Acute Coronary Syndrome and prehospital delay: The impact of prodromal symptoms, emotional and mental withdrawal, and presentation of chest pains

Birte Hedegaard Larsen, Vibeke Lorentzen

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In the pre-hospital phase, patients with Acute Coronary Syndrome symptoms delay making contact to medical services. Initiatives taken to improve knowledge and reduce pre-hospital delay have proven unsuccessful, and a need to focus on subjective factors was emphasised. The aims of this study were to identify and discuss patient’s mental and emotional responses, including interpretations and delaying strategies concerning Acute Coronary Syndrome symptoms, with a view to elucidating patterns in the pre-hospital decision-making process of female and male persons to contact medical services. A phenomenological design inspired by Steinar Kvale provided the methodological foundation. 15 women and 15 men with a first-time diagnosis of Acute Coronary Syndrome were interviewed 48–72 hours after admission. On symptom debut, the participants’ strategies were to «wait and see» and «let me be». Chest pains were cardinal. Male participants often used expletives and expressed symptoms in concrete terms. Women expressed symptoms in vaguer terms. Both genders used linguistic metaphors. The implications for nursing emphasised the impact of prodromal symptoms, mental and emotional withdrawal, and linguistic presentation of chest pains to understand and reduce pre-hospital delay.
TidsskriftNordic Journal of Nursing Research
Udgave nummer2
Sider (fra-til)145-162
StatusUdgivet - 2016
Udgivet eksterntJa


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