Living with angina pectoris--a phenomenological study.

Angina pectoris is a common medical condition with a high mortality and morbidity rate and normally requires medical therapy to control symptoms. The impact of angina and treatment strategies are gauged almost solely on clinical measurements. This approach does not provide insight into the effects of the disease from the patients' perspectives. Understanding these effects enables a patient centred approach to care, which may facilitate adherence to treatment strategies. Previous studies examining heart disease from the patients' perspective have tended to focus on myocardial infarction or coronary surgery and not, as this study does, on angina per se. Unstructured interviews of seven patients with clinically stable angina pectoris were carried out and analysed using a phenomenological approach. Seven themes were identified: limitation and adjustment; resignation; indignation; caution; reluctant compliance; surprise; and the unknown. Patients made adjustments to their lifestyles because of the limitations imposed on them by angina. These changes were accepted reluctantly, initially with annoyance, but ultimately with resignation. They were cautious in everyday activities to avoid something 'worse' happening. On the whole, they were surprised that they had developed the disease despite little understanding of risk factors. They had not considered the long-term effects of the disease. Angina patients need to have access to information sources to understand the disease and to make adjustments to their lives. An opportunity to discuss the disease with a specialist health care professional is essential. The study showed that phenomenology has a contribution to make in areas such as cardiology where the research agenda is predominantly positivistic.