Petriček Goranka, Buljan Josip, Prljević Gordana, Owens Patricia, Vrcić-Keglević Mladenka
Department of Family Medicine, University of Zagreb, School of Medicine,'Andrija Štampar' School of Public Health , Zagreb , Croatia.
Eur J Gen Pract. 2015 Mar;21(1):19-25. doi: 10.3109/13814788.2014.907269. Epub 2014 May 30.
Patient experience is increasingly recognized as one of the three pillars of quality in health care, alongside clinical effectiveness and patient safety. However, little attention has been paid to the patients' experience from the point of view of health care delivery.
To explore the initial experience of patients facing a new diagnosis of myocardial infarction (MI).
Thirty semi-structured, individual interviews were performed. The Grounded Theory method was used. Atlas.ti qualitative data analysis software facilitated the analysis.
Three patterns of MI diagnosis experience were found: a close encounter with death, severe pain, and 'silent' MI. Newly-diagnosed MI patients who experienced a close encounter with death expected that, after necessary life-saving measures, their physician would not force immediate conversation, but leave them alone, simply to take pleasure in being alive. Newly-diagnosed MI patients who did not experience a close encounter with death expected that their physician would provide not only medical care but also immediate emotional support and opportunities to discuss in their own words their ideas, thoughts, concerns and fears. Six factors facilitated patients coping with a new diagnosis of MI: stay in hospital, completion of diagnostic tests, trust in physicians, the patient's previous expectation that he/she could have a heart attack, the patient's personality, and the need for solitude.
Physicians should be aware that different patterns of patient experience when facing MI could indicate patients' differing needs for immediate emotional support and communication.
患者体验日益被视为医疗质量的三大支柱之一，与临床疗效和患者安全并列。然而，从医疗服务提供的角度来看，患者体验很少受到关注。
探讨初诊为心肌梗死（MI）的患者的初始体验。
进行了30次半结构化的个人访谈。采用扎根理论方法。Atlas.ti定性数据分析软件辅助分析。
发现了三种心肌梗死诊断体验模式：与死亡的近距离接触、剧痛和“无症状”心肌梗死。经历过与死亡近距离接触的初诊心肌梗死患者期望，在采取必要的救生措施后，医生不会强迫立即交谈，而是让他们独处，仅仅享受活着的乐趣。没有经历过与死亡近距离接触的初诊心肌梗死患者期望医生不仅提供医疗护理，还能立即给予情感支持，并提供机会让他们用自己的语言表达想法、担忧和恐惧。六个因素有助于患者应对心肌梗死的新诊断：住院、完成诊断测试、对医生的信任、患者之前认为自己可能心脏病发作的预期、患者的性格以及对独处的需求。
医生应意识到，面对心肌梗死时患者体验的不同模式可能表明患者对立即情感支持和沟通的不同需求。
