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Mental health
Original research
Understanding men’s psychological reactions and experience following a cardiac event: a qualitative study from the MindTheHeart project
  1. Jalila Jbilou1,2,
  2. Jean Grenier3,
  3. Marie-Helene Chomienne4,5,
  4. France Talbot1,
  5. Heather Tulloch6,
  6. Bianca D'Antono7,
  7. Paul Greenman3,8
  8. On behalf of MindTheHeart Project Team
  1. 1 Psychology, Universite de Moncton, Moncton, New Brunswick, Canada
  2. 2 Centre de formation médicale du Nouveau Brunswick, Universite de Moncton, Moncton, New Brunswick, Canada
  3. 3 Institut du Savoir Montfort, Hopital Montfort, Ottawa, Ontario, Canada
  4. 4 Family Medicine, University of Ottawa, Ottawa, Ontario, Canada
  5. 5 School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
  6. 6 University of Ottawa Heart Institute, Cardiac Prevention and Rehabilitation, University of Ottawa, Ottawa, Ontario, Canada
  7. 7 Psychology Department and Research Centre at the Montreal Heart Institute, Universite de Montreal, Montreal, Quebec, Canada
  8. 8 Département de Psychoéducation et de Psychologie, Universite du Quebec en Outaouais, Gatineau, Quebec, Canada
  1. Correspondence to Dr Jalila Jbilou; jalila.jbilou{at}umoncton.ca

Abstract

Objectives Emotional issues such as depression, anxiety and post-traumatic stress disorder are common following a cardiac event. Despite their high prevalence, they often go undiagnosed and research suggests that men in particular are at higher risk. Therefore, a better understanding of men’s experiences with a cardiac event and ensuing health services is key for adapting approaches that meet their needs. The aim of this study was to describe the self-reported emotional challenges that men face following a cardiac event and to understand their patterns of psychosocial adjustment.

Design Qualitative study (focus groups and one-on-one interviews) using an interpretive phenomenal analysis.

Setting Clinical settings (cardiac departments in hospitals, cardiac rehabilitation programme and family medicine clinics) and in the community in three Canadian provinces.

Participants A total of 93 men participated in the study through 22 focus groups and 5 semi-structured interviews, none has been excluded based on comorbidities.

Results Four major themes emerged: (1) managing uncertainty and adversity; (2) distancing, normalising and accepting; (3) conformity to traditional masculine norms and (4) social, literacy and communication challenges.

Conclusions Healthcare professionals caring for men following a cardiac event must be aware of the psychological and social adjustments that accompany the physical challenges. However, there is a lack of explicit guidelines, tools and clinical training in men-sensitive approaches. Further research is required to better inform clinical practices and healthcare services.

  • depression & mood disorders
  • qualitative research
  • rehabilitation medicine
  • coronary heart disease
  • ischaemic heart disease
  • myocardial infarction

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjopen-2019-029560

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    Footnotes

    • Contributors All authors (JJ, JG, MHC, FT, HT, BDA and PSG) have contributed significantly to the design of the project, the planning and the conduct of the data collection. They participated in the team work for the analysis of the data (development of the codebook, training of the research assistants for first coding and codes’ organisation), discussions if consensus was not achieved and worked collaboratively on second coding and conceptual categorisation) and the discussion of the results. JJ and JG prepared the first manuscript draft; all authors contributed to, reviewed and approved the final manuscript.

    • Funding This paper represents independent research, for which authors received funding from the Movember Foundation-Canada and from the New Brunswick Health Research Foundation. JJ was provided the logistic and financial support by the Centre de formation médicale du Nouveau-Brunswick to support this publication.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Ethics approval The study received ethical approval from the research ethics boards (REB) of the participating study sites: Réseau de santé horizon: 2016-2295; Réseau de santé Vitalité: 2016-04-13; Université de Moncton: 1516-047; Hôpital Montfort: JJ-04-11-15; Institut de cardiologie de l’Université d’Ottawa: 2014-1801 (#projet), formulaire F11-4318; Université de Montréal: MP-33-2016-2006 (# projet), demande # F0-7529 and Hôpital de Hull: 2016-159 (# projet). All participants signed a confidentiality and consent form.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement Data may be obtained from a third party and are not publicly available.