Management of emotional distress following a myocardial infarction: a qualitative content analysis

Figures & data

Figure 1. The behavioural model of depression and anxiety after a myocardial infarction.

Table 1. Demographic characteristics of the participants.

Age (years), mean (range)	58.4 (31–74)
Female, n (%)	34 (37.0)
Marital status, n (%)
Cohabiting/Married	74 (80.4)
Single	14 (15.2)
Other	4 (4.3)
Education, n (%)
Elementary school	15 (16.3)
Upper secondary school	32 (34.8)
Higher education ≤3 years	20 (21.7)
Higher education >3 years	25 (27.2)
Country of birth, n (%)
Sweden	76 (82.6)
Work situation, n (%)
Full time	51 (55.4)
Part time	13 (14.1)
Sick leave	2 (2.2)
Retired, full time	23 (25.0)
Other	3 (3.3)

Table 2. Coding tree sample.

Theme	HYPOAROUSAL REACTIONS AND LOW MOOD
Category	DEPRESSION
Subcategory	Sadness	Low mood	Anhedonia	Guilt and shame
Codes	Being close to tears Feeling sad Feeling sorry for oneself Crying Having a need to mourn	Feeling numb Depression Feelings of emptiness Feeling unhappy	Having lost the spark Most things feel worthless Feeling unengaged Difficulties finding joy	Self-blame Embarrassing to be affected Limitations cause guilt Fatigue causes shame

Table 3. Frequency table. Number of coding references and participants represented in each category presented according to the participants rank.

Research question, theme and category	Coding references, N	Participants, N (%)
Emotional reactions
Hypoarousal reactions and low mood
Depression*	135	54 (59)
Loneliness and social isolation	13	11 (12)
Fatigue and limited strength	23	19 (21)
Positive or mixed emotions following the MI	12	7 (8)
Hyperarousal reactions
Heart-focused anxiety*	284	82 (89)
Difficulties sleeping	16	11 (12)
Stress	35	23 (25)
Anger and agitation	37	23 (25)
Difficulties concentrating	11	8 (9)
A changed sense of self and outlook on life
Experiencing a changed reality	46	33 (36)
Experiencing a changed self-image	85	45 (49)
The MI as a motivation for change	36	24 (26)
Strategies for managing emotional distress
Avoidance of potentially rewarding situations*
Withdrawal from social situations	44	30 (33)
Withdrawal from positive activities	12	7 (8)
Avoidance of heart-relevant stimuli triggering anxiety*
Avoiding emotions	33	27 (29)
Avoiding activities	12	8 (9)
Engagement in potentially positive activities and acceptance
Engaging in pleasant activities	15	10 (11)
Engaging in physical activity	12	12 (13)
Relaxation	11	10 (11)
Adopting a mindful coping approach	21	19 (21)
Seeking support from loved ones	13	12 (13)
Seeking healthcare support	8	7 (8)
Doing nothing at all	7	7 (8)
Total	921	92

*= Initial deductively generated categories.