Coronary heart disease patients transitioning to a normal life: perspectives and stages identified through a grounded theory approach


  • Tahereh Najafi Ghezeljeh BScN, MScN, PhD,

    Assistant Professor, Corresponding author
    1. Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
    2. Department of Neurobiology, Care Sciences, and Society, Division of Nursing, Karolinska Institutet, Huddinge, Sweden
    • Correspondence: Tahereh Najafi Ghezeljeh, Assistant Professor, Faculty of Nursing and Midwifery, Tehran University of Medical Sciences, Nosrat St., Tohid Sq. 1419733171, Tehran, Iran. Telephone: +98 21 61054323; +98 935 9838447.


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  • Mansoureh Yadavar Nikravesh BScN, MScN, PhD,

    Associate Professor
    1. Nursing and Midwifery Faculty, Iran University of Medical Sciences, Tehran, Iran
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  • Azita Emami PhD, RN, RNT

    Professor and Dean of College of Nursing
    1. College of Nursing, Seattle University, Stockholm, Sweden
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Aims and objectives

To explore how Iranian patients with coronary heart disease experience their lives.


Coronary heart disease is a leading cause of death in Iran and worldwide. Understanding qualitatively how patients experience the acute and postacute stages of this chronic condition is essential knowledge for minimising the negative consequences of coronary heart disease.


Qualitative study using grounded theory for the data analysis.


Data for this study were collected through individual qualitative interviews with 24 patients with coronary heart disease, conducted between January 2009 and January 2011. Patients with angina pectoris were selected for participation through purposive sampling, and sample size was determined by data saturation. Data analysis began with initial coding and continued with focused coding. Categories were determined, and the core category was subsequently developed and finalised.


The main categories of the transition from acute phase to a modified or ‘new normal’ life were: (1) Loss of normal life. Experiencing emotions and consequences of illness; (2) Coming to terms. Using coping strategies; (3) Recreating normal life. Healthcare providers must correctly recognise the stages of transition patients navigate while coping with coronary heart disease to support and educate them appropriately throughout these stages.


Patients with coronary heart disease lose their normal lives and must work towards recreating a revised life using coping strategies that enable them to come to terms with their situations.

Relevance to clinical practice

By understanding Iranian patients' experiences, healthcare providers and especially nurses can use the information to support and educate patients with coronary heart disease on how to more effectively deal with their illness and its consequences.