"I just haven't experienced anything like this before": A qualitative exploration of callers' interpretation of experienced conditions in telephone consultations preceding a myocardial infarction. (April 2023)

• Record Type: Journal Article
• Authors: Jensen, Britta; Vardinghus-Nielsen, Henrik; Mills, Elisabeth Helen Anna; Møller, Amalie Lykkemark; Gnesin, Filip; Zylyftari, Nertila; Kragholm, Kristian; Folke, Fredrik; Christensen, Helle Collatz; Blomberg, Stig Nikolaj; Torp-Pedersen, Christian; Bøggild, Henrik
• Is Part Of: Patient education and counseling. Volume 109(2023)
• Publication Date: 2023-04
• Subjects: Myocardial infarction -- Atypical symptoms -- Emergency medical services -- Communication -- Qualitative content analysis -- Systems theory; Patient education -- Periodicals; Health counseling -- Periodicals; Health education -- Periodicals; Counseling -- Periodicals; Patient Education -- Periodicals; Éducation des patients -- Périodiques; Counseling -- Périodiques; Éducation sanitaire -- Périodiques; 615.5071
• DOI: 10.1016/j.pec.2023.107643
• Languages: English
• ISSNs: 0738-3991

Abstract

Abstract: Objectives: Callers with myocardial infarction presenting atypical symptoms in telephone consultations when calling out-of-hours medical services risk misrecognition. We investigated characteristics in callers' interpretation of experienced conditions through communication with call-takers. Methods: Recording of calls resulting in not having an ambulance dispatched for 21 callers who contacted a non-emergency medical helpline, Copenhagen (Denmark), up to one week before they were diagnosed with myocardial infarction. Qualitative content analysis was applied. Results: Awareness of illness, remedial actions and previous experiences contributed to callers' interpretation of the experienced condition. Unclear symptoms resulted in callers reacting to their interpretation by being unsure and worried. Negotiation of the interpretation was seen when callers tested the call-taker's interpretation of the condition and when either caller or call-taker suggested: "wait and see". Conclusion: Callers sought to interpret the experienced conditions but faced challenges when the conditions appeared unclear and did not correspond to the health system's understanding of symptoms associated with myocardial infarction. It affected the communicative interaction with the call-taker and influenced the call-taker's choice of response. Practice Implications: Call-takers, as part of the decision-making process, could ask further questions about the caller's insecurity and worry. It might facilitate faster recognition of conditions warranting hospital referral. Highlights: Qualitative content analysis examined calls turning out to be myocardial infarction. Medical helpline callers are challenged by unclear symptoms. Helpline callers lack previous experience and understanding of medical concepts. Exploring caller's unclear symptoms may improve myocardial infarction recognition.