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The turning point: from self-regulative illness behaviour to care-seeking in patients with an acute myocardial infarction.
Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital.
University West, Department of Nursing, Health and Culture, Division of Nursing.
Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital.
Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital.
2009 (English)In: Journal of clinical nursing, ISSN 1365-2702, Vol. 18, no 23, p. 3358-3365Article in journal (Refereed) Published
Abstract [en]

Aims and objectives. To describe the care-seeking process from interpretation of an initial symptom to the decision to seek medical care in patients with an acute myocardial infarction. Background. Patients afflicted by symptoms of an acute myocardial infarction delay in seeking care far exceeding the desired time limits. This results in avoidable loss of life. There is thus a need to understand these patients' initial discomfort, appraisal and behaviour to design interventions that could reduce delay in care-seeking. Design. Focus group discussions with patients who had had a recent acute myocardial infarction. Methods. The analysis of the transcribed text was inspired by the self-regulatory model of illness behaviour. Results. Patients with acute myocardial infarction describe problems to identify the exact time of onset of often vague symptoms. Their experiences of symptoms did not match their expectations. These patients exhibit self-regulatory illness behaviour that seems to cause a considerable delay in care-seeking. Conclusions. We found indications of a pertinent shift in appraisal and coping-strategy when a patient changes from self-regulative illness behaviour to seeking care - the turning point. This shift seems to be affected by several partly contradictory influences and it takes a considerable time for a person to reach this stage. All aspects of the patients' self-regulative illness behaviour have to be considered if we want patients to seek medical care more rapidly. Relevance to clinical practice. Our findings are important to consider in future design of public health and rehabilitation strategies to save patient lives. To identify the turning point is a profitable way to deepen the understanding of patient behaviour during the initial phase of an acute myocardial infarction.

Place, publisher, year, edition, pages
2009. Vol. 18, no 23, p. 3358-3365
National Category
Nursing
Research subject
NURSING AND PUBLIC HEALTH SCIENCE, Nursing science
Identifiers
URN: urn:nbn:se:hv:diva-1777DOI: 10.1111/j.1365-2702.2009.02911.xPubMedID: 19735342OAI: oai:DiVA.org:hv-1777DiVA, id: diva2:242041
Available from: 2009-10-06 Created: 2009-10-02 Last updated: 2009-12-09Bibliographically approved

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