TY - JOUR

T1 - "I just haven't experienced anything like this before"

T2 - A qualitative exploration of callers' interpretation of experienced conditions in telephone consultations preceding a myocardial infarction

AU - Jensen, Britta

AU - Vardinghus-Nielsen, Henrik

AU - Mills, Elisabeth Helen Anna

AU - Møller, Amalie Lykkemark

AU - Gnesin, Filip

AU - Zylyftari, Nertila

AU - Kragholm, Kristian

AU - Folke, Fredrik

AU - Christensen, Helle Collatz

AU - Blomberg, Stig Nikolaj

AU - Torp-Pedersen, Christian

AU - Bøggild, Henrik

N1 - Publisher Copyright: Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.

PY - 2023

Y1 - 2023

N2 - 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.

AB - 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.

KW - Atypical symptoms

KW - Communication

KW - Emergency medical services

KW - Myocardial infarction

KW - Qualitative content analysis

KW - Systems theory

U2 - 10.1016/j.pec.2023.107643

DO - 10.1016/j.pec.2023.107643

M3 - Journal article

C2 - 36716564

AN - SCOPUS:85148250484

VL - 109

JO - Patient Education and Counseling

JF - Patient Education and Counseling

SN - 0738-3991

M1 - 107643

ER -