Convalescent Discomfort Following Acute Coronary Events

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In a follow-up program for patients convalescing from acute coronary events, expressions of discomfort were quantified for 83 subjects after 17 months. Discomfort scores were generated by summing the reported presence of six cardiac symptoms and five measures of unpleasant moods. Associations between these scores and concurrent and antecedent demographic, clinical, and emotional variables were examined. Higher discomfort scores at 17-month follow-up were associated with several characteristics noted at initial entry: sex, occupation, education, employment, assessment of home situation, feeling more negative, degree of engagement, functional classification prior to acute event, and the presence of congestive heart failure on the cornary care unit. Contrary to hypotheses, age, diagnosis, previously diagnosed disease conditions, and selected CCU complications were not associated with higher discomfort scores measured 17 months later. At follow-up, higher discomfort scores were associated with concurrent variables: employment, assessment of home situation, degree of engagement, and use of pro re nata medications (nitroglycerin, tranquilizers, sedatives). Use of other cardiovascular medications was not associated with more expressed discomfort. Derivation of discomfort scores permits study of the relationship between coexisting components of moods and clinical symptoms. If these scores, after refinement and replication, can be established as an objective and useful construct, future investigations could be carried out to study how various types of nursing interventions might reduce discomfort during convalescence.

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