Date of Award

1986

Degree Type

Thesis

Degree Name

Nursing (M.S.N.)

Department

College of Nursing

Abstract

Myocardial infarction affects many people each year. Patients begin to form ideas regarding their myocardial infarction and perceive elements of their environment shortly after admission to the Coronary Care Unit (Runions, 1985). One of the ideas formed concerns the severity level of their myocardial infarction. The pupose of this study was to identify factors contributing to patients' perceptions of the severity level of their myocardial infarction and in turn compare these perceptions with predicted clinical severity. Numerous studies have explored patients' psychosocial reactions and adaptation to coronary artery disease and myocardial infarction. However, few studies identify patients' perceptions of events and infarct severity with actual clinical severity. Conceptualization of this study was based on theories of crisis and cognition. Research questions asked were: 1) Is there a relationship between patients' perceptions of the level of severity and the level of clinical severity in acute myocardial infarction? 2) Do specific events occurring during the acute phase of hospitalization relate to patients' perceptions of the severity of myocardial infarction? A descriptive-correlational design was used to analyze data collected on 50 patients admitted to the Critical Care Units of two acute care centers. Two instruments were used: a 5-level numerical scale on which patients ranked severity and responses to factors contributing to their perceptions and the Norris Coronary Prognostic Index, a tool measuring clinical severity. Demographic data were also collected to facilitate correlation of these factors with perceptions of severity. Data were analyzed using Spearman's Rho. A significant positive correlation (r=.497, p < .01) was obtained between perceived and actual clinical severity. In addition, seven of ten specific factors contributed to perception of severity above a neutral level, with physician response to one's myocardial infarction consistently ranking the highest of all factors. Several implications for nursing practice were identified.

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