The experiences of myocardial infarction patients readmitted within six months of primary percutaneous coronary intervention

Iles-Smith, HM; Deaton, C; Campbell, M; Mercer, C; McGowan, L

Abstract

Aims and objectives
To explore the experiences of patients readmitted due to potential ischaemic heart disease symptoms within six months of primary percutaneous coronary intervention.
Background
Following myocardial infarction and primary percutaneous coronary intervention, some patients experience potential ischaemic heart disease symptoms that may lead to readmission. Symptoms may be related to cardiac ischaemia, reduced psychological health or a comorbid condition.
Design
A qualitative study involving semistructured, in‐depth interviews conducted once, mean 196 (50–384) days following readmission (at least six months following original ST‐elevation myocardial infarction and primary percutaneous coronary intervention). This is the qualitative part of a mixed methods study.
Methods
Participants were purposefully selected, and concurrent sampling, data collection and data analysis were performed. Data were organised using framework analysis; constant comparative analysis involving deduction and induction led to identification of cogent themes and subthemes.
Results
Twenty‐five participants (14 men, 27–79 years) experienced 1–4 readmissions; discharge diagnoses were cardiac, psychological, indeterminate, pulmonary and gastric. Three main themes emerged: (1) anxiety, uncertainty and inability to determine cause of symptoms, (2) fear of experiencing further myocardial infarction and (3) insufficient opportunity to validate self‐construction of illness.
Conclusion
Fear of dying or experiencing a further myocardial infarction led to patients seeking help at the time of potential ischaemic heart disease symptoms. Participants were anxious and lacked understanding regarding symptom attribution at the time of readmission and generally following their heart attack. Additionally, original heart attack symptoms were used as a comparator for future symptoms. Participants reported feeling well immediately after primary percutaneous coronary intervention but later experiencing fatigue and debilitation often linked to potential ischaemic heart disease symptoms.
Relevance to clinical practice
Increased education and information related to symptom attribution post‐primary percutaneous coronary intervention and postreadmission are worthy of exploration and may lead to increased understanding and reassurance for this patient group.

Citation

Iles-Smith, H., Deaton, C., Campbell, M., Mercer, C., & McGowan, L. (2017). The experiences of myocardial infarction patients readmitted within six months of primary percutaneous coronary intervention. Journal of Clinical Nursing, 26(21-22), 3511-3518. https://doi.org/10.1111/jocn.13715

• Journal Article Type: Article
• Acceptance Date: Dec 28, 2016
• Online Publication Date: Jan 2, 2017
• Publication Date: Oct 11, 2017
• Deposit Date: Nov 20, 2020
• Publicly Available Date: Nov 20, 2020
• Journal: Journal of Clinical Nursing
• Print ISSN: 0962-1067
• Electronic ISSN: 1365-2702
• Publisher: Wiley
• Volume: 26
• Issue: 21-22
• Pages: 3511-3518
• DOI: https://doi.org/10.1111/jocn.13715
• Publisher URL: https://doi.org/10.1111/jocn.13715
• Related Public URLs: http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1365-2702
• Additional Information: Additional Information : This output is also available at the White Rose Research Online (University of Leeds) Repository: http://eprints.whiterose.ac.uk/114965/; Access Information : This is the peer reviewed version of the following article: Iles‐Smith, H., Deaton, C., Campbell, M., Mercer, C. and McGowan, L. (2017), The experiences of myocardial infarction patients readmitted within six months of primary percutaneous coronary intervention. Journal of Clinical Nursing, 26 (21-22): 3511-3518., which has been published in final form at https://doi.org/10.1111/jocn.13715. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.