Taking problematic arbitrary measures: a grounded theory of the process of inefficient prehospital self-management of myocardial infarction

Introduction: Myocardial infarction (MI) is a cardiovascular emergency that needs immediate diagnosis and treatment. Ineffective self-management of MI may lead to adverse consequences and complications. This study was conducted to explore the process of ineffective prehospital self-management of MI. Methods This study was conducted using the grounded theory design. Sixteen patients with MI and six family members were purposefully and theoretically selected from a leading hospital in Kashan, Iran. Data were collected using unstructured and semi-structured interviews and were analyzed through the constant comparison method proposed by Corbin and Strauss (2015). The length of the interviews was 40–60 minutes and data collection was kept on to reach data saturation. Findings: The onset of MI symptoms had encountered patients with unfamiliar conditions which required them to use different self-management strategies, namely fighting between awareness and preference, taking problematic arbitrary measures, and consulting lay people. These ineffective strategies together with contextual factors had aggravated their conditions. Contextual factors were loneliness at the time of MI, affliction by underlying diseases, occurrence of symptoms at inappropriate time, and referring to non-specialty centers. The outcomes of this process were symptom aggravation and close encounter with death. Conclusion Unfamiliarity with MI and its management makes MI management very difficult for patients and family members. Therefore, MI-specific educations are needed to improve patients’ self-management abilities.