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心肌梗死后第一年的症状与功能限制:一项定性研究

Symptoms and Functional Limitations in the First Year Following a Myocardial Infarction: A Qualitative Study.

作者信息

Gwaltney Chad, Reaney Matthew, Krohe Meaghan, Martin Mona M, Falvey Heather, Mollon Patrick

机构信息

ERT and Brown University, 1 Bucks Trail, Westerly, RI, 02891, USA.

ERT, Peterborough Business Park, Lynch Wood, Peterborough, PE2 6FZ, UK.

出版信息

Patient. 2017 Apr;10(2):225-235. doi: 10.1007/s40271-016-0194-8.

Abstract

BACKGROUND AND OBJECTIVES

This qualitative interview study was designed to highlight the symptoms and functional limitations experienced by patients in the year following a myocardial infarction (MI). This information can support the use or development of patient-reported outcome (PRO) instruments in the post-MI population.

METHODS

Individual face-to-face interviews were conducted with 38 participants who had experienced an MI (with or without ST segment elevation) within the past month to <6 months (n = 17), or 6 months to ≤12 months (n = 21). Using content and thematic analysis, patient reports of symptoms and functional limitations were coded and then grouped into categories. The specific content and frequency of the symptom and functional limitation reports were summarized.

RESULTS

Nearly half of all symptom expressions were related to fatigue. Within this fatigue category, patients reported experiencing general tiredness, as well as a loss of physical energy, mental energy, and/or motivation. Chest pain and discomfort, sleep disruption, and shortness of breath were also frequently reported. Additionally, patients reported emotional effects, including worry and depression, as well as a negative impact on relationships and social activities.

CONCLUSIONS

Patients reported a wide variety of symptoms and functional limitations after an MI. Fatigue was the most commonly reported symptom and included several specific dimensions related to tiredness. Consideration of these concepts associated with the patient's experience following an MI may yield novel endpoints for use in clinical trials and better therapies.

摘要

背景与目的

本定性访谈研究旨在突出心肌梗死(MI)后一年内患者所经历的症状和功能限制。这些信息有助于支持心肌梗死后人群中患者报告结局(PRO)工具的使用或开发。

方法

对38名参与者进行了个人面对面访谈,这些参与者在过去1个月至<6个月内(n = 17)或6个月至≤12个月内(n = 21)经历过心肌梗死(无论有无ST段抬高)。采用内容和主题分析方法,对患者报告的症状和功能限制进行编码,然后归类。总结了症状和功能限制报告的具体内容和频率。

结果

几乎一半的症状表现与疲劳有关。在这一疲劳类别中,患者报告经历了全身疲倦,以及体力、精神能量和/或动力的丧失。胸痛和不适、睡眠中断和呼吸急促也经常被报告。此外,患者报告了情绪影响,包括担忧和抑郁,以及对人际关系和社交活动的负面影响。

结论

患者在心肌梗死后报告了各种各样的症状和功能限制。疲劳是最常报告的症状,包括与疲倦相关的几个具体方面。考虑这些与心肌梗死后患者经历相关的概念可能会产生用于临床试验的新终点和更好的治疗方法。

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