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Older Women’s Prehospital Experiences of Their First Myocardial Infarction

Isaksson, Rose-Marie PhD, RN; Brulin, Christine RNT, PhD; Eliasson, Mats MD, PhD; Näslund, Ulf MD, PhD; Zingmark, Karin MD, RN

Journal of Cardiovascular Nursing: July/August 2013 - Volume 28 - Issue 4 - p 360–369
doi: 10.1097/JCN.0b013e31824bcebc
Articles

Background: Few qualitative studies have been conducted on older women’s experiences of myocardial infarction (MI) and, in particular, the time before they seek medical care.

Objective: The aim of this study was to explore older women’s prehospital experiences of their first MI.

Methods: Qualitative content analysis was performed on data from individual interviews with 20 women, aged 65 to 80 years (mean, 73.0 years). The participants were interviewed 3 days after admission to a hospital for a confirmed first MI.

Results: The women perceived their symptoms as a strange and unfamiliar development from indistinct physical sensations to persistent and overwhelming chest pain. Throughout the prehospital phase, they used different strategies such as downplaying and neglecting the symptoms. The symptoms were seen as intrusions in their daily lives, against which the participants defended themselves to remain in control and to maintain social responsibilities. As their symptoms evolved into constant chest pain, the women began to realize the seriousness of their symptoms. When the pain became unbearable, the women took the decision to seek medical care.

Conclusion: Understanding the complex experiences of older women in the prehospital phase is essential to reducing their patient decision times. The findings of this study should be incorporated into the education of professionals involved in the care of cardiac patients, including those who answer informational and emergency telephone lines.

Rose-Marie Isaksson, PhD, RN Registered Nurse, Northern Sweden MONICA Myocardial Registry, Department of Research, Norrbotten County Council, Luleå, and Department of Nursing, Umeå University, Sweden.

Christine Brulin, RNT, PhD Professor, Department of Nursing, Umeå University, Sweden.

Mats Eliasson, MD, PhD Professor, Department of Medicine, Sunderby Hospital, Luleå, and Department of Public Health and Clinical Medicine, Umeå University, Sweden.

Ulf Näslund, MD, PhD Professor, Department of Public Health and Clinical Medicine, Umeå University, and Department of Cardiology, Heart Centre, University Hospital, Umeå, Sweden.

Karin Zingmark, MD, RN Research Manager, Department of Research, Norrbotten County Council, Luleå, Sweden.

This work was supported by Norrbotten County Council. Additional support for this project was provided through The Swedish Heart-Lung Foundation, The Joint Committee of Regional Authorities, and The Heart Foundation of Northern Sweden.

The authors have no conflicts of interest to disclose.

Correspondence Rose-Marie Isaksson, PhD, RN, Northern Sweden MONICA Myocardial Registry, Department of Research, Norrbotten County Council, 971 89 Luleå, Sweden (rose-marie.isaksson@nll.se).

© 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins