Actual Nursing Practice by Proficient Nurses for Elderly Myocardial Infarction Patients and Problems with Self-Care

Purpose:The study was conducted to ascertain what was actually done for elderly myocardial infarction (hereafter MI)patients by proficient nurses and to identify problems with self-care that they encountered in their daily nursing practice. Methods:A focus-group interview was carried out on proficient nurses in two hospitals. The interview was recorded and later transcribed for inductive qualitative analysis. Results:Content-wise problems with self-care that proficient nurses encountered in their nursing care were related to the issues of a low-salt diet,medication management,and activities,whereas method-wise problems were related to the issues of a decline in understanding and cognitive abilities,family functions, and continuity of nursing. The major place of nursing for patients was the hospital ward (treatment right after MI). Out of the features categorized into 15 extracted from my preceding study,the categories that were frequently confirmed by both groups were:“Patient’s anxiety about recurrence,”“Reduction in the level and scope of activities,”and“Observation of the process up to coronary angiography after leaving hospital.” This study added three categories as to issues in continuous nursing. Conclusions: In order to cope with difficulties in supporting elderly patients who had self-care problems in a limited period of hospitalization,important were the continuity of nursing in the ward,the outpatient department and a hospital stay for examination, and coordination with people in other domains such as registered dieticians and pharmacists.(Kitakanto Med J 2011;61:319~326)