health care quality improvement;
ischemia with non-obstructive coronary arteries (INOCA);
patient centered care;
patient journey map;
patients experiences;
qualitative study;
INTERNATIONAL STANDARDIZATION;
DIAGNOSTIC-CRITERIA;
CENTERED CARE;
HEALTH-CARE;
OF-LIFE;
ANGINA;
D O I:
10.1111/jocn.16409
中图分类号:
R47 [护理学];
学科分类号:
1011 ;
摘要:
Aims and objectives To visualise the health care experiences and needs of patients with ischemia with non-obstructive coronary arteries in a patient journey map. As such, future design challenges can be provided, and it can be used for future healthcare optimization. Background Ischemia with non-obstructive coronary arteries is a chronic cardiac condition caused by vascular dysfunctions. Ischemia with non-obstructive coronary arteries is often unrecognised, significantly impairs daily functioning, and is more prevalent among women. Patients' experiences remain unexplored, and a clear patient-centered care pathway is lacking. Design A qualitative interpretative research design was performed and the standards for reporting qualitative research (SRQR) has been used. Methods In total, 36 women were included and participated in eight semi-structured focus group interviews. Thematic analysis was used, and identified themes were further classified using 'patient journey mapping.' Additionally, Picker's 'eight principles of patient-centered care' were linked to the results and integrated in the patient journey map. Results Participants experienced a lack of familiarity with the specific cardiac condition by healthcare providers, repeated hospitalisation, testing and referrals, shortage of specialised cardiologists, and feelings of not being heard. In addition, needs for a multidisciplinary treatment program (including physical and psychological support), better information provision, and an easily accessible contact person were expressed. Conclusions The resulting patient journey map shows how patients experienced and interacted with the current healthcare system. Overall, the results show a complex and long healthcare pathway and important themes for healthcare experiences and needs were identified. Future research could focus on the development and implementation of a patient-centered evidence-based clinical pathway optimising experiences and quality of life. Relevance to clinical practice The visual tool can help health care professionals, policy makers, and researchers improve healthcare provision which is patient-centered and tailored to the preferences of patients with ischemia with non-obstructive coronary arteries.
机构:
Huazhong Univ Sci & Technol, Union Shenzhen Hosp, Dept Cardiol, Shenzhen, Peoples R ChinaHuazhong Univ Sci & Technol, Union Shenzhen Hosp, Dept Cardiol, Shenzhen, Peoples R China
Huang, Bihan
Han, Xueying
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机构:
Huazhong Univ Sci & Technol, Union Shenzhen Hosp, Dept Intens Care, Shenzhen, Peoples R ChinaHuazhong Univ Sci & Technol, Union Shenzhen Hosp, Dept Cardiol, Shenzhen, Peoples R China
Han, Xueying
Xie, Peiyi
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机构:
Huazhong Univ Sci & Technol, Union Shenzhen Hosp, Dept Cardiol, Shenzhen, Peoples R ChinaHuazhong Univ Sci & Technol, Union Shenzhen Hosp, Dept Cardiol, Shenzhen, Peoples R China
Xie, Peiyi
Chen, Shaoyuan
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h-index: 0
机构:
Huazhong Univ Sci & Technol, Union Shenzhen Hosp, Dept Cardiol, Shenzhen, Peoples R China
Shenzhen Univ, Affiliated Hosp 6, Med Sch, Dept Cardiol, Shenzhen, Peoples R ChinaHuazhong Univ Sci & Technol, Union Shenzhen Hosp, Dept Cardiol, Shenzhen, Peoples R China
机构:
Capital Med Univ, Natl Clin Res Ctr Geriatr Dis, Dept Geriatr, Xuanwu Hosp, 45 Changchun St, Beijing 100053, Peoples R ChinaCapital Med Univ, Natl Clin Res Ctr Geriatr Dis, Dept Geriatr, Xuanwu Hosp, 45 Changchun St, Beijing 100053, Peoples R China
Xiao, Keling
Liu, Machao
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Capital Med Univ, Div Cardiol, Xuanwu Hosp, 45 Changchun St, Beijing 100053, Peoples R ChinaCapital Med Univ, Natl Clin Res Ctr Geriatr Dis, Dept Geriatr, Xuanwu Hosp, 45 Changchun St, Beijing 100053, Peoples R China
Liu, Machao
Sun, Xipeng
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Capital Med Univ, Div Cardiol, Xuanwu Hosp, 45 Changchun St, Beijing 100053, Peoples R ChinaCapital Med Univ, Natl Clin Res Ctr Geriatr Dis, Dept Geriatr, Xuanwu Hosp, 45 Changchun St, Beijing 100053, Peoples R China
