Social Support Needs Of Patients With Acute Myocardial Infarction At Different Stages:a Phenomenological Study

Objective:1.To explore the social support needs and experiences of patients with acute myocardial infarction(AMI)at various stages of the whole course from acute attack of myocardial infarction to emergency PCI surgery to family return.From the perspective of patients’ practical needs,the existing AMI nursing procedures should be optimized to reduce nursing delay before emergency PCI and promote postoperative functional state recovery and cardiac rehabilitation.2.To explore the longitudinal evolution process and law of social support demand in the whole course of AMI patients,in order to establish and improve the social support demand framework in line with the local humanities,change the traditional concept of care,adopt the view of continuous dynamic,and find the optimal adaptation from standardized care to individualized care.Methods:Using the method of interpretative phenomenology,from December 2019 to July2020,21 patients with acute myocardial infarction who underwent emergency PCI surgery in cardiology department of two Grade A hospitals in Taiyuan City,Shanxi Province,who met the inclusion criteria,were selected as the research objects by using the largest differentiated sampling in the target sampling method,after the review and approval of the Ethics Committee of the First Hospital of Shanxi Medical University and the informed consent of the subjects,according to the course of disease,four semi-structured indepth interviews were conducted respectively,combined with participatory observation.With Nvivo12.0 Plus software,the data were analyzed by interpretative phenomenological analysis(IPA),the results were categorized by using the social support multidimensional model.Results:A total of 23 topics were extracted from the five dimensions of social support needs,including information support needs,tool support needs,emotional support needs,social network support needs and self-esteem support needs,in the diagnosis period of AMI,PCI perioperative period,discharge preparation period,adjustment period and adaptation period.The information support requirements of each disease stage are as follows: AMI diagnostic period: diagnosis and risk;PCI perioperative period: AMI and PCI knowledge,right to medical disclosure;discharge preparation period: personalized paper discharge instructions;adjustment period and adaptation period: cause of discomfort and first-aid knowledge.Tool support requirements of each disease stage are as follows: AMI diagnostic period: Emergency Medical Services;PCI perioperative period: advanced stents and emergency PCI technology,green channel;discharge preparation period:economic support;adjustment period and adaptation period: mobile health care resources.Emotional support requirements of each disease stage are as follows: AMI diagnostic period: companionship and security;PCI perioperative period: acceptance and encouragement;discharge preparation period and adjustment period: psychological adjustment and construction;adaptation period: enhance independence.Social network support requirements of each disease stage are as follows: AMI diagnostic period:strangers assisted in medical delivery;PCI perioperative period: double morality and art of medical staff,peer support;discharge preparation period,adjustment period and adaptation period: reintegration into society.Self-esteem support requirements of each disease stage are as follows: AMI diagnostic period: believe that you will survive;PCI perioperative period: try to take care of oneself;discharge preparation period:confidentiality of illness;adjustment period: cardiac rehabilitation is recognized;adaptation period: give back to others.Conclusion:The social support needs of emergency PCI patients at different stages of acute myocardial infarction are different and change with the course of the disease.It is suggested that health care workers should adopt the concept of dynamic and continuous care,and establish and improve the framework of social support needs in line with local humanities to facilitate education and intervention.