ABSTRACT

Myocardial infarction (MI) is one of the leading causes of mortality and disability worldwide. Emotional distress, such as anxiety and depression, are common among MI patients. The aim of this study was to investigate emotional reactions following MI and to explore how MI patients self-manage their emotional distress using the perspective of an explanatory behavioural model of depression and anxiety. Written testimonies from 92 MI patients starting an internet-based cognitive behavioural therapy (iCBT) were analysed using qualitative content analysis with a mixed deductive and inductive approach. Six themes were identified. The first three highlight the emotional reactions post-MI: Hypoarousal reactions and low mood; Hyperarousal reactions; and A changed sense of self and outlook on life. The following three themes describe strategies for managing emotional distress: Avoidance of potentially rewarding situations; Avoidance of heart relevant stimuli triggering anxiety; and Engaging in potentially positive activities and acceptance. The MI experience may trigger emotional reactions, with a particular emphasis on heart-focused anxiety, depression and a shift in the perception of one’s identity. Patients tend to manage emotional distress through social withdrawal and experiential avoidance which likely maintains the distress. Applying a behavioural model to the management of emotional distress following MI is suited.

摘要

心肌梗死 (MI) 是全世界死亡和残疾的主要原因之一。情绪困扰，如焦虑和抑郁，在 MI 患者中很常见。本研究的目的是调查 MI 后的情绪反应，并探索 MI 患者如何使用抑郁和焦虑的解释性行为模型的角度自我管理他们的情绪困扰。使用定性内容分析和混合演绎和归纳方法分析了 92 名开始基于互联网的认知行为疗法 (iCBT) 的 MI 患者的书面证词。确定了六个主题。前三个突出了 MI 后的情绪反应：低觉醒反应和情绪低落；过度兴奋反应；改变自我意识和人生观。以下三个主题描述了管理情绪困扰的策略： 避免可能有益的情况；避免引发焦虑的心脏相关刺激；从事潜在的积极活动和接受。MI 体验可能会引发情绪反应，特别强调以心脏为中心的焦虑、抑郁和个人身份认知的转变。患者倾向于通过社会退缩和可能维持痛苦的经验性回避来控制情绪痛苦。将行为模型应用于 MI 后情绪困扰的管理是合适的。MI 体验可能会引发情绪反应，特别强调以心脏为中心的焦虑、抑郁和个人身份认知的转变。患者倾向于通过社会退缩和可能维持痛苦的经验性回避来控制情绪痛苦。将行为模型应用于 MI 后情绪困扰的管理是合适的。MI 体验可能会引发情绪反应，特别强调以心脏为中心的焦虑、抑郁和个人身份认知的转变。患者倾向于通过社会退缩和可能维持痛苦的经验性回避来控制情绪痛苦。将行为模型应用于 MI 后情绪困扰的管理是合适的。