Method: We used between-method, objectively measured data from quantitative studies and subjective data from qualitative studies. Subjects were women admitted to a hospital with IHD. Consent was obtained after discharge was scheduled, applying the selection criteria. For quantitative studies, exercise energy expenditure (EEE) for walking-based activity by a pedometer and resting energy expenditure (REE) by a potable calorimeter were measured at 4 time-points during one year. Using a semi-structured interview for qualitative studies, living experiences during the first year after discharge were analyzed.

Results: Data were analyzed for 12 of 13 subjects (aged 66.3±6.5 years). Mean ejection fraction (LVEF) was 68.4±10.4%. Mean EEE/kcal/kg/day at 1 month, 3 months, and 12 months were 1.35±0.72, 1.23±0.82, and 1.73±0.53; mean REE was 17.2±3.6 at discharge, 19.0±4.7 at 1 month, 17.1±4.7 at 3 months, and 20.5±4.0 at 12 months. For 7 subjects, two core-categories from 13 categories were identified: anxiety regarding possible future cardiac events, and self-protective behavior limiting daily activities.

Conclusions: Despite good LVEF, EEE was limited in the early period. EEE changes at one year indicated a small increase, as did REE. The qualitative analysis described protective behavior prompted by anxiety regarding triggering cardiac events by increasing activity. Such behavior is considered motivated by wanting to minimize the risk of life-threatening events during the rehabilitation phase. EEE changes may be rationalized by the core-categories. Thus, between-triangulation method is helpful to understand the reality.

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