Department of Heart Disease, Haukeland University Hospital, Jonas Lies vei 65, NO-5021 Bergen, Norway.
Centre of Interprofessional Collaboration within Emergency care (CISE), Linnaeus University, 35195 Växjö, Sweden.
Eur J Cardiovasc Nurs. 2021 Aug 20;20(6):526-533. doi: 10.1093/eurjcn/zvaa035.
Early treatment is crucial to successful therapy in patients with acute myocardial infarction (MI). Prehospital delay is associated with increased morbidity and mortality. There is little empirical evidence of patients' reflections on prehospital symptoms of MI and timely treatment at the time of discharge from hospital. To explore patients' reflections on prehospital symptoms of MI and their experiences of interaction with local hospitals, general practitioners, and laypersons.
An inductive explorative design with a qualitative method approach was used to conduct in-depth interviews of patients after confirmed MI. Twenty patients were purposefully selected based on age and gender. Face-to-face, semi-structured interviews were conducted prior to hospital discharge. The interviews were organized around a set of predetermined, open-ended questions, transcribed verbatim and analysed using qualitative content analysis. There were patients who acted upon severe symptoms of MI by seeking medical assistance. Patients commonly experienced that the time from the onset of symptoms to treatment posed a transitional challenge. They did not take subtle signs of MI seriously; they underestimated symptoms of MI and delayed seeking medical assistance. Patients frequently experienced that healthcare professionals did not take them seriously, as they struggled to gain access to healthcare services.
This study highlights patients' unique experiences of the pathway from symptom onset to confirmed MI. Severe chest pain is associated with MI and triggers an immediate need for care. However, patients often underestimated moderate chest pain or subtle signs and symptoms of MI. Existing knowledge gaps concerning the misinterpretation of symptoms in primary care need to be addressed in order to reduce this clinical challenge.
对于急性心肌梗死（MI）患者，早期治疗至关重要。院前延迟与发病率和死亡率的增加有关。很少有实证证据表明患者对 MI 的院前症状和出院时及时治疗有反思。为了探讨患者对 MI 的院前症状的反思以及他们与当地医院、全科医生和非专业人士互动的经验。
采用一种归纳性探索性设计和定性方法，对确诊 MI 后的患者进行深入访谈。根据年龄和性别，有目的选择了 20 名患者。在出院前进行面对面、半结构化访谈。访谈围绕一组预定的、开放式问题进行，逐字转录并进行定性内容分析。有些患者对严重的 MI 症状采取了寻求医疗帮助的行动。患者通常经历从症状发作到治疗的时间过渡带来挑战。他们没有认真对待 MI 的细微迹象；他们低估了 MI 的症状并延迟了寻求医疗帮助。患者经常感到医护人员不重视他们，因为他们难以获得医疗服务。
本研究强调了患者从症状发作到确诊 MI 的独特经历。剧烈胸痛与 MI 有关，并引发立即需要护理。然而，患者常常低估中度胸痛或 MI 的细微迹象和症状。需要解决初级保健中对症状的误解的现有知识差距，以减少这一临床挑战。