Sun, Xipeng
Zhang, Yinghua
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Capital Med Univ, Natl Clin Res Ctr Geriatr Dis, Dept Geriatr, Xuanwu Hosp, 45 Changchun St, Beijing 100053, Peoples R ChinaCapital Med Univ, Natl Clin Res Ctr Geriatr Dis, Dept Geriatr, Xuanwu Hosp, 45 Changchun St, Beijing 100053, Peoples R China
Zhang, Yinghua
Si, Jin
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Capital Med Univ, Natl Clin Res Ctr Geriatr Dis, Dept Geriatr, Xuanwu Hosp, 45 Changchun St, Beijing 100053, Peoples R ChinaCapital Med Univ, Natl Clin Res Ctr Geriatr Dis, Dept Geriatr, Xuanwu Hosp, 45 Changchun St, Beijing 100053, Peoples R China
Si, Jin
Shi, Ning
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Capital Med Univ, Natl Clin Res Ctr Geriatr Dis, Dept Geriatr, Xuanwu Hosp, 45 Changchun St, Beijing 100053, Peoples R ChinaCapital Med Univ, Natl Clin Res Ctr Geriatr Dis, Dept Geriatr, Xuanwu Hosp, 45 Changchun St, Beijing 100053, Peoples R China
Shi, Ning
Sun, Lijie
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Capital Med Univ, Natl Clin Res Ctr Geriatr Dis, Dept Geriatr, Xuanwu Hosp, 45 Changchun St, Beijing 100053, Peoples R ChinaCapital Med Univ, Natl Clin Res Ctr Geriatr Dis, Dept Geriatr, Xuanwu Hosp, 45 Changchun St, Beijing 100053, Peoples R China
Sun, Lijie
Miao, Zupei
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Capital Med Univ, Natl Clin Res Ctr Geriatr Dis, Dept Geriatr, Xuanwu Hosp, 45 Changchun St, Beijing 100053, Peoples R ChinaCapital Med Univ, Natl Clin Res Ctr Geriatr Dis, Dept Geriatr, Xuanwu Hosp, 45 Changchun St, Beijing 100053, Peoples R China
Miao, Zupei
Zhang, Haoyu
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机构:
Capital Med Univ, Natl Clin Res Ctr Geriatr Dis, Dept Geriatr, Xuanwu Hosp, 45 Changchun St, Beijing 100053, Peoples R ChinaCapital Med Univ, Natl Clin Res Ctr Geriatr Dis, Dept Geriatr, Xuanwu Hosp, 45 Changchun St, Beijing 100053, Peoples R China
Zhang, Haoyu
Zhao, Ting
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机构:
Capital Med Univ, Natl Clin Res Ctr Geriatr Dis, Dept Geriatr, Xuanwu Hosp, 45 Changchun St, Beijing 100053, Peoples R ChinaCapital Med Univ, Natl Clin Res Ctr Geriatr Dis, Dept Geriatr, Xuanwu Hosp, 45 Changchun St, Beijing 100053, Peoples R China
Zhao, Ting
Liu, Zhi
论文数: 0引用数: 0
h-index: 0
机构:
Capital Med Univ, Div Cardiol, Xuanwu Hosp, 45 Changchun St, Beijing 100053, Peoples R ChinaCapital Med Univ, Natl Clin Res Ctr Geriatr Dis, Dept Geriatr, Xuanwu Hosp, 45 Changchun St, Beijing 100053, Peoples R China
Liu, Zhi
Fan, Zhenxing
论文数: 0引用数: 0
h-index: 0
机构:
Capital Med Univ, Div Cardiol, Xuanwu Hosp, 45 Changchun St, Beijing 100053, Peoples R ChinaCapital Med Univ, Natl Clin Res Ctr Geriatr Dis, Dept Geriatr, Xuanwu Hosp, 45 Changchun St, Beijing 100053, Peoples R China
Fan, Zhenxing
Gao, Jing
论文数: 0引用数: 0
h-index: 0
机构:
Capital Med Univ, Div Cardiol, Xuanwu Hosp, 45 Changchun St, Beijing 100053, Peoples R ChinaCapital Med Univ, Natl Clin Res Ctr Geriatr Dis, Dept Geriatr, Xuanwu Hosp, 45 Changchun St, Beijing 100053, Peoples R China
Gao, Jing
Li, Jing
论文数: 0引用数: 0
h-index: 0
机构:
Capital Med Univ, Natl Clin Res Ctr Geriatr Dis, Dept Geriatr, Xuanwu Hosp, 45 Changchun St, Beijing 100053, Peoples R ChinaCapital Med Univ, Natl Clin Res Ctr Geriatr Dis, Dept Geriatr, Xuanwu Hosp, 45 Changchun St, Beijing 100053, Peoples R China
机构:
Ulsan Univ Hosp, Univ Ulsan Coll Med, Dept Med, Ulsan, South Korea
Ernst Moritz Arndt Univ Greifswald, Dietrich Bonhoeffer Hosp, Div Cardiol, Acad Teaching Hosp, Greifswald, GermanyUlsan Univ Hosp, Univ Ulsan Coll Med, Dept Med, Ulsan, South Korea
Shin, Eun-Seok
Park, Jai-Wun
论文数: 0引用数: 0
h-index: 0
机构:
Ernst Moritz Arndt Univ Greifswald, Dietrich Bonhoeffer Hosp, Div Cardiol, Acad Teaching Hosp, Greifswald, GermanyUlsan Univ Hosp, Univ Ulsan Coll Med, Dept Med, Ulsan, South Korea
Park, Jai-Wun
Lim, Do-Sun
论文数: 0引用数: 0
h-index: 0
机构:
Korea Univ, Anam Hosp, Cardiovasc Ctr, Dept Cardiol, 126-1,5ka Anam Dong, Seoul 136705, South KoreaUlsan Univ Hosp, Univ Ulsan Coll Med, Dept Med, Ulsan, South Korea
机构:
Univ Fed Sao Paulo UNIFESP, Sao Paulo, SP, Brazil
Univ Fed Sao Paulo, Rua Loefgren 1350, BR-04040001 Sao Paulo, SP, BrazilUniv Fed Sao Paulo UNIFESP, Sao Paulo, SP, Brazil