title: Chest pain among combat veterans: a conceptual framework.
abstract: This article describes the decision-making processes regarding seeking treatment for the symptom of chest pain in a population of combat veterans with post-traumatic stress disorder and panic disorder. Qualitative methods and standardized tools were used to explore the prehospital experiences of combat veterans who met diagnostic criteria for post-traumatic stress disorder, panic disorder, and admission to a coronary care unit for the symptom of chest pain. Semistructured audiotaped interviews were conducted. Obtaining medical treatment for the chest pain was dependent on internal and external motivating forces outweighing internal and external restraining forces in the decision-making process. The experience of military training influenced responses because of the expectation of self-reliance. A conceptual model emerged from the data that described the influences and restraints in seeking medical treatment.
authors.affiliation: Department of Veterans Affairs, Greater Los Angeles Healthcare System, Sepulveda Ambulatory Care Center, Sepulveda, CA 91343, USA.
authors.forename: Natalie Matson
authors.initials: NM
authors.lastname: Alcaras
authors.forename: Janice M
authors.initials: JM
authors.lastname: Roper
mesh_terms: D000368:Aged; D002637:Chest Pain / Q000175:diagnosis* / Q000523:psychology; D003130:Combat Disorders / Q000150:complications / Q000175:diagnosis*; D003325:Coronary Care Units / Q000706:statistics & numerical data; D003657:Decision Making; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009042:Motivation; D016584:Panic Disorder / Q000150:complications / Q000175:diagnosis*; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D036301:Qualitative Research; D018570:Risk Assessment; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014481:United States; D014728:Veterans / Q000523:psychology*; D014857:Warfare