'Watchful insecurity' : a grounded theory to explain the meaning of recovery after a heart attack.

A heart attack can be devastating. If recovery is not well managed, such an
event can seriously impair quality of life. However, recovery is a relatively
unexplored concept in research. This study aimed to generate a theory to
explain the meaning of heart attack recovery from the perspective of those
who have encountered a heart attack. The theory of 'Watchful Insecurity"
was developed.
The study used a modified constructivist grounded theory methodology,
incorporating qualitative methods and grounded theory analysis techniques.
The sample included i) twenty four cardiac support group members who
attended one of four group interviews ii) 10 patients six to eight months
following their heart attack who participated in individual interviews iii) 10
informal interviews with people with "expert" conceptual knowledge.
The theory of Watchful Insecurity emerged from the participants' stories and
their perception that they were a different person after their heart attack.
Watchful Insecurity is identified as an enduring state that dominates the
process of recovery. Recovery is understood as a social process through
which people come to live with and manage Watchful Insecurity. Thetriggers of Watchful Insecurity after a heart attack are identified. Different
types and levels of "watchful insecurity" become apparent. The theory of
Watchful Insecurity challenges the assumption that recovery follows a linear
trajectory. Instead, recovery is experienced as a series of "peaks and
troughs". Watchful Insecurity is a core category that applies to all, but the
overall trajectory of recovery is unique for each individual. Tools that
participants used in order to learn to deal with Watchful Insecurity are
discussed.
This study illuminates heart attack recovery by exploring it as a concept and
a process. This understanding can be used in developing acceptable and
accessible services to support recovery.