Posttraumatic Growth after Spontaneous Coronary Artery Dissection: A Mixed-Methods Study

Abstract

Background: Heart attacks caused by spontaneous coronary artery dissection (SCAD) are traumatic events. While stressful, traumatic events can also be catalysts for positive growth. Aims: This study investigated the nature, prevalence, and correlates of posttraumatic growth (PTG) after SCAD. Methods: A mixed-methods approach was used. Part 1 involved seven focus groups with SCAD survivors (n = 30), the findings of which were analyzed thematically. Part 2 involved an online survey of SCAD survivors (n = 263), which included the PTG inventory (PTGI). Bivariate and multivariable analyses determined the significant correlates of PTG after SCAD. Results: Part 1 revealed four key themes, namely appreciating life and living in the moment, personal agency, new work-life balance, and spiritual clarity. Part 2 demonstrated that 79% of participants reported some degree of PTG. The mean total PTGI score was 46.4; standard deviation = 25.5. In terms of PTGI factors, the most common aspects of growth were appreciation of life and personal strength. PTG was significantly associated (P < 0.05) with education, partner status, living arrangements, presence of a close confidante, social support, time since SCAD, number of SCADs, and cardiac rehabilitation (CR) attendance. Variables retained in the multivariable model were younger age, mid-level education, high social support, being nondepressed, longer time since SCAD, greater number of SCADs, and CR attendance. Conclusion: This is the first study to demonstrate that, despite the associated stresses and challenges, there is a great potential for positive growth after SCAD. These findings have implications for the development and targeting of interventions to support post-SCAD recovery.

Keywords

• mixed-methods
• posttraumatic growth
• spontaneous coronary artery dissection