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Women's descriptions of their experiences regarding lifestyle management after spontaneous coronary artery dissection Clark, Connie

Abstract

Spontaneous coronary artery dissection (SCAD) is a form of acute coronary syndrome (ACS) most commonly experienced by younger women and occurs when an arterial dissection or hematoma causes a blockage in one or more coronary arteries. A review of the literature reveals that women may experience ACS differently than men; most of the lifestyle management strategies used by health care providers are based on the needs of men. Additionally, there is minimal literature about SCAD and its impact on health status. The purpose of this qualitative research study is to learn more about younger women’s experiences of SCAD, more specifically their experiences with lifestyle management following the event. Guided by interpretive description methodology, seven women were interviewed 3-18 months after their SCAD event. An iterative data analysis process revealed the overarching theme of being lost in an unfamiliar diagnosis and four subthemes: being diagnosed with an unfamiliar disease, swirling in an information vacuum, finding something to hold on to, and reconstructing life. Study participants felt that their lives were on hold after SCAD because SCAD is a rare diagnosis, lacks established guidelines, and has a different disease pattern with treatment and management than is the case for typical ACS. They lacked the informational support they needed and had to wait several months for an appointment with an HCP who had expert knowledge and understanding of this particular disease. The implications of these findings include the observation that the experience of these women is similar to that of other patients with a rare disease or health condition in that they face an information vacuum. It seems women with SCAD would benefit from more information about their diagnosis early in their recovery. The findings suggest that there may be a role for an advanced practice nurse, or a team-based approach, to ensure that the knowledge needs of this population are better served. A diagnosis of SCAD creates multiple challenges in managing the condition and adjusting to a new lifestyle; therefore, it is important to find better strategies to support these women in this difficult process.

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