2.50
Hdl Handle:
http://hdl.handle.net/10755/157344
Type:
Presentation
Title:
TOWARD A NEW UNDERSTANDING OF SYMPTOM TRAJECTORIES
Abstract:
TOWARD A NEW UNDERSTANDING OF SYMPTOM TRAJECTORIES
Conference Sponsor:Western Institute of Nursing
Conference Year:2010
Author:Rosenfeld, Anne, PhD, RN, FAHA, FAAN
P.I. Institution Name:Oregon Health & Science University
Title:Professor
Contact Address:3455 SW US Veterans Hospital Rd., SN-ADM, Portland, OR, 97239, USA
PURPOSE: Symptom trajectories are the path or course that symptoms take, as related by those experiencing them, and can be described for acute as well as chronic symptoms. The purpose of this presentation is to apply the new conceptual framework to an exemplar of acute myocardial infarction (AMI) symptom trajectories of women with first time AMI.
CONCEPTUAL FRAMEWORK: In our prior work we described the treatment-seeking delay trajectories, that is, the patterns or courses of symptoms, decisions and actions, related by women with first time AMI. Women were asked to describe their symptoms from the time they started until the time the women reached the hospital. Narrative analysis was used to examine the stories from qualitative data and to identify trajectory types. Women described 1 of 2 types of trajectories: knowing (defined as knowing almost immediately they would seek help) and managing (treating an alternate hypothesis or minimizing their symptoms). Four sub-groups of knowing were identified: knowing and going immediately; knowing and going on her own terms; knowing and letting someone take over; and knowing and waiting (until morning or Monday). Each trajectory type is now analyzed and reconceptualized from the four perspectives of the new conceptual framework: self-regulation, symptom appraisal, health systems, and the broader context of cultural and social groups. Self-regulation theory has guided much of the research on treatment-seeking delay for cardiac symptoms. The addition of other perspectives can expand understanding of the symptom phenomenon, including symptom appraisal (e.g, how women decided symptoms were cardiac versus something they could manage themselves); health systems (e.g. reluctance to call 911; fear of bankruptcy due to lack of health insurance); the broader context of cultural and social groups (e.g., gender roles; cultural expressions of symptoms).
CONCLUSIONS: Reconceptualizing treatment-seeking delay trajectories as symptom trajectories broadens our understanding of the symptom experience of women with AMI. and highlights the critical role of symptom self-management. This exemplar also demonstrates the applicability of the new conceptual framework to other symptoms and conditions. The concept of symptom trajectory has utility for research on symptom management as well as for clinical practice as an assessment approach.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleTOWARD A NEW UNDERSTANDING OF SYMPTOM TRAJECTORIESen_GB
dc.identifier.urihttp://hdl.handle.net/10755/157344-
dc.description.abstract<table><tr><td colspan="2" class="item-title">TOWARD A NEW UNDERSTANDING OF SYMPTOM TRAJECTORIES</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Western Institute of Nursing</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2010</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Rosenfeld, Anne, PhD, RN, FAHA, FAAN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Oregon Health &amp; Science University</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Professor</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">3455 SW US Veterans Hospital Rd., SN-ADM, Portland, OR, 97239, USA</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">rosenfea@ohsu.edu</td></tr><tr><td colspan="2" class="item-abstract">PURPOSE: Symptom trajectories are the path or course that symptoms take, as related by those experiencing them, and can be described for acute as well as chronic symptoms. The purpose of this presentation is to apply the new conceptual framework to an exemplar of acute myocardial infarction (AMI) symptom trajectories of women with first time AMI.<br/>CONCEPTUAL FRAMEWORK: In our prior work we described the treatment-seeking delay trajectories, that is, the patterns or courses of symptoms, decisions and actions, related by women with first time AMI. Women were asked to describe their symptoms from the time they started until the time the women reached the hospital. Narrative analysis was used to examine the stories from qualitative data and to identify trajectory types. Women described 1 of 2 types of trajectories: knowing (defined as knowing almost immediately they would seek help) and managing (treating an alternate hypothesis or minimizing their symptoms). Four sub-groups of knowing were identified: knowing and going immediately; knowing and going on her own terms; knowing and letting someone take over; and knowing and waiting (until morning or Monday). Each trajectory type is now analyzed and reconceptualized from the four perspectives of the new conceptual framework: self-regulation, symptom appraisal, health systems, and the broader context of cultural and social groups. Self-regulation theory has guided much of the research on treatment-seeking delay for cardiac symptoms. The addition of other perspectives can expand understanding of the symptom phenomenon, including symptom appraisal (e.g, how women decided symptoms were cardiac versus something they could manage themselves); health systems (e.g. reluctance to call 911; fear of bankruptcy due to lack of health insurance); the broader context of cultural and social groups (e.g., gender roles; cultural expressions of symptoms). <br/>CONCLUSIONS: Reconceptualizing treatment-seeking delay trajectories as symptom trajectories broadens our understanding of the symptom experience of women with AMI. and highlights the critical role of symptom self-management. This exemplar also demonstrates the applicability of the new conceptual framework to other symptoms and conditions. The concept of symptom trajectory has utility for research on symptom management as well as for clinical practice as an assessment approach.<br/></td></tr></table>en_GB
dc.date.available2011-10-26T19:47:16Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T19:47:16Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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