The experience of primary PCI: A patients' perspectives

Background

Primary Percutaneous Coronary Intervention (p-PCI) is recognized as the gold standard treatment for patients with STEMI. Little is known about patients' experiences of p-PCI and the way in which events that occur during hospitalization might influence ways in which they ‘make sense’ of their illness during recovery.
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Purpose

To explore patients' experiences of p-PCI and the way they ‘make sense’ of events.
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Methods

Mixed methods were used (Semi-structured interviews and Illness Perception Questionnaire—Revised version, (IPQ-R) Moss-Morris et al. 2002) and a purposive sample of 29 patients recruited from a specialist UK cardiac centre serving a population of over 2 million. The average age of participants was 60 years (range 36–83), 59% were male and 14% lived alone. Interviews were conducted 3–12 days after primary PCI. All participants were fluent in English, had no documented cognitive deficits or prior cardiac history. One-to-one interviews were audio-taped and transcribed verbatim. NVivo software was used in conjunction with Framework Analysis techniques to systematically order and synthesize findings. As part of this method, a priori issues and available literature were integrated into the data analysis. A thematic framework to guide analysis was reached by consensus with a researcher not involved in the interview process and subsequently applied to all the transcripts. Scores from the IPQ-R were used to illuminate and inform qualitative data.
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Result

Patients often experienced a mismatch between their expectations and reality. They often expected to have a general anesthetic and more procedural pain. The lack of a scar and unexpected feelings of energy was incongruent with the seriousness of their condition. Quantitative data supported the notion that patients experienced difficulty in ‘making sense’ of their condition. They tended to see their condition as ‘acute’ rather than ‘chronic’ and their treatment as curative.
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Conclusions

Collaborative discussions between patients and health professional about their interpretations of their p-PCI experience may promote a more coherent understanding