Citation Angus NJ (2005) The angina patient's journey: early uncertainties (Published Abstract). European Journal of Cardiovascular Nursing, 4 (1), pp. 57-58. https://doi.org/10.1177/147451510500400122
Abstract Purpose: Angina pectoris is the most common clinical manifestation of coronary artery disease. Although the purpose of medical management is to alleviate symptoms and minimise the risk of future cardiac events, it is also increasingly recognised that there is a need to improve other aspects of the angina patient's journey. Previous research identifies uncertainty as a significant part of the experience of heart disease. Uncertainty can be conceptualised as an inability to determine the meaning of illness-related events. This occurs when an individual is unable to meaningfully interpret illness and treatment cues or accurately predict outcomes. Patients are often uncertain about their diagnosis, investigation, treatment and interaction with health services. The present study aims to explore this aspect of patient experience, in the 6 months following clinical diagnosis, thereby contributing to an improved understanding of how patients view their situation and needs at this time.
Method: A prospective, longitudinal, mixed-method design was used to address the study aim. The researcher contacted and interviewed patients (n=73) on three occasions over a 6-month period. Instrumentation included measures of symptom severity (CLASP Profile), uncertainty in illness (MUIS-A), quality of life (SF-36 UK v2) and coping (Ways of Coping Questionnaire). A sub-group of participants was selected for in-depth interview on the basis of their uncertainty score.
Results: Preliminary findings identify that high levels of uncertainty were experienced during the first 6 months of the angina patient's journey. The extent of uncertainty varied depending on age, education and gender. In quality of life terms, physical component scores were consistently lower than population norms, the converse was observed for mental component scores. The major coping processes reported by patients included seeking of social support, distancing, planful problem solving and self-controlling. These processes varied in relation to gender and age. Review of interview data complemented quantitative findings and suggested that uncertainty arises from a range of existential, informational and illness management concerns.
Conclusion: Individuals with a new clinical diagnosis of angina report high levels of uncertainty. There is considerable scope to reduce this, thereby improving the patient's journey and enhancing secondary prevention gains. Observed patterns of coping behaviour highlight differences between individuals that should be considered when providing patient support. Tentative findings suggest a range of possible strategies to improve communication and care organisation that have potential to enhance the early part of the patient journey.
Journal European Journal of Cardiovascular Nursing: Volume 4, Issue 1