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Abstract

In the UK Coronary Heart Disease is the leading cause of death among women. It also causes an incalculable amount of morbidity and suffering. Despite these arresting facts, however, women have been comprehensively neglected by researchers and by the health care system. There is a vast database on Coronary Heart Disease in men which largely ignores the changes in disease prevalence that make it of equal importance to women.

Psychological adjustment to heart attack is of immense importance because of its impact on quality of life and because of its influence on bio-medical endpoints. Until recently, almost no research had been conducted on psychological adjustment in women, and much of the research that does exist is problematic. Most of it is predicated on androgenic assumptions, gender biased variable selection, adopts a cross sectional design and view heart attack as a discrete event. However, the data that do exist indicate that women’s psychological adjustment to heart attack is less favourable than men’s.

The study presented here adopts a qualitative process-based approach, seeking to describe and explain these apparent gender differences in psychological adjustment. Twenty women and ten men were interviewed at two time points following discharge from hospital, and the results were subjected to computer assisted content analysis. Many differences in participant’s experiences were identified, and four superordinate themes emerged: perception, decision-making and action in relation to heart attack symptoms; the emotional aftermath of heart attack; making sense of what had happened; and issues surrounding subsequent health-related behaviour.

The problem encountered during analysis was that, although there appeared to be many differences between men and women, these differences were seldom exclusive or universal within either sex. By studying the exceptions to these sex differences, it was possible to conclude that much psychological adjustment was a product of the social roles and norms rather than sex or any global notion of gender.

The thesis is divided into three parts. The first part includes four chapters providing background information including the literature, the research design and process. The second part comprises four results chapters. Finally, the third part consists of three chapters which draw conclusions from the research process and results, and consider their implications.

Publication Type:	Thesis (Doctoral)
Subjects:	B Philosophy. Psychology. Religion > BF Psychology R Medicine > RA Public aspects of medicine
Departments:	School of Health & Psychological Sciences > Psychology School of Health & Psychological Sciences > School of Health & Psychological Sciences Doctoral Theses Doctoral Theses

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