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Patient perspectives on engagement in decision-making in early management of non-ST elevation acute coronary syndrome: a qualitative study

BACKGROUND: Surveys of patients suggest many want to be actively involved in treatment decisions for acute coronary syndromes. However, patient experiences of their engagement and participation in early phase decision-making have not been well described. METHODS: We performed a patient led qualitati...

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Autores principales: Wilson, Todd, Miller, Jean, Teare, Sylvia, Penman, Colin, Pearson, Winnie, Marlett, Nancy J., Shklarov, Svetlana, Diane Galbraith, P., Southern, Danielle A., Knudtson, Merril L., Norris, Colleen M., James, Matthew T., Wilton, Stephen B.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5704522/
https://www.ncbi.nlm.nih.gov/pubmed/29179716
http://dx.doi.org/10.1186/s12911-017-0555-9
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author Wilson, Todd
Miller, Jean
Teare, Sylvia
Penman, Colin
Pearson, Winnie
Marlett, Nancy J.
Shklarov, Svetlana
Diane Galbraith, P.
Southern, Danielle A.
Knudtson, Merril L.
Norris, Colleen M.
James, Matthew T.
Wilton, Stephen B.
author_facet Wilson, Todd
Miller, Jean
Teare, Sylvia
Penman, Colin
Pearson, Winnie
Marlett, Nancy J.
Shklarov, Svetlana
Diane Galbraith, P.
Southern, Danielle A.
Knudtson, Merril L.
Norris, Colleen M.
James, Matthew T.
Wilton, Stephen B.
author_sort Wilson, Todd
collection PubMed
description BACKGROUND: Surveys of patients suggest many want to be actively involved in treatment decisions for acute coronary syndromes. However, patient experiences of their engagement and participation in early phase decision-making have not been well described. METHODS: We performed a patient led qualitative study to explore patient experiences with decision-making processes when admitted to hospital with non-ST elevation acute coronary syndrome. Trained patient-researchers conducted the study via a three-phase approach using focus groups and semi-structured interviews and employing grounded theory methodology. RESULTS: Twenty patients discharged within one year of a non-ST elevation acute coronary syndrome participated in the study. Several common themes emerged. First, patients characterized the admission and early treatment of ACS as a rapidly unfolding process where they had little control. Participants felt they played a passive role in early phase decision-making. Furthermore, participants described feeling reduced capacity for decision-making owing to fear and mental stress from acute illness, and therefore most but not all participants were relieved that expert clinicians made decisions for them. Finally, once past the emergent phase of care, participants wanted to retake a more active role in their treatment and follow-up plans. CONCLUSIONS: Patients admitted with ACS often do not take an active role in initial clinical decisions, and are satisfied to allow the medical team to direct early phase care. These results provide important insight relevant to designing patient-centered interventions in ACS and other urgent care situations.
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spelling pubmed-57045222017-12-05 Patient perspectives on engagement in decision-making in early management of non-ST elevation acute coronary syndrome: a qualitative study Wilson, Todd Miller, Jean Teare, Sylvia Penman, Colin Pearson, Winnie Marlett, Nancy J. Shklarov, Svetlana Diane Galbraith, P. Southern, Danielle A. Knudtson, Merril L. Norris, Colleen M. James, Matthew T. Wilton, Stephen B. BMC Med Inform Decis Mak Research Article BACKGROUND: Surveys of patients suggest many want to be actively involved in treatment decisions for acute coronary syndromes. However, patient experiences of their engagement and participation in early phase decision-making have not been well described. METHODS: We performed a patient led qualitative study to explore patient experiences with decision-making processes when admitted to hospital with non-ST elevation acute coronary syndrome. Trained patient-researchers conducted the study via a three-phase approach using focus groups and semi-structured interviews and employing grounded theory methodology. RESULTS: Twenty patients discharged within one year of a non-ST elevation acute coronary syndrome participated in the study. Several common themes emerged. First, patients characterized the admission and early treatment of ACS as a rapidly unfolding process where they had little control. Participants felt they played a passive role in early phase decision-making. Furthermore, participants described feeling reduced capacity for decision-making owing to fear and mental stress from acute illness, and therefore most but not all participants were relieved that expert clinicians made decisions for them. Finally, once past the emergent phase of care, participants wanted to retake a more active role in their treatment and follow-up plans. CONCLUSIONS: Patients admitted with ACS often do not take an active role in initial clinical decisions, and are satisfied to allow the medical team to direct early phase care. These results provide important insight relevant to designing patient-centered interventions in ACS and other urgent care situations. BioMed Central 2017-11-28 /pmc/articles/PMC5704522/ /pubmed/29179716 http://dx.doi.org/10.1186/s12911-017-0555-9 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Wilson, Todd
Miller, Jean
Teare, Sylvia
Penman, Colin
Pearson, Winnie
Marlett, Nancy J.
Shklarov, Svetlana
Diane Galbraith, P.
Southern, Danielle A.
Knudtson, Merril L.
Norris, Colleen M.
James, Matthew T.
Wilton, Stephen B.
Patient perspectives on engagement in decision-making in early management of non-ST elevation acute coronary syndrome: a qualitative study
title Patient perspectives on engagement in decision-making in early management of non-ST elevation acute coronary syndrome: a qualitative study
title_full Patient perspectives on engagement in decision-making in early management of non-ST elevation acute coronary syndrome: a qualitative study
title_fullStr Patient perspectives on engagement in decision-making in early management of non-ST elevation acute coronary syndrome: a qualitative study
title_full_unstemmed Patient perspectives on engagement in decision-making in early management of non-ST elevation acute coronary syndrome: a qualitative study
title_short Patient perspectives on engagement in decision-making in early management of non-ST elevation acute coronary syndrome: a qualitative study
title_sort patient perspectives on engagement in decision-making in early management of non-st elevation acute coronary syndrome: a qualitative study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5704522/
https://www.ncbi.nlm.nih.gov/pubmed/29179716
http://dx.doi.org/10.1186/s12911-017-0555-9
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