Manageability, vulnerability and interaction: A qualitative analysis of acute myocardial infarction patients' conceptions of the event

摘要

Background: Delay in seeking care remains a problem for many patients with myocardial infarction. There is a great deal of knowledgeavailable about clinical factors contributing to this delay, while studies focusing on the patients' own experiences are few.Aim: Describe variations in how individuals perceived suffering symptoms of an acute myocardial infarction.Design: A qualitative method using phenomenographic design was applied. Interviews were conducted with 15 strategically selected patientswith myocardial infarction.Findings: Eight sub-categories in the pre-hospital phase were summarised into three categories: manageability, vulnerability, and interaction.To manage their situation, patients expressed a need tp understand it and to have a similar situation to compare with. They also describedcoping with the arising threat to their lives by self-medication or denying their symptoms. Patients expressed vulnerability, with feelings ofanxiety, both as triggers and barriers to seeking medical care. In interaction with others, psychosocial support and guidance from theenvironment, was fundamental in helping the patients to manage the situation.Conclusions: There were large variations in myocardial infarction patients' conceptions of the event. To improve disease management in thepre-hospital phase, the awareness of this large variation in conceptions about suffering symptoms of an myocardial infarction could be usedin the dialogue between patients and health care professionals, in cardiac prevention programmes, as well as in health care education.