title: Manageability, vulnerability and interaction: a qualitative analysis of acute myocardial infarction patients' conceptions of the event.
abstract: BACKGROUND
  Delay in seeking care remains a problem for many patients with myocardial infarction. There is a great deal of knowledge available about clinical factors contributing to this delay, while studies focusing on the patients' own experiences are few.
  
  
  OBJECTIVE
  Describe variations in how individuals perceived suffering symptoms of an acute myocardial infarction.
  
  
  METHODS
  A qualitative method using phenomenographic design was applied. Interviews were conducted with 15 strategically selected patients with myocardial infarction.
  
  
  RESULTS
  Eight sub-categories in the pre-hospital phase were summarised into three categories: manageability, vulnerability, and interaction. To manage their situation, patients expressed a need to understand it and to have a similar situation to compare with. They also described coping with the arising threat to their lives by self-medication or denying their symptoms. Patients expressed vulnerability, with feelings of anxiety, both as triggers and barriers to seeking medical care. In interaction with others, psychosocial support and guidance from the environment, was fundamental in helping the patients to manage the situation.
  
  
  CONCLUSIONS
  There were large variations in myocardial infarction patients' conceptions of the event. To improve disease management in the pre-hospital phase, the awareness of this large variation in conceptions about suffering symptoms of an myocardial infarction could be used in the dialogue between patients and health care professionals, in cardiac prevention programmes, as well as in health care education.
authors.affiliation: Department of Cardiology, University Hospital, Linköping, Sweden; Department of Medicine and Care, Linköping University, Linköping, Sweden. ingela.johansson@lio.se
authors.forename: Ingela
authors.initials: I
authors.lastname: Johansson
authors.forename: Eva
authors.initials: E
authors.lastname: Swahn
authors.forename: Anna
authors.initials: A
authors.lastname: Strömberg
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000209:etiology / Q000523:psychology; D003657:Decision Making; D003717:Denial, Psychological; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000517:prevention & control / Q000523:psychology*; D015404:Nursing Methodology Research; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D011369:Professional-Patient Relations; D036301:Qualitative Research; D012648:Self Care / Q000379:methods / Q000523:psychology; D020377:Self Efficacy; D012720:Severity of Illness Index; D012944:Social Support; D011795:Surveys and Questionnaires; D013548:Sweden; D035862:Vulnerable Populations / Q000523:psychology*