Are Patients Losing Their Chance of Survival Because They Are Unaware of Having a Myocardial Infarction? A Phenomenological Study

Yıl 2021, Cilt: 15 Sayı: 3, 424 - 433, 10.09.2021

Hatice Çiçek Damla Bayrak , Nuran Tosun

https://doi.org/10.21763/tjfmpc.822967

Cited By: 1

Öz

Objective: The aim of this study was to explore the experiences of patients with myocardial infarction and their relatives. Methods: This qualitative and phenomenological study was conducted with 20 patients hospitalized due to the diagnosis of myocardial infarction and 15 relatives. A semi-structured interview form and data collection form including socio-demographic characteristics were used. The data of the study were collected using the in-depth individual interview method and were assessed using the phenomenological approach developed by Colaizzi. The researchers analyzed statements of the participants regarding their experiences and prepared categories and themes. Results: Three categories and seven themes emerged as a result of the data analysis. These categories included symptom experiences, views about death, transportation to health care facility. The statements of participants revealed that patients experienced various symptoms including sweating, chest pain, gastrointestinal system symptoms, shortness of breath, yellow and purple skin tone. It was also determined that they generally had a lack of knowledge about myocardial infarction symptoms, could not associate symptoms with myocardial infarction, attributed myocardial infarction to other matters, used various ineffective methods to cope with symptoms. The majority of the patients arrived at the health care facility by self-transport and some patients even drove themselves to the health care facility. Conclusion: Participants had a lack of knowledge about the symptoms of myocardial infarction and appropriate transport to the health care facility, for example, utilizing an ambulance. This, in turn, prolongs the period of prehospital delay that has an effect on the chance of survival and receiving an effective treatment.

Anahtar Kelimeler

myocardial infarction, nursing, prehospital delay, qualitative research

Teşekkür

We would like to thank the cardiology intensive care clinic where the study was conducted, as well as all patients and their relatives participating in the present study.

Hastalar miyokard infarktüsü geçirdiğini bilmedikleri için mi hayatta kalma şansını kaybediyorlar? fenomenolojik bir çalışma

Öz

Amaç: Bu çalışmanın amacı, miyokard infarktüsü geçiren hasta ve yakınlarının deneyimlerini incelemektir. Yöntem: Bu niteliksel ve fenomenolojik çalışma miyokard infarktüsü tanısı ile hastanede yatan 20 hasta ve 15 hasta yakınıyla yürütülmüştür. Verilerin toplanmasında yarı yapılandırılmış görüşme formu ve sosyodemografik özellikleri içeren form kullanılmıştır. Veriler, derinlemesine bireysel görüşme yöntemi kullanılarak toplanmıştır. Elde edilen veriler Colaizzi tarafından geliştirilen fenomonolojik veri analizi yöntemiyle değerlendirilmiştir. Katılımcıların deneyimlerine ilişkin ifadeleri araştırmacılar tarafından analiz edilmiş, kategori ve temalar oluşturulmuştur. Bulgular: Veri analizi sonucunda üç kategori ve yedi tema belirlenmiştir. Kategoriler; semptom deneyimleri, ölüme ilişkin düşünceler ve sağlık kurumuna ulaşımdır. Katılımcıların ifadelerinden; hastaların terleme, göğüs ağrısı, gastrointestinal sistem belirtileri, nefes darlığı, cilt renginde sararma ve morarma olmak üzere çeşitli semptomları deneyimledikleri belirlenmiştir. Ayrıca, miyokard infarktüsü belirtileri hakkında genel bir bilgi eksikliklerinin olduğu, semptomlar ile miyokard infarktüsünü ilişkilendiremedikleri, hatta başka şeylere atfettikleri ve semptomlarla baş etmek için etkin olmayan çeşitli yöntemlere başvurdukları tespit edilmiştir. Hastaların çoğunun sağlık kuruluşuna başvuruda kendi özel araçları ile ulaştığı ve bazı hastaların araçlarını kendilerinin kullandığı saptanmıştır. Sonuç: Katılımcılar, miyokard infarktüsü belirtileri ve örneğin ambulans kullanımı gibi sağlık kurumuna uygun ulaşım hakkında bilgi eksikliğine sahip olduğu saptanmıştır. Bunun sonucunda ise etkin tedavi olma ve hayatta kalma şanslarını etkileyen hastane öncesi gecikme süresi uzamaktadır.

