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The trajectory to diagnosis with pulmonary arterial hypertension: a qualitative study

OBJECTIVES: To investigate the patient's experience of the trajectory to receiving a diagnosis of pulmonary arterial hypertension (PAH) and inform the provision of care for this patient group. DESIGN: Qualitative study using in-depth one-to-one interviews and pictorial representations. Data wer...

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Autores principales: Armstrong, Ian, Rochnia, Nikki, Harries, Carl, Bundock, Sarah, Yorke, Janelle
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Group 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3332243/
https://www.ncbi.nlm.nih.gov/pubmed/22514243
http://dx.doi.org/10.1136/bmjopen-2011-000806
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author Armstrong, Ian
Rochnia, Nikki
Harries, Carl
Bundock, Sarah
Yorke, Janelle
author_facet Armstrong, Ian
Rochnia, Nikki
Harries, Carl
Bundock, Sarah
Yorke, Janelle
author_sort Armstrong, Ian
collection PubMed
description OBJECTIVES: To investigate the patient's experience of the trajectory to receiving a diagnosis of pulmonary arterial hypertension (PAH) and inform the provision of care for this patient group. DESIGN: Qualitative study using in-depth one-to-one interviews and pictorial representations. Data were analysed using thematic analysis. SETTING: Participants were interviewed in their own homes across England. PARTICIPANTS: 30 patients with a diagnosis of pulmonary hypertension (18 participants were women, mean age 56 and range 26-80 years and time since diagnosis ranged from a few months to more than 12 years) participated. RESULTS: All participants, regardless of the time since diagnosis, vividly described the process from manifestation of symptoms to receiving a confirmed diagnosis. The authors present data using three major themes: (i) making sense of symptoms, (ii) process of elimination and (iii) being diagnosed with PAH. Making sense of symptoms represented an early period of perseverance—people tried to carry-on as usual despite ‘unexplained breathlessness’. As time progressed, this period was punctuated by critical events that triggered seeking medical advice. Once medical contact had been made, patients described a period of ‘elimination’ and convoluted contact with the medical profession. Dyspnoea misdiagnosis was a key factor that delayed the PAH diagnosis. Diagnosis disclosure by some medical professionals was also viewed as lacking empathy. More positive experiences were relayed when the medical team disclosing the diagnosis acknowledged previous limitations. CONCLUSIONS: A lack of awareness of this illness from both the sufferer themselves and the medical profession emerged as a central theme and led to prolonged periods of being misdiagnosed. The application of a diagnostic pathway for unexplained dyspnoea that alerts practitioners to rare conditions could expedite the process of correct diagnosis.
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spelling pubmed-33322432012-04-23 The trajectory to diagnosis with pulmonary arterial hypertension: a qualitative study Armstrong, Ian Rochnia, Nikki Harries, Carl Bundock, Sarah Yorke, Janelle BMJ Open Qualitative Research OBJECTIVES: To investigate the patient's experience of the trajectory to receiving a diagnosis of pulmonary arterial hypertension (PAH) and inform the provision of care for this patient group. DESIGN: Qualitative study using in-depth one-to-one interviews and pictorial representations. Data were analysed using thematic analysis. SETTING: Participants were interviewed in their own homes across England. PARTICIPANTS: 30 patients with a diagnosis of pulmonary hypertension (18 participants were women, mean age 56 and range 26-80 years and time since diagnosis ranged from a few months to more than 12 years) participated. RESULTS: All participants, regardless of the time since diagnosis, vividly described the process from manifestation of symptoms to receiving a confirmed diagnosis. The authors present data using three major themes: (i) making sense of symptoms, (ii) process of elimination and (iii) being diagnosed with PAH. Making sense of symptoms represented an early period of perseverance—people tried to carry-on as usual despite ‘unexplained breathlessness’. As time progressed, this period was punctuated by critical events that triggered seeking medical advice. Once medical contact had been made, patients described a period of ‘elimination’ and convoluted contact with the medical profession. Dyspnoea misdiagnosis was a key factor that delayed the PAH diagnosis. Diagnosis disclosure by some medical professionals was also viewed as lacking empathy. More positive experiences were relayed when the medical team disclosing the diagnosis acknowledged previous limitations. CONCLUSIONS: A lack of awareness of this illness from both the sufferer themselves and the medical profession emerged as a central theme and led to prolonged periods of being misdiagnosed. The application of a diagnostic pathway for unexplained dyspnoea that alerts practitioners to rare conditions could expedite the process of correct diagnosis. BMJ Group 2012-04-18 /pmc/articles/PMC3332243/ /pubmed/22514243 http://dx.doi.org/10.1136/bmjopen-2011-000806 Text en © 2012, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/ and http://creativecommons.org/licenses/by-nc/2.0/legalcode.
spellingShingle Qualitative Research
Armstrong, Ian
Rochnia, Nikki
Harries, Carl
Bundock, Sarah
Yorke, Janelle
The trajectory to diagnosis with pulmonary arterial hypertension: a qualitative study
title The trajectory to diagnosis with pulmonary arterial hypertension: a qualitative study
title_full The trajectory to diagnosis with pulmonary arterial hypertension: a qualitative study
title_fullStr The trajectory to diagnosis with pulmonary arterial hypertension: a qualitative study
title_full_unstemmed The trajectory to diagnosis with pulmonary arterial hypertension: a qualitative study
title_short The trajectory to diagnosis with pulmonary arterial hypertension: a qualitative study
title_sort trajectory to diagnosis with pulmonary arterial hypertension: a qualitative study
topic Qualitative Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3332243/
https://www.ncbi.nlm.nih.gov/pubmed/22514243
http://dx.doi.org/10.1136/bmjopen-2011-000806
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