Key result
A meta-synthesis of 21 qualitative studies identified four primary themes in AMI patients with prolonged treatment-seeking: difficulty recognising symptoms, attempt to act, unwillingness to change, and self-sacrifice.
Why the study?
Previous attempts to reduce treatment-seeking time in acute myocardial infarction have been less than optimal, and prehospital delay has potentially worsened due to the COVID-19 pandemic.
Systematic Review (n=21)
Deciding to seek treatment for AMI is a complex social and psychological process involving difficulty recognizing symptoms, attempts to act, unwillingness to change, and self-sacrifice.
Informs targeted education on AMI symptom recognition; hypothesis-generating for delay-reduction strategies pending prospective trials.
AIMS: To describe the experiences and perceptions of acute myocardial infarction (AMI) patients with a prolonged decision-making phase of treatment-seeking. BACKGROUND: Previous attempts to reduce the treatment-seeking time of AMI have been less than optimal. Due to the coronavirus disease 2019 (COVID-19) pandemic, the situation of prehospital delay is possibly worse. Decisions to seek treatment are influenced by multiple factors and need individualised interventions. Understanding patients' external and internal experiences and psychological perceptions is essential. DESIGN: Meta-synthesis. DATA SOURCES: We searched PubMed, Embase, Cochrane Library, Web of Science, Scopus and four Chinese databases from inception to April 2022. METHODS: We screened the retrieved articles with predetermined inclusion and exclusion criteria, and reviewed articles using Thomas and Harden's (BMC Medical Research Methodology, 2008 8, 45) qualitative thematic synthesis approach. The Joanna Briggs Institute critical appraisal tool for qualitative research was used to assess the quality of studies. RESULTS: Twenty-one studies were included, identifying four themes and nine sub-themes. The four primary themes were difficulty recognising and attributing symptoms, attempt to act, unwillingness to change and self-sacrifice. CONCLUSION: Deciding to seek treatment is a complex social and psychological process, which needs comprehensive interventions considering personal and sociocultural factors and factors related to the COVID-19 pandemic. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Details of interventions for decisions to seek treatment in AMI patients need to be further designed and evaluated. IMPACT: Results would help healthcare professionals to implement individualised management of decision-making of treatment-seeking among AMI patients, and improve medical records of patients' prehospital experiences. REPORTING METHOD: The Preferred Reporting Items for Systematic Reviews 2020 checklist was used to report the findings. PATIENT OR PUBLIC CONTRIBUTION: Two AMI patients contributed to the data synthesis by giving simple feedback about the final themes.
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Su et al. (2023) conducted a systematic review in Acute myocardial infarction (n=21). Prolonged decision-making phase of treatment-seeking was evaluated on Experiences and perceptions (themes). A meta-synthesis of 21 qualitative studies identified four primary themes in AMI patients with prolonged treatment-seeking: difficulty recognising symptoms, attempt to act, unwillingness to change, and self-sacrifice.
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