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Coventry, Shirley (2011) The psychological adjustment of West African men post myocardial infarction: a counselling psychology study using interpretative phenomenological analysis. Doctoral thesis, London Metropolitan University.
Introduction: Increasingly effective medical practices and treatments for Coronary Heart Disease (CHD) have resulted in a growing need for Cardiac Rehabilitation programmes to improve morbidity and reduce further mortality. However, poor service uptake figures for the ethnic minority groups, especially of West African men, have highlighted the need for research, as this appears to be an unexplored area, and the National Service Framework (2000) also recognised the ethnic groups as a `special' interest focus, requiring specific attention. This Counselling Psychology study, therefore, aimed to explore the post heart attach experience of these men to ascertain if their psychological adjustment may be deterring service uptake. More specifically this study attempts to investigate the adjustment experience of these men (their cognitive appraisal and coping strategies), seeking to assist in explaining their low attendance of health programmes, and highlight any specific needs that the cardiac teams and psychological services must address.
Method: Five West African men, post myocardial infarction, were interviewed about their experiences using a semi-structured format. Interviews were analysed qualitatively using Interpretative Phenomenological Analysis (IPA). Results are presented in terms of the main themes emerging from the data.
Results: The results are presented using a 4 stage chronological understanding of the men's adjustment process. The men's stories reveal how these stages are regulated by ongoing cognitive appraisal style and coping strategies. A main theme of Degree of trust in the Medical and social systems, featured throughout the phases of adjustment.
Discussion: The findings are presented in relation to the initial study aims and existing literature. Most results are well supported in the literature, and thus show little variation in psychological adjustment being associated with ethnicity. The theme regarding mistrust of health services warrants further research, interestingly this did not deter these men from service engagement. Recommendations for further research and clinical applications are outlined.
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