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患者在遭遇心尖球形综合征时的体验——是否到了制定相关指南的时候?

Patients' experiences when afflicted by takotsubo syndrome - is it time for guidelines?

机构信息

Karolinska University Hospital, Stockholm, Sweden.

Jönköping Academy for Improvement of Health and Welfare, Jönköping University, Jönköping, Sweden.

出版信息

Scand J Caring Sci. 2021 Sep;35(3):824-832. doi: 10.1111/scs.12897. Epub 2020 Aug 17.

Abstract

BACKGROUND

Takotsubo syndrome (TTS) is an acute and reversible type of heart failure that shares common features with acute coronary syndrome. It is usually caused by psychological or physical stress, but for a third, triggers cannot be identified. Patients also suffer from residual symptoms and decreased mental health in the recovery phase and may struggle to comprehend and manage everyday living.

AIM

To describe patients' experiences when afflicted by takotsubo syndrome, after discharge from hospital.

METHOD

An inductive explorative design using a qualitative approach with semi-structured individual interviews. The text was analysed using qualitative content analysis according to Graneheim and Lundman.

RESULT

Ten women and one man afflicted by TTS were interviewed two to twelve months after discharge. Six sub-categories were identified, and a main category emerged: The process from symptom onset and understanding to increased awareness and changes in life. The patients suffered from emotional reactions and they sought answers and understanding about the underlying causes. The disease led to changes in patients' daily lives as they were affected physically and psychologically. Spouses and/or bystanders had a positive supporting role, but the patients desired more support from the healthcare professionals such as an earlier appointment for follow-up with a nurse.

CONCLUSION

Being afflicted by TTS can lead to changes in life conditions but these changes vary among patients. Becoming ill was associated to acute physical stress and prolonged psychological stress and they suffered from emotional reactions. The follow-up care needs to improve as the patients need more guidance from healthcare professionals and earlier appointment for follow-up with a nurse. A structured and multiprofessional treatment with a person-centred approach could support patients in their recovery.

摘要

背景

心尖球囊样综合征(TTS)是一种急性且可逆转的心力衰竭类型,与急性冠状动脉综合征具有共同特征。它通常由心理或身体压力引起,但有三分之一的病例无法确定诱因。患者在恢复期还会出现残留症状和心理健康下降的问题,可能难以理解和管理日常生活。

目的

描述患者在出院后患心尖球囊样综合征的经历。

方法

采用定性方法中的归纳性探索性设计,使用半结构化个体访谈。根据 Graneheim 和 Lundman 的方法,对文本进行了定性内容分析。

结果

10 名女性和 1 名男性心尖球囊样综合征患者在出院后 2 至 12 个月接受了采访。确定了 6 个亚类别,并出现了一个主要类别:从症状发作和理解到增强意识和生活方式改变的过程。患者经历了情绪反应,他们寻求有关潜在原因的答案和理解。疾病导致患者的日常生活发生变化,因为他们在身体和心理上都受到了影响。配偶和/或旁观者起到了积极的支持作用,但患者希望从医疗保健专业人员那里获得更多支持,例如更早预约与护士的随访。

结论

患心尖球囊样综合征可能会导致生活条件发生变化,但这些变化因患者而异。患病与急性身体压力和长期心理压力有关,他们经历了情绪反应。随访护理需要改进,因为患者需要从医疗保健专业人员那里获得更多指导,并更早预约与护士的随访。一种结构化和多专业的以患者为中心的治疗方法可以支持患者的康复。

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