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• Commentary: Symptoms in patients with takotsubo syndrome: a qualitative interview study
  Laura Craigie
  Published on: 18 January 2017
• Re:Commentary: Symptoms in patients with takotsubo syndrome: a qualitative interview study
  Sara Wallstrom
  Published on: 5 January 2017
• Commentary: Symptoms in patients with takotsubo syndrome: a qualitative interview study
  Laura Craigie
  Published on: 23 November 2016

• Published on: 18 January 2017

  Commentary: Symptoms in patients with takotsubo syndrome: a qualitative interview study

  • Laura Craigie, Nurse Clinician McGill University Health Centre

  Wallström, S., Ulin, K., Omerovic, E., & Ekman, I. (2016). Symptoms in patients with takotsubo syndrome: a qualitative interview study. BMJ open, 6(10), e011820.

  The study “Symptoms in patients with takotsubo syndrome: a qualitative interview study” was a very interesting read. As a critical care cardiology nurse in Canada I found the results very informative for practice. I really appreciated that this phenomenon was explored by two registered nurse interviewers.

  One section that was well done that is often not included in qualitative studies was the Methodological considerations section. Each aspect of trustworthiness was broken down and justified in terms of this study. However, no justification for the sample size of n=25 was mentioned, nor was the idea of data saturation. In the strengths and limitations information box, small sample size was listed as a limitation; yet in the methodological consideration section the sample size was discussed as being large for a phenomenological study. For qualitative research the value is placed on richness of data rather than number of participants. I wonder if saturation had been the goal, would there have needed to be so many participants. The use of quotations helped to illustrate the themes, but I would have liked to see some longer quotations in the original context to deepen the richness of the study.

  Overall I really enjoyed this study, and I believe it is very relevant to practice. As a practicing...

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  Wallström, S., Ulin, K., Omerovic, E., & Ekman, I. (2016). Symptoms in patients with takotsubo syndrome: a qualitative interview study. BMJ open, 6(10), e011820.

  The study “Symptoms in patients with takotsubo syndrome: a qualitative interview study” was a very interesting read. As a critical care cardiology nurse in Canada I found the results very informative for practice. I really appreciated that this phenomenon was explored by two registered nurse interviewers.

  One section that was well done that is often not included in qualitative studies was the Methodological considerations section. Each aspect of trustworthiness was broken down and justified in terms of this study. However, no justification for the sample size of n=25 was mentioned, nor was the idea of data saturation. In the strengths and limitations information box, small sample size was listed as a limitation; yet in the methodological consideration section the sample size was discussed as being large for a phenomenological study. For qualitative research the value is placed on richness of data rather than number of participants. I wonder if saturation had been the goal, would there have needed to be so many participants. The use of quotations helped to illustrate the themes, but I would have liked to see some longer quotations in the original context to deepen the richness of the study.

  Overall I really enjoyed this study, and I believe it is very relevant to practice. As a practicing cardiology nurse who sees 5-10 takotsubo patients per year, I will be adapting my practice to include more discussion of illness narratives. I will also be including more focused discharge educating for my clients on expectations regarding residual symptoms, as it seems this was a key concern of many of the patients interviewed. I think this study has very important and relevant findings for cardiology nurses who treat takotsubo patients.

  These findings could be particularly useful when placed in the context of Leventhal’s Self-Regulatory Model (Leventhal & Cameron, 1987) to answer the need for further research on integrating illness experience and symptoms into patient-centered care. This model explains how people build perceptions of their illness based on what makes sense to them, how these perceptions then influence their coping behaviors, and how they evaluate their coping responses. I think integrating the finding of this study with this model could help to prevent initial maladaptive coping that was found in the Fear of permanent illness section. I think this could be an interesting area of future study for intervention with takotsubo patients considering the significant amount of worry expressed by participants surrounding residual symptoms. Further research is undeniably needed on this important topic of symptom and illness experience.

  Laura Craigie R.N., BN(I)., CCN(C).
  Student of Master of Science Applied in Nursing Education
  Ingram School Of Nursing
  McGill University
  Montreal, Quebec
  Canada

  Reference:
  1. Leventhal, H., & Cameron, L. (1987). Behavioral theories and the problem of compliance. Patient Education and Counseling, 10(2), 117- 138.

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  Conflict of Interest:
  None declared.

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• Published on: 5 January 2017

  Re:Commentary: Symptoms in patients with takotsubo syndrome: a qualitative interview study

  • Sara Wallstrom, PhD-student, RN

  Dear Ms Craigie,

  Thank you for taking the time to read and response to Wallstrom, S., Ulin, K., Omerovic, E., & Ekman, I. (2016). Symptoms in patients with takotsubo syndrome: a qualitative interview study. BMJ open, 6(10), e011820. I am glad you find the article informative and useful in practice. I would, however, like to address your concerns. First, regarding sample size, richness of data and saturation...

