School of Nursing, The University of British Columbia, Canada.
School of Health and Exercise Sciences, The University of British Columbia, Canada.
Eur J Cardiovasc Nurs. 2021 Mar 1;20(3):231-242. doi: 10.1177/1474515120952220.
Atrial fibrillation is a complex condition associated with a broad spectrum of symptoms, coupled with variability in the frequency, duration and severity of symptoms. Early treatment seeking is important to reduce the risk of stroke, heart failure and dementia. Despite the increasing prevalence, there remains a limited understanding of the symptom experience prior to an atrial fibrillation diagnosis, and how these experiences influence treatment-related decisions and time frames.
This qualitative study aimed to explore the symptom experiences of patients receiving an early diagnosis of less than 48 hours and a late diagnosis of 48 hours or more after symptom awareness.
Twenty-six adults were interviewed guided by the symptom experience model. The symptom checklist was used to probe patient's symptoms further. Data were analysed using a two-step approach to thematic analysis utilising concepts from the symptom experience model.
The two groups differed in their perception, evaluation and response to symptoms. The early diagnosis group (n = 6) experienced traumatic, severe and persistent symptoms, evoking concern and urgent treatment seeking. Conversely, the late diagnosis group (n = 20) reported more vague, paroxysmal symptoms that were readily ignored, self-theorised as non-illness related, and engaged in non-treatment strategies. Healthy self-perceptions, past experiences, atrial fibrillation knowledge and healthcare provider interactions influenced early or late treatment seeking.
For many, the atrial fibrillation pre-diagnosis was a tumultuous period, requiring prolonged periods to recognise symptoms and formulate treatment-seeking responses. This study may promote future research and strategies aimed at facilitating the early identification and response to symptoms among atrial fibrillation patients.
心房颤动是一种复杂的病症,与广泛的症状相关联,且症状的频率、持续时间和严重程度存在变化。早期寻求治疗对于降低中风、心力衰竭和痴呆的风险至关重要。尽管发病率不断上升,但对于心房颤动诊断前的症状体验以及这些体验如何影响与治疗相关的决策和时间框架,仍缺乏深入的了解。
本定性研究旨在探讨在症状出现后 48 小时内接受早期诊断(少于 48 小时)和 48 小时或更长时间接受晚期诊断的患者的症状体验。
采用症状体验模型指导对 26 名成年人进行访谈。使用症状清单进一步探查患者的症状。采用两步主题分析方法对数据进行分析,利用症状体验模型中的概念。
两组患者在对症状的感知、评估和反应方面存在差异。早期诊断组(n=6)经历了创伤性、严重且持续的症状,引起了关注并促使他们紧急寻求治疗。相比之下,晚期诊断组(n=20)报告了更多模糊、阵发性的症状,这些症状很容易被忽视,被自我归因于与疾病无关,并采取了非治疗策略。健康的自我认知、既往经历、心房颤动知识和医疗保健提供者的互动影响了早期或晚期的治疗寻求。
对于许多人来说,心房颤动的诊断前是一段动荡的时期,需要长时间才能识别症状并制定治疗反应。本研究可能会促进未来旨在促进心房颤动患者早期识别和对症状做出反应的研究和策略。