Long-term psychological consequences of symptomatic pulmonary embolism: a qualitative study
Long-term psychological consequences of symptomatic pulmonary embolism: a qualitative study
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DOI：
10.1136/bmjopen-2013-004561
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发表时间：
2014-01-01
期刊：
影响因子：
2.9
通讯作者：
Bennett, Paul
中科院分区：
文献类型：
--
作者：
Noble, Simon;Lewis, Rhian;Bennett, Paul
目的探讨症状性肺栓塞(PE)患者的心理后果，采用解释性现象学分析方法，设计定性访谈研究，选取某地区综合医院抗凝门诊就诊患者，对因有症状PE入院后到抗凝门诊就诊的患者进行访谈。共有11名患者中的9名(4名女性，5名男性)同意接受采访。受试者年龄在26岁至72岁之间，之前经历过9个月至60个月的PE(中位数为26个月，平均为24个月)。干预录音半结构定性访谈被用来探索参与者进行PE的经历及其对他们生活的影响。使用解释现象学分析对数据进行转录和分析，以确定紧急主题。结果确定了三个主要主题和相关的次主题。参与者将体育描述为一种改变生活的经历，包括最初的震惊，然后是失去自我的感觉，改变生活的决定和行为改变。创伤后应激障碍(PTSD)的特征被描述为闪回、高度警惕和侵入性思维最普遍。参与者确定了这类患者需要的几个方面的支持，包括通过提供信息和情感支持更容易获得支持。结论静脉血栓栓塞症的长期后果不仅仅是身体上的。患者描述说，经历有症状的PE是一种改变生活的痛苦事件，导致行为改变，在一些创伤后应激障碍中。早期的心理干预很可能会减少这种长期的后遗症。
Objective To explore the psychological consequences of experiencing symptomatic pulmonary embolism (PE).Design Qualitative interview-based study using interpretative phenomenological analysis.Setting Outpatients who attended an anticoagulation clinic in a district general hospital.Participants Patients attending an anticoagulation clinic following hospital admission for symptomatic PE were approached to participate. A total of 9 (4 women, 5 men) of 11 patients approached agreed to be interviewed. Participants were aged between 26 and 72years and had previously experienced a PE between 9 and 60months (median=26months, mean=24months).Intervention Audiotaped semistructured qualitative interviews were undertaken to explore participants experiences of having a PE and how it had affected their lives since. Data were transcribed and analysed using interpretative phenomenological analysis to identify emergent themes.Results Three major themes with associated subthemes were identified. Participants described having a PE as a life-changing experience comprising initial shock, followed by feeling of loss of self, life-changing decisions and behaviour modification. Features of post-traumatic stress disorder (PTSD) were described with flashbacks, hypervigilance and intrusive thoughts being most prevalent. Participants identified several areas of support needed for such patients including easier access to support through information giving and emotional support.Conclusions Long-term consequences of venous thromboembolism go beyond the physical alone. Patients describe experiencing symptomatic PE to be a life-changing distressing event leading to behaviour modification and in some PTSD. It is likely that earlier psychological intervention may reduce such long-term sequelae.