SORA

Advancing, promoting and sharing knowledge of health through excellence in teaching, clinical practice and research into the prevention and treatment of illness

'Just like a normal pain', what do people with diabetes mellitus experience when having a myocardial infarction: a qualitative study recruited from UK hospitals.

Berman, N; Jones, MM; De Coster, DA (2017) 'Just like a normal pain', what do people with diabetes mellitus experience when having a myocardial infarction: a qualitative study recruited from UK hospitals. BMJ Open, 7 (9). e015736. ISSN 2044-6055 https://doi.org/10.1136/bmjopen-2016-015736
SGUL Authors: Jones, Melvyn Mark

[img]
Preview
PDF Published Version
Available under License Creative Commons Attribution Non-commercial.

Download (780kB) | Preview

Abstract

OBJECTIVE: The objective of the study was to investigate the symptoms people with diabetes experience when having a myocardial infarction (MI), their illness narrative and how they present their symptoms to the health service. SETTING: Three London (UK) hospitals (coronary care units and medical wards). PARTICIPANTS: Patients were recruited with diabetes mellitus (DM) (types 1 and 2) with a clinical presentation of MI (ST elevated MI (STEMI), non-ST elevated MI (NSTEMI), acute MI unspecified and cardiac arrest). A total of 43 participants were recruited, and 39 interviews met the study criteria and were analysed. They were predominantly male (n=30), aged 40-90 years and white British (18/39), and just over a half were from other ethnic groups. The majority had type 2 DM (n=35), 24 had an NSTEMI, 10 had an STEMI and five had other cardiac events. DEFINITIONS OF SELECTION/EXCLUSION CRITERIA: A diagnosis of MI and DM and the ability to communicate enough English to complete the interview. Ward staff made a clinical judgement that the participant was post-treatment, clinically stable and well enough to participate. METHODS: A qualitative study using taped and transcribed interviews analysed using a thematic analysis. RESULTS: While most participants did experience chest pain, it was often not their most striking symptom. As their chest pain did not match their expectations of what a 'heart attack' should be, participants developed narratives to explain these symptoms, including the symptoms being effects of their DM ('hypos'), side effects of medication (oral hypoglycaemics) or symptoms (such as breathlessness and indigestion) related to other comorbidities, often leading to delays in seeking care. CONCLUSIONS: While truly absent chest pain during MI among people with DM was rare in this study, patients' attenuated symptoms often led to delay in seeking attention, and this may result in delays in receiving treatment.

Item Type: Article
Additional Information: © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Keywords: chest pain, myocardial infarction, Adult, Aged, Aged, 80 and over, Chest Pain, Comorbidity, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Female, Humans, Interviews as Topic, London, Male, Middle Aged, Myocardial Infarction, Qualitative Research, Humans, Myocardial Infarction, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Chest Pain, Comorbidity, Qualitative Research, Adult, Aged, Aged, 80 and over, Middle Aged, London, Female, Male, Interviews as Topic
SGUL Research Institute / Research Centre: Academic Structure > Institute of Medical & Biomedical Education (IMBE)
Journal or Publication Title: BMJ Open
ISSN: 2044-6055
Language: eng
Dates:
DateEvent
15 September 2017Published
7 July 2017Accepted
Publisher License: Creative Commons: Attribution-Noncommercial 4.0
Projects:
Project IDFunderFunder ID
SFB 2011-25Royal College of General Practitioners' Scientific Foundation BoardUNSPECIFIED
PubMed ID: 28918410
Web of Science ID: WOS:000412650700069
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/112187
Publisher's version: https://doi.org/10.1136/bmjopen-2016-015736

Actions (login required)

Edit Item Edit Item