Pre-Hospital Decision Process and Prognosis in Men and Women with Coronary Heart Disease

摘要: The overall aim of this thesis was to describe experiences, strategies and actions in the prehospital phase among patients with a first acute myocardial infarction examine long-term trends survival coronary heart disease. consists two qualitative quantitative studies. Interviews were conducted 21 men 17 women, experiencing symptoms from (AMI) analyzed Grounded Theory. Two national prospective cohort studies performed by using Swedish Inpatient register (IPR). From this, prognosis for 37,276 adult 18 years who underwent artery bypass (CABG) 1987-2006 could be estimated. During decision process, various spectra bodily changes described both sometimes over an extended period before submission hospital. Intermittent, vague insidious caused confusion about how act. Vague experienced did not match their preconception typical infarction. To come understanding they compared past experiences which led awareness abnormality, severity need contact medical attention. women usually attributed harmless conditions struggled continue responsibilities daily lives. Intensified made unable perform task no longer maintain earlier explanations discomfort contributed professional help. Sometimes, when sought attention discomfort, had objective signs AMI dismissed, diagnosis, hesitation care once again. This emphasizes that health professionals have pay more patient’s narrative. In part younger 2 4-fold risk mortality same age general population while 6 14-fold during last study (2002-2006). Survival increased men. there favorable trend until 2002-2006 but then reverted second (1992-1996) period. Men ≥55 surviving 30 days after CABG (coronary grafting) showed lower than those decreasing Women below 55 significant improvement population. <55 displayed improved survival, higher