Date of Award

2002

Degree Type

Dissertation

First Advisor

Cynthia Padula

Abstract

Coronary heart disease is the leading cause of death in American women. Cardiac rehabilitation can reduce cardiac risk, but women underutilize cardiac rehabilitation. Research has not described how women who do participate cope with integrating cardiac rehabilitation into their lives. The purpose of this research study was to explore women's coping with a Phase II (12-week) cardiac rehabilitation program by analyzing interview data for common elements and other ways of coping. A secondary purpose was to explore to what extent the women's descriptions in their interviews corresponded with Lazarus' theoretical concepts of appraisal and coping. The purposive sample was comprised of 13 English-speaking women currently enrolled in a Phase II cardiac rehabilitation program. A cardiac rehabilitation site in New England provided the clinical site for the study. A qualitative approach, comprised of modified participant-observation and intensive interviewing with the use of an interview guide, was used. Modified participant-observation described the cardiac rehabilitation setting in terms of spatial, temporal, and social mapping to understand the context in which the women participated in cardiac rehabilitation. The researcher transcribed audiotaped interviews, conducted at the cardiac rehabilitation site after week nine of the twelve-week program. Content analysis was used to analyze the interview data; analysis was concurrent with data collection. Data collection was terminated when saturation of the common elements was evident. The data were analyzed as a whole in terms of the research questions. Six common elements, occurring in seven or more of the women's descriptions, emerged from the data: managing external demands; perceiving benefit; perceiving support of family, health team, or employer; valuing cardiac rehabilitation; managing internal demands, and prioritizing self-care. Other ways of coping (less than seven): demonstrating determination, managing chronic illness demands, illuminating perceptions, and developing the ability to use exercise equipment. There was correspondence, of the interview data, with appraisal and coping as theorized by Lazarus. This research was a beginning effort to explore women's coping with cardiac rehabilitation and to provide the underpinning for development of specific approaches that help women integrate cardiac rehabilitation into their lives.

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