Two contrasting cases of men\u27s experiences with chronic coronary heart disease post 1985

Since 1985 medical treatment for patients with chronic coronary heart disease (CHD) has changed drastically. Newer treatments almost assure return to previous activities, following myocardial infarction. Empirical studies of patients\u27 long term experiences living with chronic CHD are lacking. The purpose of this study was to describe the post 1985 experiences of patients with chronic CHD who have had multiple cardiac interventions and to identify the kind of meanings, if any, emerging from these experiences and their possible association with patient orientations toward life style changes The case study method was used to focus on the individual as the unit of analysis and including in-depth interviews with patients, spouses and in one instance a registered nurse who worked with a patient, and content analysis of medical and nursing records. The original intent was to identify the similarities of patient experiences across six cases. However, based on the unusual trajectory and complexity of the first patient\u27s experiences, the focus shifted to dealing with the widely differing experiences of this individual in relation to a second patient, whose trajectory had a more common textbook appearance. Bernie and Ed\u27s experiences with chronic CHD are best portrayed and understood as a journey. To date, Bernie\u27s journey has included 5 phases: The Early Days, The Heart Attack, Going Home and Recovery, The First Few Years, and Getting By-Living Day to Day. Meaning was tied to day to day survival and was situational. Bernie\u27s experiences, and their meaning influenced his early and continued efforts in changing his diet, exercise and stress reduction. Ed\u27s journey thus far, has included 7 phases: A Thirty Year Man, First Heart Attack, Back to Normal Activities, Second Heart Attack, The Next Five Years, Third Heart Attack, and Recovery. For Ed, meaning, like his illness, emerged slowly and subtly. Symbolic interaction theory was partially useful in deciphering the mid level of meaning. Existential analysis was useful in identifying the absence of meaning during portions of Bernie\u27s journey. Suggestion for future nursing research include adapting the traditional model of treatment experience to better meet the unique needs of patients with chronic CHD