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Symptom description in patients with chest pain-A qualitative analysis of emergency medical calls involving high-risk conditions.
University of Borås, Faculty of Caring Science, Work Life and Social Welfare.ORCID iD: 0000-0003-4139-6235
University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
2019 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 28, no 15-16, p. 2844-2857Article in journal (Refereed) Published
Abstract [en]

AIMS AND OBJECTIVES: To explore the symptoms descriptions and situational information provided by patients during ongoing chest pain events caused by a high-risk condition.

BACKGROUND: Chest pain is a common symptom in patients contacting emergency dispatch centres. Only 15% of these patients are later classified as suffering from a high-risk condition. Prehospital personnel are largely dependent on symptom characteristics when trying to identify these patients.

DESIGN: Qualitative descriptive.

METHODS: Manifest content analysis of 56 emergency medical calls involving patients with chest pain was carried out. A stratified purposive sampling was used to obtain calls concerning patients with high-risk conditions. These calls were then listened to and transcribed. Thereafter, meaning units were identified and coded and finally categorised. Consolidated criteria for reporting qualitative studies guidelines have been applied.

RESULTS: A wide range of situational information and symptoms descriptions was found. Pain and affected breathing were dominating aspects, but other situational information and several other symptoms were also reported. The situational information and these symptoms were classified into seven categories: Pain narrative, Affected breathing, Bodily reactions, Time, Bodily whereabouts, Fear and concern and Situation management. The seven categories consisted of 17 subcategories.

CONCLUSIONS: Patients with chest pain caused by a high-risk condition present a wide range of symptoms which are described in a variety of ways. They describe different kinds of chest pain accompanied by pain from other parts of the body. Breathing difficulties and bodily reactions such as muscle weakness are also reported. The variety of symptoms and the absence of a typical symptomatology make risk stratification on the basis of symptoms alone difficult.

RELEVANCE TO CLINICAL PRACTICE: This study highlights the importance of an open mind when assessing patients with chest pain and the requirement of a decision support tool in order to improve risk stratification in these patients.

Place, publisher, year, edition, pages
2019. Vol. 28, no 15-16, p. 2844-2857
Keywords [en]
chest pain, emergency medical dispatch, emergency medical services, patient assessment, patient experience, prehospital, risk assessment, symptoms
National Category
Cardiac and Cardiovascular Systems
Research subject
Människan i vården
Identifiers
URN: urn:nbn:se:hb:diva-22166DOI: 10.1111/jocn.14867ISI: 000476595300013PubMedID: 30938902Scopus ID: 2-s2.0-85064713239OAI: oai:DiVA.org:hb-22166DiVA, id: diva2:1376430
Available from: 2019-12-09 Created: 2019-12-09 Last updated: 2019-12-19Bibliographically approved

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Herlitz, JohanBång, Angela

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