Facing the diagnosis of myocardial infarction: a qualitative study

Patient experience is increasingly recognized as one of the three pillars of quality in health care, alongside clinical effectiveness and patient safety. However, little attention has been paid to the patients' experience from the point of view of health care delivery.

To explore the initial experience of patients facing a new diagnosis of myocardial infarction (MI).

Thirty semi-structured, individual interviews were performed. The Grounded Theory method was used. Atlas.ti qualitative data analysis software facilitated the analysis.

Three patterns of MI diagnosis experience were found: a close encounter with death, severe pain, and 'silent' MI. Newly-diagnosed MI patients who experienced a close encounter with death expected that, after necessary life-saving measures, their physician would not force immediate conversation, but leave them alone, simply to take pleasure in being alive. Newly-diagnosed MI patients who did not experience a close encounter with death expected that their physician would provide not only medical care but also immediate emotional support and opportunities to discuss in their own words their ideas, thoughts, concerns and fears. Six factors facilitated patients coping with a new diagnosis of MI: stay in hospital, completion of diagnostic tests, trust in physicians, the patient's previous expectation that he/she could have a heart attack, the patient's personality, and the need for solitude.

Physicians should be aware that different patterns of patient experience when facing MI could indicate patients' differing needs for immediate emotional support and communication.