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

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dc.contributor.authorWilson, Todd
dc.contributor.authorMiller, Jean
dc.contributor.authorTeare, Sylvia
dc.contributor.authorPenman, Colin
dc.contributor.authorPearson, Winnie
dc.contributor.authorMarlett, Nancy J
dc.contributor.authorShklarov, Svetlana
dc.contributor.authorDiane Galbraith, P.
dc.contributor.authorSouthern, Danielle A
dc.contributor.authorKnudtson, Merril L
dc.contributor.authorNorris, Colleen M
dc.contributor.authorJames, Matthew T
dc.contributor.authorWilton, Stephen B
dc.date.accessioned2018-09-26T12:02:48Z
dc.date.available2018-09-26T12:02:48Z
dc.date.issued2017-11-28
dc.date.updated2018-09-26T12:02:48Z
dc.description.abstractAbstract 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.
dc.identifier.citationBMC Medical Informatics and Decision Making. 2017 Nov 28;17(1):153
dc.identifier.doihttps://doi.org/10.1186/s12911-017-0555-9
dc.identifier.urihttp://hdl.handle.net/1880/107906
dc.identifier.urihttps://doi.org/10.11575/PRISM/45943
dc.language.rfc3066en
dc.rights.holderThe Author(s).
dc.titlePatient perspectives on engagement in decision-making in early management of non-ST elevation acute coronary syndrome: a qualitative study
dc.typeJournal Article
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