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Relationships between appraisal and coping strategies used over time by myocardial infarction patients Béchard, Pâquerette


This descriptive correlational and longitudinal study was designed to assess the changes in cognitive appraisal of emotions and coping strategies which myocardial infarction (Ml) patients used at two points in time. Additionally, the variables of cognitive appraisal of emotions were investigated for their relationships to coping strategies. A convenience sample of 21 confirmed first MI patients was selected from coronary care units (CCU) of four hospitals in western Canada. Participants completed the Emotion Appraisal Scale, the Revised Ways of Coping checklist as well as an information sheet. Overall, the participants experienced a wide range of the four appraisal types of threat, harm, challenge and benefit. Challenge emotions were the most frequent appraisal type at both interviews. Initially-, benefit emotions were the least frequent appraisal type, while harm emotions were the least frequent at the second period. While results indicated changes, no significant changes were found in the four emotion appraisals of threat, harm, challenge and benefit over time. The complexity of emotions experienced reflects the multifacated nature of the MI situation influencing patients in early phases of recovery. The participants used a variety of coping strategies which are related to emotion-focused and problem-focused coping to manage the demands of their MI. Most of the participants used all eight available types of coping. The strategies of seeking social support, distancing and positive reappraisal were the most predominant types of coping at both interviews. The strategies of self-controlling, planful problem-solving and accepting responsibility were moderately used, while escape-avoidance and confrontive coping were the least used types of coping at both times. The findings suggest that coping with a cardiac event is a complex process. The MI crisis present the patients with multiple tasks which require a combination of coping strategies. At the initial period, a significant relationship was found between threat emotions and planful problem-solving coping. Harm emotions were significantly and positively correlated with accepting responsibility, planful problem-solving and confrontive coping. Similarly, challenge emotions correlated with seeking social support and positive reappraisal coping. Significant relationships were found between benefit emotions and two forms of coping: confrontive and seeking social support coping. At the second period, only two significant correlations were found: benefit emotions significantly correlated with self-controlling and accepting responsibility. The findings suggest that a heart attack is appraised as moderately stressful by first MI patients in early phases of recovery. The MI patients' perception or understanding of the contextual factors affect appraisal of harm, threat, benefit and challenge emotions which in turn influence the choice of coping strategies.

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