Active and effective coping is contributive to the prevention of disease recurrence and delay the development of complications. It has been reported that more than 50% of young and middle-aged patients with acute myocardial infarction (AMI) adopt a negative response to the disease, which negatively influences their prognosis and quality of life. But the underlying personal and sociocultural factors associated with the choice of disease coping styles in this population are still unclear. Self-regulation theory has been extensively used in studies of behaviors, comprehensive intervention, and health promotion in patients with stroke, chronic heart failure, or chronic obstructive pulmonary disease. Currently, there is a lack of research on disease coping style and its influencing factors in young and middle-aged patients with first AMI using the framework of this theory.

To explore disease coping styles in young and middle-aged patients with first AMI using the four-component framework of self-regulation theory.

Purposive sampling was used to recruit young and middle-aged patients with first AMI from the First Affiliated Hospital of Jinan University from January to June 2021. They were invited to attend an individual, semi-structured interview guided using an outline determined based on our research team members and experts' consensuses on the analysis results of a relevant pre-interview. The interview was conducted till data saturation, and the interview results were analyzed using Colaizzi's phenomenological methodology.

Altogether, the study included 15 cases. Two themes arose from the results of interview with them: (1) the coexistence of positive coping (adjustment of mentality, emotional control, positive attitude towards AMI, self-motivation, lifestyle change, exploring a new way to achieve psychological balance) and negative coping (tolerance, avoidance, reluctant acceptance, submission, concealment) ; (2) influencing factors of coping styles (social support, prognosis estimation, behavioral benefit acquisition, and the powder of role models) .

Both positive and negative methods for coping with first AMI were found in the young and middle-aged patient population, and the negative coping cannot be overlooked. To improve the physical and mental recovery of these patients via reducing patients' negative coping styles and increasing their positive coping styles, medical workers should guide the patients and their families to make full use of the social support system, provide them with individualized health education and education on benefits of healthy behaviors through multiple ways, and set a good example of leadership, motivation and supervision.

积极有效的应对方式能够预防疾病复发和延缓并发症的发生。过往研究提示50%以上的中青年急性心肌梗死患者采取疾病消极应对方式，并对其预后和生命质量造成负向影响，但其疾病应对方式选择的个人及社会文化方面的深层原因尚不明晰。自我调节理论已被广泛运用于脑卒中、慢性心力衰竭、慢性阻塞性肺疾病等慢性疾病患者的行为分析、综合干预、健康促进等研究中，目前尚缺乏从该理论视角出发深入探讨中青年首次急性心肌梗死患者疾病应对方式及其影响因素的研究。

基于自我调节系统四因素理论探讨中青年首次急性心肌梗死患者的疾病应对方式。

采用目的抽样法选取2021年1—6月暨南大学附属第一医院收治的中青年首次急性心肌梗死患者，按照信息饱和原则确定研究样本量，最终纳入15例患者。课题组成员和专家对预访谈结果进行分析和评价后确定最终访谈提纲，对研究对象进行一对一半结构式访谈。采用质性研究中的现象学研究方法，运用Colaizzi现象学资料7步分析法对原始资料进行整理、分析。

中青年首次急性心肌梗死患者的疾病应对方式可归纳为2个主题：（1）积极应对与消极应对并存，包括积极应对（调整心态与控制情绪，正面疾病与自我激励，转变生活方式，寻找新的平衡），消极应对（忍耐、回避、无奈接受、屈服、隐瞒）；（2）影响应对方式选择的因素（社会支持、预后估计、行为益处获得情况、榜样的力量）。

中青年首次急性心肌梗死患者的疾病应对方式为积极应对与消极应对并存，且消极应对情况不容忽视，医护人员应指导患者及其家属充分利用社会支持系统，进行多途径个性化健康教育，切实做好健康行为益处教育，并善于发挥榜样引领、激励和监督的作用，以改善患者疾病消极应对的状况、增强积极应对，最终促进患者身心全面康复。