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  Dear Ms Craigie,

  Thank you for taking the time to read and response to Wallstrom, S., Ulin, K., Omerovic, E., & Ekman, I. (2016). Symptoms in patients with takotsubo syndrome: a qualitative interview study. BMJ open, 6(10), e011820. I am glad you find the article informative and useful in practice. I would, however, like to address your concerns. First, regarding sample size, richness of data and saturation. I agree that it seems like a contradiction to say that the sample size is small compared to quantitative studies, and large for a phenomenological hermeneutic study. The sample size is depending on the scientific method you use in the respective study, in qualitative studies the meaning of phenomena is in focus and not numbers and quantities. When conducting the interviews, we had no specific number as a target. Instead we strived for rich interviews and continued to conduct interviews until the research question was answered. Saturation is not a concept usually referred to in connection to phenomenological hermeneutics and that is why we have chosen not to use the term in the article. Instead interviews are done until the research question is adequately answered and this was also the case in this study.

  Second, regarding quotations. I am glad that you found the quotations informative and helpful. I initially wanted to have more and longer quotations but we had to make the hard choice to omit some in order to make the article concise and not too long.

  Last, thank you for your recommendation of Leventhal's Self- Regulatory Model (Leventhal & Cameron, 1987). I will certainly look into it and take it into consideration in future research.

  Kind Regards

  Sara Wallstrom

  Conflict of Interest:

  None declared

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  Conflict of Interest:
  None declared.

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• Published on: 23 November 2016

  Commentary: Symptoms in patients with takotsubo syndrome: a qualitative interview study

  • Laura Craigie, Nurse Clinician

  Wallstrom, S., Ulin, K., Omerovic, E., & Ekman, I. (2016). Symptoms in patients with takotsubo syndrome: a qualitative interview study. BMJ open, 6(10), e011820.

  The study "Symptoms in patients with takotsubo syndrome: a qualitative interview study" was a very interesting read. As a critical care cardiology nurse in Canada I found the results very informative for practice. I really appreciated that this phe...

  Show More

  Wallstrom, S., Ulin, K., Omerovic, E., & Ekman, I. (2016). Symptoms in patients with takotsubo syndrome: a qualitative interview study. BMJ open, 6(10), e011820.

  The study "Symptoms in patients with takotsubo syndrome: a qualitative interview study" was a very interesting read. As a critical care cardiology nurse in Canada I found the results very informative for practice. I really appreciated that this phenomenon was explored by two registered nurse interviewers.

  One section that was well done that is often not included in qualitative studies was the Methodological considerations section. Each aspect of trustworthiness was broken down and justified in terms of this study. However, no justification for the sample size of n=25 was mentioned, nor was the idea of data saturation. In the strengths and limitations information box, small sample size was listed as a limitation; yet in the methodological consideration section the sample size was discussed as being large for a phenomenological study. For qualitative research the value is placed on richness of data rather than number of participants. I wonder if saturation had been the goal, would there have needed to be so many participants. The use of quotations helped to illustrate the themes, but I would have liked to see some longer quotations in the original context to deepen the richness of the study.

  Overall I really enjoyed this study, and I believe it is very relevant to practice. As a practicing cardiology nurse who sees 5-10 takotsubo patients per year, I will be adapting my practice to include more discussion of illness narratives. I will also be including more focused discharge educating for my clients on expectations regarding residual symptoms, as it seems this was a key concern of many of the patients interviewed. I think this study has very important and relevant findings for cardiology nurses who treat takotsubo patients.

  These findings could be particularly useful when placed in the context of Leventhal's Self-Regulatory Model (Leventhal & Cameron, 1987) to answer the need for further research on integrating illness experience and symptoms into patient-centered care. This model explains how people build perceptions of their illness based on what makes sense to them, how these perceptions then influence their coping behaviors, and how they evaluate their coping responses. I think integrating the finding of this study with this model could help to prevent initial maladaptive coping that was found in the Fear of permanent illness section. I think this could be an interesting area of future study for intervention with takotsubo patients considering the significant amount of worry expressed by participants surrounding residual symptoms. Further research is undeniably needed on this important topic of symptom and illness experience.

  Laura Craigie R.N., BN(I)., CCN(C). Student of Master of Science Applied in Nursing Education Ingram School Of Nursing McGill University Montreal, Quebec Canada

  Conflict of Interest:

  None declared

  Show Less

  Conflict of Interest:
  None declared.

  • Back to top