“Do what you can with a happy heart”: a longitudinal study of patient and family members’ lived experiences of physical activity post-myocardial infarction

Physical activity (PA) post-myocardial infarction (MI) can reduce risk of reoccurrence and mortality. Yet uptake of PA through cardiac rehabilitation (CR) is poor, and little is known about the long-term PA behaviour of cardiac patients. This study aimed to explore the lived experiences of patients’ engagement with PA post-MI, together with the experiences of their family. Longitudinal interviews with six family-dyads were conducted which drew on interpretative phenomenology to understand the lived experiences of PA for post-MI patients and family members. Participants described a journey that involved leaving “normality” (doing what PA they wanted and when) and transitioning to a new “normality” (being active within post-MI parameters). This journey was expressed through feelings of “I can’t do what I was doing before,” “finding my way,” and “accepting this way”. The role of family within the patient’s journey was complex, with PA identity, beliefs, and fear of MI re-occurrence influencing PA support both positively and negatively. PA engagement post-MI is a dynamic and interactive process within which the family can have an important influence.IMPLICATIONS FOR REHABILITATIONThe process of (re-)engaging in physical activity post-myocardial infarction involves a complex journey towards acceptance of a new “normality”.Family play an important role in regulating and supporting patients’ physical activity during the rehabilitation process.Promoting positive health beliefs and helping families understand what, how and when patients should be physically active may optimise the rehabilitation journey for post-myocardial infarction patients. The process of (re-)engaging in physical activity post-myocardial infarction involves a complex journey towards acceptance of a new “normality”. Family play an important role in regulating and supporting patients’ physical activity during the rehabilitation process. Promoting positive health beliefs and helping families understand what, how and when patients should be physically active may optimise the rehabilitation journey for post-myocardial infarction patients.

心肌梗死（myocardial infarction，MI）后的身体活动（Physical Activity，PA）可降低疾病复发与死亡风险。然而，通过心脏康复（cardiac rehabilitation，CR）参与身体活动的参与率较低，学界对心脏疾病患者的长期身体活动行为尚缺乏充分认知。本研究旨在探究心肌梗死后患者参与身体活动的生活体验，及其家属的相关体验。本研究采用解释现象学研究范式，对6组家庭配对开展纵向访谈，以了解心肌梗死后患者与家属参与身体活动的生活体验。受访对象将该过程描述为一段"告别旧常态（即可按自身意愿与时间安排开展身体活动），并过渡至全新常态（即需遵循心肌梗死后的活动限制进行活动）"的历程。该历程可通过三种核心情绪感受体现："无法再从事过往活动""摸索适配自身的活动路径"以及"接纳当前的活动状态"。家属在患者的这段历程中扮演的角色较为复杂：患者对身体活动的身份认同、健康信念，以及对心肌梗死复发的恐惧，均会对家属提供的活动支持产生双向影响。心肌梗死后的身体活动参与是一个动态且互动的过程，家属在此过程中可发挥重要作用。康复启示：心肌梗死后（重新）参与身体活动的过程，是一段朝向接纳全新"常态"的复杂历程。在康复过程中，家属对患者的身体活动起到调节与支持的关键作用。倡导积极健康信念，并协助家属了解患者应开展何种活动、如何开展活动以及何时开展活动，可优化心肌梗死后患者的康复历程。心肌梗死后（重新）参与身体活动的过程，是一段朝向接纳全新"常态"的复杂历程。在康复过程中，家属对患者的身体活动起到调节与支持的关键作用。倡导积极健康信念，并协助家属了解患者应开展何种活动、如何开展活动以及何时开展活动，可优化心肌梗死后患者的康复历程。