Review for Health Psychology - Article Example

?Running head: ARTICLE REVIEW FOR HEALTH PSYCHOLOGY Article Review for Health Psychology ARTICLE REVIEW FOR HEALTH PSYCHOLOGY 2 Article Review for Health Psychology This study, published in the Journal of Health Psychology deals with the stories people tell after a serious heart attack about their illness and healing. As a starting point, the researchers Maria I. Medved and Jens Brockmeier did an extensive literature review that showed gender differences in the performance of gendered roles and identities. They, however, wanted to concentrate on how these differences are told in narratives about cardiac healing and rehabilitation. It had been written that there was an urgent need for qualitative cardiovascular heart disease (CHD) research that considered gendered roles and identities because if this did not occur, an important dimension of human experience is sidelined and silenced. Consequently, the researchers wanted to carry out research that focused on gendered stories/narratives of men and women who had survived a serious cardiac incident. To do this, they focused on the three main questions they wanted answered; namely, how these narratives i) reflect, represent, and construe gendered attitudes toward and beliefs about CHD; ii) capture social relations, especially forms of social support in the context of healing; and iii) give shape to emotions in relations to people’s functional rehabilitation activities (Medved, M.I. and Brockmeier, J, 2010, p.323). The participants in the study were individuals recruited from a hospital-based cardiovascular rehabilitation program located in a Canadian urban center. All had experienced a serious cardiac event that resulted in coronary artery bypass surgery, angioplasty, or other medical intervention (e.g. stent) within the last five to seven months. None mentioned serious cardiac incidents prior to this cardiac event although many had symptoms associated with CHD. ARTICLE REVIEW FOR HEALTH PSYCHOLOGY 3 Participants for this study were recruited from an inner city hospital-based cardiovascular rehabilitation program located in a Canadian urban center. The sample consisted of six men out of the eight approached, who had a mean age of 63 years of age (range 59 to 74), being interviewed. Four individuals were married, one was black, four were white, one was Asian, all had a full-time work history, and three had retired. Based on income and work histories, they appeared to be of lower and middle class socioeconomic status. The sample also contained seven women out of the nine approached, who had a mean age of 70 years (range 60 to 82), being interviewed. All were married, one was black, six were white, five were retired, and all had at least a part-time work history. They appeared to be of lower and middle class socioeconomic status. They also fit the profile of women with CHD in that they were older and had many additional illnesses such as arthritis and diabetes. Although much research has been carried out in the many various institutions because of the ease of finding subjects, there have usually been some murmurings about the ethics involved in such cases because the individuals were in a sort of a captive situation. Medved M.I. and Brockmeier, J., p. 324) did, however, seek and receive approval from an institutional review committee prior to beginning their research. Furthermore, that not all of the individuals approached were interviewed might be taken as a positive indication that no undue pressure was put on the participants of the cardiovascular rehabilitation program to participate in the study. The method of study involved obtaining data through in-depth narrative interviews that were audiotaped and transcribed. Ethics were again evident in that all identifying details and specifics were altered to protect participants’ anonymity and confidentiality. Medical charts were accessed to obtain medical histories for which, hopefully, permission was obtained beforehand. ARTICLE REVIEW FOR HEALTH PSYCHOLOGY 4 The researchers also drew on informal observations during visits to the participants’ homes, which were recorded in the form of field notes. The interviews were one hour in length and conducted privately. Participants were interviewed twice two to three weeks apart so that the researchers had the opportunity to discuss their interpretations with them. This provided the participants with some feedback, another sign of good research. The interviews were, however, using a broad interview guide focusing on participants’ rehabilitation and healing experiences since their cardiac incident. All interviews covered the same main questions (another sign of good research); namely: “ i) How has it been for you since you have been released from the hospital? ii) How is your health now? iii) What are your thoughts about your CHD? iv) How have people responded to you after your cardiac incident?” (ibid.) The analysis of the data included a detailed review of how the narratives gave shape to the psychological and social aspects in which the researchers were interested. “A combination of narrative and discursive analytic methods which conceived of narrative sequences as integral to larger discursive dynamics while focusing on the narrative parts of conversational discourse” (ibid.) was used. Using an ideographic approach, each interview was separately analyzed until finally the results from each individual interview were cumulatively compared, male or female. The researchers achieved internal validity and reliability by reflective listing during interviews to ensure internal coherence of the analysis. Furthermore, each step was subject to independent review by other members of the research team. There were several interesting results of the study. One was that men, unlike women, tend to draw on mechanical metaphors to organize and reflect their experiences (Wasn’t looking after things and let things go...the engine broke, it was fixed. That’s it...). All of the men ARTICLE REVIEW FOR HEALTH PSYCHOLOGY 5 believed that with medical intervention the “broken machine” was fixed and they had pretty much recovered. Their CHD did not stop them from doing any activities, even those that were cardiac contraindicated. None of the women used mechanical metaphors. The researchers believed one reason for this to be the fact that women suffered from at least one additional chronic illness, which is typical for most female cardiac patients. Consequently, CHD was viewed by some women as just a further annoyance in a long line of diseases and injuries. The belief that their heart problem could be fixed by limited intervention did not capture their reality. The women expressed more worry about their long term health situation and the pain that might come with its possible deterioration and age. None of the women mentioned garnering social support, not even from family members. Men, however, talked a lot with spouses, colleagues, and acquaintances about their CHD incident. Women’s stories with respect to healing were saturated with negative emotion. They felt rehabilitation activities added another stressor. In conclusion, the researchers, in analyzing their participants’ stories/narratives found that beliefs about CHD, social relations, and emotions lend themselves to gender specific plotlines. The mechanical metaphors used by men lend themselves to plots that follow a straight storyline: I didn’t take care of myself (work, stress), got sick (the engine broke), had surgery (the engine was fixed), and am about to recover (the engine running the way it should). These narratives have been labelled as restitution narratives, which is the culturally imposed healing narrative imposed on men with CHD by medical establishments and public health discourses. The women’s narratives were emotionally saturated chaos narratives that offer only minimal openings for change. Hopefully the knowledge gained from this study can help support both men and women in contesting ingrained cultural patterns underlying common ideas about disease. ARTICLE REVIEW FOR HEALTH PSYCHOLOGY 6 References Medved, M.I. and Brockmeier, J. (2010. Heart stories: Men and women after a cardiac Incident. Journal of Health Psychology. 322 – 331. Read More