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Word descriptors in suspected acute myocardial infarction: a comparison between patients with and without confirmed
C Hofgren1, B W Karlson, F Gaston-Johansson
1Division of Cardiology, Sahlgrenska Hospital, Goteborg, Sweden.
Insights
Patients admitted for suspected acute myocardial infarction (AMI) do not consistently use unique pain descriptors. Word choice differences were minor and insufficient for differentiating confirmed AMI cases from non-AMI cases.
Area of Science:
- Cardiology
- Medical Linguistics
- Patient Experience
Background:
- A significant number of patients admitted for suspected acute myocardial infarction (AMI) do not ultimately receive this diagnosis.
- Differentiating between patients with and without confirmed AMI based on initial presentation is clinically important.
Purpose of the Study:
- To investigate if patients with confirmed AMI utilize distinct verbal pain descriptors compared to those without AMI.
- To determine if specific sensory or affective words can reliably differentiate between these patient groups.
Main Methods:
- Retrospective descriptive study design.
- Utilized the Pain-O-Meter, a validated verbal pain scale with sensory and affective word descriptors.
- Analyzed data from 889 consecutive patients admitted to a coronary care unit for suspected AMI.
Main Results:
- Patients with confirmed AMI showed statistically significant differences in using "tearing" (more frequent) and "pricking" (less frequent) sensory descriptors compared to non-AMI patients.
- Affective descriptors showed differences, with confirmed AMI patients using "terrifying" and "intolerable" more frequently, and "worrying" less frequently.
- Women, overall, used stronger pain descriptors more often than men.
Conclusions:
- The study did not find sufficient evidence to support the use of specific pain word descriptors for reliably differentiating patients with confirmed AMI from those without.
- While some word usage differences exist, they do not constitute a distinct clinical profile for diagnosis.
- Further research may be needed to explore nuanced pain communication in cardiac patients.
Background:
Acute myocardial infarction (AMI) will not develop in a large proportion of patients admitted to the coronary care unit because of suspected AMI.
Objective:
To evaluate whether patients with confirmed AMI use different words to describe their pain than patients in whom AMI was not confirmed.
Design:
A retrospective descriptive design.
Methods:
The Pain-O-Meter, a verbal pain scale composed of 12 sensory and 10 emotional word descriptors, was used to assess pain.
Setting:
Coronary care unit in Sahlgrenska Hospital in Goteborg, Sweden.
Subjects:
A convenience sample of 889 consecutive patients admitted to the coronary care unit because of suspected AMI.
Results:
SENSORY COMPONENT--patients with confirmed AMI differed from those without AMI in the use of the words "pricking" (12% vs 17%; p < 0.05) and "tearing" (11% vs 6%; p < 0.05). No difference was found in the remaining 10 words. Affective components--Patients with confirmed AMI differed from those without AMI in the use of "terrifying" (29% vs 18%; p < 0.001), "intolerable" (16% vs 10%; p < 0.01), and "worrying" (48% vs 59%; p < 0.01). Women used stronger word descriptors more frequently than men.
Conclusion:
The use of specific or more word descriptors to separate patients with AMI from those without AMI was not supported by the study data. Although patients with AMI more frequently used the sensory word tearing as well as the affective words terrifying and intolerable and less frequently used the sensory word pricking and the affective word worrying than patients without AMI, the differences do not suggest a clinical profile that can be used to differentiate these clinical entities.