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Experiences and Actions During the Decision Making Process Among Men With a First Acute Myocardial Infarction

Nielsen, Susanne MSc; Falk, Kristin PhD; Gyberg, Anna MSc; Määttä, Sylvia PhD; Björck, Lena PhD

Journal of Cardiovascular Nursing: July/August 2015 - Volume 30 - Issue 4 - p 332–339
doi: 10.1097/JCN.0000000000000137
Articles

Background: Previous studies have shown that people hesitate to seek medical attention when experiencing the initial symptoms of acute myocardial infarction (AMI), but the reasons why and the events underpinning the decision-making process are unclear. The aim of this study was to describe the actions and experiences involved in the process of seeking medical attention in men with a first AMI.

Methods: We studied 21 men, aged 39–73 years, hospitalized with a first AMI between May 2011 and March 2013. All were interviewed in the coronary unit before discharge, with one exception. Data collection and analysis were carried out simultaneously in accordance with grounded theory methodology.

Results: Men diagnosed with a first AMI experienced a spectrum of insidious and vague symptoms, which they did not associate with an AMI. This caused uncertainty in how to interpret symptom severity and contributed to a reluctance to seek medical care. Participants also had difficulty interpreting online information when seeking to explain their symptoms. Weighing up and comparing the various experiences during the early stages of AMI proved to be the trigger that changed the men’s perspectives and made them aware of the abnormality, the severity of their illness, and the need for action.

Conclusion: Healthcare professionals should be aware that men experience a range of insidious and vague symptoms during their first AMI and must give greater emphasis to their narratives, particularly when objective clinical signs are limited or absent. Consideration should be given to the ways laypeople interpret online information when designing healthcare resources for the Internet.

Susanne Nielsen, MSc PhD Student, Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden.

Kristin Falk, PhD Senior Lecturer, Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden.

Anna Gyberg, MSc Faculty of Education, Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden.

Sylvia Määttä, PhDAdjunct Senior Lecturer, Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden.

Lena Björck, PhD Senior Lecturer, Department of Molecular and Clinical Medicine, and Institute of Health and Care Sciences, and Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden.

This work was supported by the Swedish Research Council (grant number VR 521-2010-2984), the Swedish Heart-Lung Foundation (grant number 2009-0390), the Swedish Council for Working Life and Social Research (grant number Epilife 2006-1506), and the Centre for Equity in Health Care, Västra Götalandsregionen.

The authors have no conflicts of interest to disclose.

Correspondence Susanne Nielsen, MSc, Department of Molecular and Clinical Medicine, Sahlgrenska University, Hospital/Östra sjukhuset, SE-41685, Gothenburg, Sweden (susanne.nielsen@gu.se).

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