Knowledge, attitude and practice on physical and psychosexual well being in a cohort of post MI patents in a Sri Lankan tertiary care cardiac center

Background

The major challenges in survivors following myocardial infarction (MI) are to prevent the subsequent coronary events for the achievement of a better quality of physical and psycho-sexual wellbeing. Issues pertaining to resumption of sexual activity, quitting smoking and psycho-social wellbeing are addressed as an integral part of the cardiac rehabilitation programme.

Objectives

To explore the knowledge, attitude and practice pertaining to physical and psycho-sexual wellbeing among post MI patients and to identify the lapses in current practice with regard to patient management with the aim of designing a locally relevant cardiac rehabilitation programme.

Methods

Across-sectional observational study was conducted at Cardiology unit, Teaching Hospital Kandy in 2015 recruiting a cohort of post MI patients who attend to Cardiology outpatient clinic. A pre-tested interviewer administered questionnaire and relevant medical records were used to obtain information.

Results

Though the majority were aware about the advantages of physical exercise following MI, most were unaware about the exact time of commencement and the self-adjustment of their exercise programme. The prevalence of anxiety and depression, especially the borderline cases were higher in post MI population than in the normal population independent of other clinical and demographic parameters. The participants had commenced sexual activity following the MI, however majority had reduced the frequency than before. Information on commencement of sexual activity was minimally conveyed and only a handful of patients discussed openly about their sexual activity with the health care providers. With regard to Health related quality of life (HRQoL) assessment, women had lower values than men and diabetic patients scored poorly than non-diabetics, especially in emotional wellbeing and endurance level. Majority of male patients were engaged in smoking. The majority had received help to quit smoking and succeeded in it, however, a significant proportion still continued to smoke even after the coronary event.

Conclusion

This study highlights the areas that need to be improved in the post MI care, especially with regard to sexual education, post MI graded exercise, improving quality of life, assistance to quit smoking and identifying the at risk patients for psychological diseases.