Betwixt and Between Health and Illness’ - Women's narratives following acute coronary syndrome

Background Cardiovascular is the main cause of mortality in women. Treatment modalities have improved health outcomes and survival rates, however, quality of life and ongoing morbidity after discharge is not clearly understood from a gender specific perspective. This study investigated experiences of women with a diagnosis of ACS in the 6 to 8 week period following discharge from hospital. The aim was to report their experiences of the mediating impact of a newly-diagnosed disease. Methods and Design Thirty women participated in this case study; a within-case analysis followed by a cross-case analysis provided meticulous knowledge of each case. Data collection included participant diaries and face to face interviews. Data were analysed using modified analytic induction which allowed the emergence of theoretical insights. The theoretical concepts, liminality and transitioning were used to inform the analysis. Within-methods triangulation captured the depth and breadth of the women's experiences. Results For many women the transition to recovery was difficult; this signposts that earlier support initiatives are required. The data provide an insight into women's experiences following ACS and highlight a need for support structures and services after discharge. While a number of women had transitioned towards recovery, many appeared to remain in a liminal space ‘betwixt and between’ health and illness. Cardiac rehabilitation was a positive experience for those who were attending. Conclusion The findings provide a platform for a wider discourse on the needs of women with ACS in the immediate period after discharge from hospital. Women may benefit from gender-specific, appropriately timed, and targeted interventions to facilitate recovery and adaptation to living with CHD. It is essential that secondary prevention services are modelled and tailored to meet the needs of women and evaluated appropriately to ensure positive outcomes. Nursing could have a key role to play in managing and providing this support. This article is protected by copyright. All rights reserved.