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Symptom Interpretation in Women With Diabetes and Myocardial Infarction

A Qualitative Study

From the School of Nursing, Oregon Health & Science University, Portland (Ms Mayer, Dr Rosenfeld), and College of Nursing, Montana State University, Missoula (Ms Mayer).

Correspondence to Dorothy "Dale" Mayer, APRN, BC, Montana State University College of Nursing, 32 Campus Drive 7416, Missoula, MT 59812-7416 (dmayer{at}montana.edu).

Purpose

The purpose of this study was to describe the role of diabetes in acute myocardial infarction (MI) symptom interpretation.

Methods

This is a secondary data analysis of a study of treatment-seeking delay in women with acute MI (N = 52). This study included a subsample of those with diabetes (n = 16). Women were interviewed while hospitalized with MI about their actions, thoughts, and feelings from symptom onset to entry into the health care system. Qualitative description was the method of analysis.

Results

Three major themes were identified in the qualitative data: diabetes and decision making, presenting symptoms, and symptom attribution. Not all women included information about diabetes in their story, but those who checked blood sugars generally found it to be elevated. Diabetes was a factor in decision making for more than half of the sample. Presenting symptoms were variable but raised hypotheses about shortness of breath as a common presenting symptom for women with diabetes and MI. The third theme, symptom attribution, revealed confusion as to the cause of symptoms.

Conclusions

These results provide insight into symptom interpretation in women with diabetes and MI. Women with diabetesshould consider atypical symptoms such as shortness of breath, gastrointestinal symptoms, and fluctuating blood sugars as reasons to seek care. Education for women with diabetes should include action plans for how to recognize and respond to symptoms. More research on the influence of diabetes on MI symptom attribution and decision making is needed.

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