

Abstract

Ischaemic heart disease (IHD), which is a Chronic Disease of Lifestyle, has been rated as one of the key illnesses that have progressively materialised as a threat across the wide demographic spectrum of South Africa’s population. Internationally, literature is relatively scarce on the psychosocial consequences of the disease for the ill person, but limited information does exist on these consequences as they affect South African individuals and their families. This study sought firstly to understand the experience of persons with IHD, their partners and medical practitioners and secondly how they coped with the illness. Participants were selected with the assistance of cardiologists at a private hospital in KwaZulu-Natal. Theoretical sampling determined the number of persons who participated in the study. Data was collected using in-depth interviews in accordance with the qualitative descriptive design and narrative inquiry that underpinned the research. Participants (13) were determined once data-saturation was reached. The data revealed that spousal support and religion/spirituality played important roles in helping people manage the illness. Genetics and lifestyle choices contributed to participants’ IHD. Not recognising their symptoms, owing to misinformation by the medical fraternity, contributed to participants not realising they were having a heart attack. Religious/spiritual coping mechanisms were among those mentioned by participants, and depression (not clinically assessed), anxiety and sadness were noted among the consequences for them. Two of the cardiologists did not acknowledge depression; nevertheless research studies have linked depression with major cardiac attacks and to surgery following cardiac problems. The data points to the lack of communication between participants and their health practitioners and the belief held by participants that the medical personnel were not particularly interested in their psychosocial wellbeing. This seems to be borne out by the limited data obtained from health practitioners. Social workers can play important roles in the health team by ensuring that the psychosocial needs of persons experiencing IHD and their families are attended to. Social workers can publish in health journals to make the medical fraternity aware of the contribution that social workers skills can make to persons who are ill.