Article Text
Abstract
Objective A number of studies have explored delayed help-seeking practices for acute coronary syndrome (ACS) and have indentified multiple intersecting factors which may play a role, for example, attributing symptoms, age, gender, ethnicity and contextual influences. However, the pathway to diagnosis for suspected coronary heart disease (CHD) symptoms in a rapid access chest pain clinic (RACPC) context is underexplored. The objective of this study was to examine patients’ help-seeking experiences of accessing RACPC services, from the point at which they notice and interpret symptoms, to their decision to seek help from their general practitioner.
Design Qualitative study.
Setting Interviews were conducted in the RACPC at Queen Mary’s Roehampton Hospital, London, UK.
Participants Maximum variation sampling was used to recruit 30 participants (15 men and 15 women) referred to a RACPC, using sampling dimensions of age, ethnicity and occupation.
Methods Semi-structured interviews focussed on the patient experience of their pathway to the RACPC. Thematic analysis was used to analyse the interview data.
Results Participant interpretation of symptoms was shaped by multiple influences; reluctance to seek help contributed to delay; various factors acted as drivers as well as barriers to help-seeking; and GP referrals to RACPC were based on symptoms as well as patients’ need for reassurance.
Conclusion We found complex issues shaped the patient’s decision-making when accessing the RACPC, including making sense of symptoms and help-seeking practices. These findings can be used to develop health promotion literature to encourage early help-seeking and improve RACPC services.
- “coronary disease”
- “symptom assessment”
- “help-seeking behaviour”
- “health services accessibility”
- “rapid access chest pain clinic”
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Supplementary materials
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This web only file has been produced by the BMJ Publishing Group from an electronic file supplied by the author(s) and has not been edited for content.
Supplementary Data
This web only file has been produced by the BMJ Publishing Group from an electronic file supplied by the author(s) and has not been edited for content.
Footnotes
Twitter @drnolanstain
Contributors NS conceived the study with input and guidance from DR and AC. NS conducted the interviews. NS analysed the interviews with support from DR and AC. NS drafted the first version of the manuscript. NS and CR revised and restructured the manuscript. DR and AC reviewed and provided input to all drafts. All authors critically read, revised and approved the final manuscript. NS is guarantor. NS is a clinical scientist and was a Professional Doctorate candidate at the time of conducting the study. DR is a Professor of Health Sciences and Research Director of the College of Liberal Arts and Sciences at the University of Westminster. AC is Research Fellow at the University of Westminster. CR is a clinical scientist and Scientific Lead at NHS England.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent for publication Not required.
Ethics approval NHS Health Research Authority Fulham Research Committee granted approval (Reference no. 14/LO/0169). Research and Development approval was granted from St George’s Joint Enterprise Research Office (Reference no. 14.0007).
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information. Since complete transcripts of interviews potentially allow for identification of individuals, complete transcripts are not provided.
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