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Published on: April 19, 2019
Designing a Web-Based Psychological Intervention for Patients With Myocardial Infarction With Nonobstructive Coronary
Sophia Monica Humphries1, Elisabet Rondung2, Fredrika Norlund1
1Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
Background:
The involvement of patient research partners (PRPs) in research aims to safeguard the needs of patient groups and produce new interventions that are developed based on patient input. Myocardial infarction with nonobstructive coronary arteries (MINOCA), unlike acute myocardial infarction (MI) with obstructive coronary arteries, is presented with no significant obstructive coronary artery disease. Patients with this diagnosis are a subset of those diagnosed with traditional MI and often need more psychological support, something that is presently not established in the current treatment scheme in Swedish health care or elsewhere, to our knowledge. An internet-delivered intervention might offer patients with MINOCA the opportunity to access a psychological treatment that is tailored to their specific needs after MINOCA and could therefore supplement the existing medical care in an easily accessible format.
Objective:
This paper aims to describe the development of a therapist-guided, internet-delivered psychological intervention designed specifically for patients with MINOCA.
Methods:
The study used a participatory design that involved 7 PRPs diagnosed with MINOCA who collaborated with a team consisting of researchers, cardiologists, and psychologists. Intervention content was developed iteratively and presented to the PRPs across several prototypes, each continually adjusted and redesigned according to the feedback received. The intervention and experience of it were discussed by PRPs in a final meeting and then presented to a panel of 2 clinical psychologists and a cardiologist for further input.
Results:
The outcome of the collaboration between PRPs and the research group produced a web-based psychological 9-step program focusing on stress, worry, and valued action. The input from PRPs contributed substantially to the therapy content, homework tasks, interactive activities, multimedia, and design presentation.
Conclusions:
Working with PRPs to develop an intervention for people with MINOCA produced a web-based intervention that can be further evaluated with the goal of offering a new psychological treatment option to a patient group currently without one. Direct contribution from PRPs enabled us to obtain relevant, insightful, and valuable feedback that was put towards the overall design and content of the intervention.
Insights
Patient research partners co-developed an internet-delivered psychological intervention for Myocardial Infarction with Non-Obstructive Coronary Arteries (MINOCA) patients. This tailored program addresses psychological needs unmet by current care, offering a new treatment avenue.
Area of Science:
- Cardiology
- Psychology
- Digital Health
Background:
- Myocardial Infarction with Non-Obstructive Coronary Arteries (MINOCA) is a distinct condition from traditional MI, often requiring specialized psychological support.
- Current healthcare schemes, including in Sweden, lack established psychological treatment protocols for MINOCA patients.
- Internet-delivered interventions present a scalable and accessible solution to meet the psychological needs of MINOCA patients.
Purpose of the Study:
- To describe the development of a therapist-guided, internet-delivered psychological intervention tailored for MINOCA patients.
- To incorporate patient perspectives throughout the intervention design process.
Main Methods:
- A participatory design approach involving 7 MINOCA patient research partners (PRPs).
- Iterative development of intervention content based on continuous PRP feedback across multiple prototypes.
- Final review and input from a panel of clinical psychologists and a cardiologist.
Main Results:
- A 9-step, web-based psychological program was co-created, focusing on stress, worry, and valued action.
- PRP input significantly influenced therapy content, homework, activities, multimedia, and overall design.
- The collaborative process ensured the intervention's relevance and applicability to the target patient group.
Conclusions:
- The co-developed web-based intervention offers a potential new psychological treatment for MINOCA patients.
- Patient research partners' direct involvement was crucial for creating a relevant and valuable intervention.
- Further evaluation is needed to establish this intervention as a supplementary treatment option for MINOCA care.
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