Empowering Cardiology Nurses: Using Participatory Health Research to Address Low Patient Compliance After Acute Myocardial Infarction

Cardiovascular disease (CVD) remains the leading cause of death and disability worldwide, with aging populations posing increasing challenges to healthcare systems. Recovery from acute myocardial infarction (AMI) requires compliance to treatment and lifestyle changes, but few patients comply with prescribed regimens. Participatory health research (PHR) has emerged as an effective approach for involving healthcare professionals and patients in jointly identifying root causes of problems, defining solutions, and evaluating interventions. This collaborative engagement fosters the development of more effective and sustainable outcomes. In clinical settings, the implementation of PHR presents both challenges and opportunities. This article offers a critical reflection on a PHR conducted with cardiology nurses in Portugal. The aim was to co-identify and co-develop solutions to the issue of low patient compliance following AMI, using the Ishikawa diagram as a co-reflective tool. This study used a participatory health approach and a qualitative design, incorporating focus groups supported by the Ishikawa diagram to identify the causes and potential solutions to low patient compliance after AMI. The cardiology nursing team ( n = 16) identified factors influencing low patient compliance after AMI, categorized into patients, healthcare professionals, procedures, facilities, and policies. Proposed solutions include personalized education, improved hospital-PHC communication, resource optimization, and the need for patient-centered policy reforms. This reappraisal of a participatory study with cardiology nurses reveals both the promise and constraints of participatory health research in clinical settings. Meaningful engagement requires trust, transparency, ethical reflexivity, and recognition of systemic boundaries. While not all co-created solutions were implementable, the process generated critical insights and momentum for ongoing change. Future participatory projects must balance aspiration with structural analysis, ensuring that collaborative inquiry is both ethically grounded and strategically impactful.