Table 3

Perceptions About Coronary Artery Disease: Second-Order Constructs

Second-Order ConstructExplanatory NotesArticles
Promote persistence
Adapting to the sick roleLearning to overcome anxieties and worries about medications by internalizing life changes after a cardiac event8, 11a
Understanding myocardial infarction as indicating future vulnerabilityPerceived vulnerability to future myocardial infarction motivated preventive action2
Ambivalence toward persistence
Uncertainty about disease and prognosisConfusion about the damage caused by cardiac event and the success of the cardiac intervention10, 15
Deter persistence
Fatalistic approach to diseaseAn overwhelming perceived threat of illness driven by personal experiences, family history, and anecdotal accounts2, 4, 5, 11a, 11b
Absence of symptoms challenging perceived need for treatmentLack of symptoms suggesting that one is cured, with no noticeable change if medications are missed4, 6, 11a, 11b, 14
Level of appreciation about the link between risk factor and diseaseLacking awareness about the causes of coronary artery disease6, 11c, 13
Understanding acute myocardial infarction as an acute eventLittle feeling of future vulnerability of acute myocardial infarction, encouraged by misinterpretation of patient information literature quoting expected time to recovery2