Anahtar Kelimeler

Miyokard infarktüsü, hemşirelik, hastane öncesi gecikme, niteliksel araştırma

Kaynakça

• 1. Global Atlas on Cardiovascular Disease Prevention and Control. Mendis S, Puska P, Norrving B editors. World Health Organization, Geneva; 2011: page2. Available from: https://apps.who.int/iris/handle/10665/44701
• 2. Bucher L, Castellucci D. Nursing management coronary artery disease and acute coronary syndrome. In: Lewis SL, Dirksen SR, Heitkemper MM, Bucher L, Camera IM, editors. Medical Surgical Nursing Assessment and Management of Clinical Problems. 8th ed. United States of America: Elsevier Mosby; 2011. p.760-96.
• 3. Ibanez B, James S, Agewall S, Antunes MJ, Bucciarelli-Ducci C, Bueno H, et al. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J 2018;39(2):119-77.
• 4. O’Gara PT, Kushner FG, Ascheim DD, Casey DE Jr, Chung MK, de Lemos JA, et al. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation 2013;127(4):e362-e425.
• 5. Moser DK, Kimble LP, Alberts MJ, Alonzo A, Croft JB, Dracup K, et al. Reducing delay in seeking treatment by patients with acute coronary syndrome and stroke: a scientific statement from the American Heart Association Council on cardiovascular nursing and stroke council. Circulation 2006;114(2):168-82.
• 6. Lesneski L. Factors influencing treatment delay for patients with acute myocardial infarction. Appl Nurs Res 2010;23(4):185-90.
• 7. Nguyen HL, Phan DT, Ha DA, Nguyen QN, Goldberg RJ. Pre-hospital delay in Vietnamese patients hospitalized with a first acute myocardial infarction: A short report. F1000Res 2018;4:633.
• 8. Saberi F, Adib-Hajbaghery M, Zohrehea J. Predictors of prehospital delay in patients with acute myocardial infarction in Kashan City. Nurs Midwifery Stud 2014;3(4):e24238.
• 9. Albarqouni L, Smenes K, Meinertz T, Schunkert H, Fang X, Ronel J, et al. Patients’ knowledge about symptoms and adequate behaviour during acute myocardial infarction and its impact on delay time: Findings from the multicentre MEDEA Study. Patient Educ Couns 2016;99(11):1845-51.
• 10. Alshahrani H, McConkey R, Wilson J, Youssef M, Fitzsimons D. Female gender doubles pre-hospital delay times for patients experiencing ST segment elevation myocardial infarction in Saudi Arabia. Eur J Cardiovasc Nurs 2014;13(5):399-407.
• 11. Hwang SY, Jeong MH. Cognitive factors that influence delayed decision to seek treatment among older patients with acute myocardial infarction in Korea. Eur J Cardiovasc Nur 2012;11(2):154-9.
• 12. Abed MA, Khalil AA, Moser DK. The contribution of symptom incongruence to prehospital delay for acute myocardial infarction symptoms among Jordanian patients. Res Nurs Health 2015;38(3):213-21.
• 13. Song L, Yan HB, Yang JG, Sun YH, Hu DY. Impact of patients’ symptom interpretation on care-seeking behaviors of patients with acute myocardial infarction. Chin Med J 2010;123(14):1840-4.
• 14. Demirkan B, Ege MR, Doğan P, İpek EG, Güray U, Güray Y. Factors influencing the use of ambulance among patients with acute coronary syndrome: results of two centers in Turkey. Anadolu Kardiyol Derg 2013;13(6):516-22.
• 15. Mirzaei S, Steffen A, Vuckovic K, Ryan C, Bronas UG, Zegre-Hemsey J, et al. The association between symptom onset characteristics and prehospital delay in women and men with acute coronary syndrome. Eur J Cardiovasc Nur 2020;19(2):142-54.
• 16. Ma J, Wang J, Zheng W, Zheng J, Wang H, Wang G, et al. Usage of ambulance transport and influencing factors in acute coronary syndrome: a cross-sectional study at a tertiary centre in China. BMJ Open 2017;7:e015809.
• 17. Thuresson M, Jarlöv MB, Lindahl B, Svensson L, Zedigh C, Herlitz J. Thoughts, actions, and factors associated with prehospital delay in patients with acute coronary syndrome. Heart Lung 2007;36(6):398-409.
• 18. Andersson EK, Borglin G, Sjöström-Strand A, Willman A. Standing alone when life takes an unexpected turn: being a midlife next of kin of a relative who has suffered a myocardial infarction. Scand J Caring Sci 2013;27(4):864-71.
• 19. Palinkas LA, Horwitz SM, Green CA, Wisdom JP, Duan N, Hoagwood K. Purposeful sampling for qualitative data collection and analysis in mixed method implementation research. Adm Policy Ment Health 2015;42(5):533-44.
• 20. Fors A, Dudas K, Ekman I. Life is lived forwards and understood backwards – experiences of being affected by acute coronary syndrome: a narrative analysis. Int J Nurs Stud 2014;51(3):430-7.
• 21. Isaksson RM, Brulin C, Eliasson M, Näslund U, Zingmark K. Prehospital experiences of older men with a first myocardial infarction: a qualitative analysis within the Northern Sweden MONICA Study. Scand J Caring Sci 2011;25(4):787-97.
• 22. O’Donnell S, Moser DK. Slow-onset myocardial infarction and its influence on help-seeking behaviors. J Cardiovasc Nurs 2012;27(4):334-44.
• 23. Gentles SJ, Charles C, Ploeg J, McKibbon KA. Sampling in qualitative research: Insights from an overview of the methods literature. The Qualitative Report 2015;20(11):1772-89.
• 24. Colaizzi PF. Psychological research as the phenomenologist views it. In: Valle RS, King M, editors. Existential Phenomenological Alternatives for Psychology. New York: Oxford University Press; 1978. p.48-71.
• 25. Khraim FM, Scherer YK, Dorn JM, Carey MG. Predictors of decision delay to seeking health care among Jordanians with acute myocardial infarction. J Nurs Scholarsh 2009;41(3):260-7.
• 26. Mooney M, McKee G, Fealy G, O' Brien F, O'Donnell S, Moser D. A randomized controlled trial to reduce prehospital delay time in patients with acute coronary syndrome (ACS). J Emerg Med 2014;46(4):495-506.
• 27. Herlitz J, Thuresson M, Svensson L, Lindqvist J, Lindahl B, Zedigh C, et al. Factors of importance for patients' decision time in acute coronary syndrome. Int J Cardiol 2010;141(3):236-42.
• 28. Mooney M, O’Brien F, McKee G, O'Donnell S, Moser D. Ambulance use in acute coronary syndrome in Ireland: a cross-sectional study. Eur J Cardiovasc Nurs 2016;15(5):345-54.
• 29. Lim SC, Rahman A, Yaacob NM. Pre-hospital factors influencing time of arrival at emergency departments for patients with acute ST-elevation myocardial infarction. Malays J Med Sci 2019;26(1):87-98.