Understanding the multi-faceted patient experience after spontaneous coronary artery dissection (SCAD)

𝗕𝗮𝗰𝗸𝗴𝗿𝗼𝘂𝗻𝗱 Spontaneous Coronary Artery Dissection (SCAD) has emerged as an important cause of acute myocardial infarction (AMI). SCAD disproportionally affects younger to middle-aged women. There is a considerable burden of adverse psychosocial outcomes including anxiety, depression and post-traumatic stress disorder after SCAD, yet research is limited on the experience of SCAD and its effects from the patient perspective. Understanding the person’s experience of SCAD is critical to the provision of patient-centred care. 𝗔𝗶𝗺𝘀 𝗮𝗻𝗱 𝗥𝗲𝘀𝗲𝗮𝗿𝗰𝗵 𝗤𝘂𝗲𝘀𝘁𝗶𝗼𝗻𝘀 The SCAD-Insights study aimed to gain a better understanding of the multifaceted patient experience and the impact of SCAD on people and their families for the purpose of informing supportive resources and services after a SCAD event. The questions that guided this research asked how people experience and make meaning of having SCAD, what facilitators and barriers exist in recovery and how existing resources and services that support recovery from SCAD are perceived. 𝗠𝗲𝘁𝗵𝗼𝗱𝘀 A feminist social constructionist approach underpinned the research design, and Interpretive Description methodology informed conduct of 17 individual semi-structured interviews with people after SCAD. Reflexive thematic analysis and a patient-centred care theoretical framework guided data analysis. 𝗙𝗶𝗻𝗱𝗶𝗻𝗴𝘀 In the first theme ‘SCAD is a mystery’, study participants reported experiencing a range of emotional responses including shock, denial, loss and loneliness. Emotional responses were exacerbated by a perceived lack of information about SCAD and the recovery process. All participants resorted to searching the internet for information. Study participants also described the perceived effects on their families and social circles. In the second theme ‘SCAD is life changing’, study participants reported on the ways in which they adapted to their lives after SCAD. Participation in cardiac rehabilitation had mixed reviews of its appropriateness and effectiveness. In the third theme ‘Finding the SCAD community’, participants described their experience in social media support groups, which provided benefits to and disadvantages in their recovery. 𝗖𝗼𝗻𝗰𝗹𝘂𝘀𝗶𝗼𝗻 A SCAD event is followed by uncertainty and frustration, with a fear of recurrence and changes to identity and lifestyle. Social media support groups fill a void in the information gap for people after SCAD. The experience of people after SCAD mirrors that of women after a ‘traditional’ AMI and people with rare disease conditions. People report a lack of information and support for recovery. The findings reinforce the need for patient-centred care that better supports people after SCAD and that may serve to reduce adverse negative mental health outcomes.

Author dc:creator

• Turner, Elizabeth Anne

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• info:eu-repo/semantics/openAccess
• The author owns the copyright in this thesis including all reproduction and reuse rights for the work. The work may not be altered without the permission of the copyright owner. Attribution is essential when quoting or paraphrasing from this thesis.
• © 2024 Elizabeth Anne Turner
• au.edu.uts.lib/cph

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en_US

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http://hdl.handle.net/10453/182357

OAI identifier oai:identifier

oai:opus.lib.uts.edu.au:10453/182357