Coping with everyday life and physical activity in the aftermath of an acute pulmonary embolism: A qualitative study exploring patients' perceptions and coping strategies

Rolving, Nanna; Brocki, Barbara C.; Andreasen, Jane

doi:10.1016/j.thromres.2019.06.007

Cited by 33 publications

(62 citation statements)

References 25 publications

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“…Our findings are more in keeping with those described in two recent qualitative studies (from Germany and Denmark) 26,27 . Like us, they found anxiety and distress, as well as a heightened awareness of their bodily symptoms after being diagnosed with PE.…”

Section: Discussionsupporting

confidence: 92%

“…Our findings are more in keeping with those described in two recent qualitative studies (from Germany and Denmark). 26,27 Like us, they found anxiety and distress, as well as a heightened awareness of their bodily symptoms after being diagnosed with PE. These studies also reported instances where patients felt confusion or discomfort when advised to discontinue their anticoagulant therapy.…”

Section: Reliance On Medicationmentioning

confidence: 68%

“…Practical information about the disease, clarifying that PE is unrelated to strokes and heart attacks, might be helpful. This lack of expert information, poor communication, or disjointed healthcare provision appears in relation to negative psychological effects following PE in almost all prior studies 10,14,26,27 . Rapid access to expert care and advice should be considered a basic requirement for people who experience PE, and a first step toward mitigating the psychological distress.…”

Section: Discussionmentioning

confidence: 99%

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The psychological impact of pulmonary embolism: A mixed‐methods study

Tran

Redley

Wit

2021

Research and Practice in Thrombosis and Haemostasis

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Background Patients diagnosed with pulmonary embolism (PE) are reported to experience symptoms of posttraumatic stress disorder (PTSD) and existential anxiety following their diagnosis. They may also experience negative changes in perspective and hypervigilance of PE symptoms. Objective The aim of this study was to document the mental and emotional experience associated with PE diagnosis through the lens of PTSD, to better understand the factors involved in psychological distress following receipt of a PE diagnosis. Patients/Methods This was a mixed‐methods study in two parts: (i) measurement of self‐reported PTSD symptoms among patients attending thrombosis clinic and (ii) semistructured interviews with patients about their experience of receiving a diagnosis of PE and its psychological aftermath. Results Of 72 patients who participated in the survey, two met the criteria for a tentative diagnosis of PTSD. The semistructured interviews with 37 patients suggested that around half of respondents experienced some degree of ongoing psychological distress. Those with psychological distress often recalled painful symptoms, recalled diagnosis delivery as stressful, worried about PE recurrence, and had anxieties about stopping their anticoagulant medication. Few patients reported inclination to seek support from professional mental health services. Conclusions We found ongoing and untreated psychological distress among people who were previously diagnosed with PE.

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Section: Discussionsupporting

confidence: 92%

Section: Reliance On Medicationmentioning

confidence: 68%

Section: Discussionmentioning

confidence: 99%

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The psychological impact of pulmonary embolism: A mixed‐methods study

Tran

Redley

Wit

2021

Research and Practice in Thrombosis and Haemostasis

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“…Studies show the great psychological impact of VTE on patients, including a sense of insecurity, fear of recurrence, feeling let down by health services and questioning the cause of their VTE [10][11][12] . These negative emotions impact the doctor-patient relationship and influence the use of healthcare sources 12 .…”

Section: Accepted Manuscriptmentioning

confidence: 99%

Deciding on Treatment Duration for Unprovoked Venous Thromboembolism: What is Important to Patients?

Brug

Winter

Wolde³

et al. 2021

Thromb Haemost

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Background After 3 months of anticoagulation for unprovoked venous thromboembolism (VTE), a decision must be made to stop or continue indefinitely by weighing risks of recurrence and bleeding through shared decision-making (SDM). Despite the importance of patient involvement, patients’ perspectives on treatment duration are understudied. Aim To describe knowledge of VTE and anticoagulation, need for education, perception of risks and benefits of extended treatment and factors influencing patient’s preference to stop or continue treatment after unprovoked VTE. Methods: Semi-structured interviews were conducted between May 2019 and August 2020 with adults with unprovoked VTE in one university hospital and one general hospital. Interviews were audio-recorded and transcribed verbatim. Data were analyzed using conventional content analysis. Results 18 patients were interviewed (median age 64, range 32-83 years). Three major themes were identified: diagnosis and initial treatment, SDM and perception of treatment. Education, knowledge, coping and attitude towards healthcare suffused the major themes. The impact of VTE on daily life varied between individuals, as did the preferred extent of SDM. Overall, patients who felt involved and informed were more satisfied with received care, more aware of risks and benefits of treatment and more likely to be treatment adherent. Generally, patients were more concerned with risk of recurrent VTE than risk of bleeding during anticoagulation. We identified a multitude of aspects important to patients when deciding to stop or continue anticoagulation. Conclusion Sufficient information and an individualized extent of SDM are of crucial importance for patients when deciding on treatment duration after unprovoked VTE.

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“…[78][79][80][81] VTE-related mental health problems are also an important contributor to post-PE functional impairment, and may include postthrombotic panic syndrome or depression. 7,10,[82][83][84] Anxiety and pain could in turn lead to less physical activity, with deconditioning and a downward spiral as result.…”

Section: Post-pe Cardiac Impairmentmentioning

confidence: 99%

Determinants and Management of the Post–Pulmonary Embolism Syndrome

Boon

Huisman

Klok

2021

Semin Respir Crit Care Med

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Acute pulmonary embolism (PE) is not only a serious and potentially life-threatening disease in the acute phase, in recent years it has become evident that it may also have a major impact on a patient's daily life in the long run. Persistent dyspnea and impaired functional status are common, occurring in up to 50% of PE survivors, and have been termed the post-PE syndrome (PPES). Chronic thromboembolic pulmonary hypertension is the most feared cause of post-PE dyspnea. When pulmonary hypertension is ruled out, cardiopulmonary exercise testing can play a central role in investigating the potential causes of persistent symptoms, including chronic thromboembolic pulmonary disease or other cardiopulmonary conditions. Alternatively, it is important to realize that post-PE cardiac impairment or post-PE functional limitations, including deconditioning, are present in a large proportion of patients. Health-related quality of life is strongly influenced by PPES, which emphasizes the importance of persistent limitations after an episode of acute PE. In this review, physiological determinants and the diagnostic management of persistent dyspnea after acute PE are elucidated.

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Coping with everyday life and physical activity in the aftermath of an acute pulmonary embolism: A qualitative study exploring patients' perceptions and coping strategies

Cited by 33 publications

References 25 publications

The psychological impact of pulmonary embolism: A mixed‐methods study

The psychological impact of pulmonary embolism: A mixed‐methods study

Deciding on Treatment Duration for Unprovoked Venous Thromboembolism: What is Important to Patients?

Determinants and Management of the Post–Pulmonary Embolism Syndrome

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