ShareHeart: A patient journey map of patients with ischemia and non‐obstructive coronary artery disease based on qualitative research

• Published in: Journal of clinical nursing 2023-07, Vol.32 (13-14), p.3434-3444
• Main Authors: Van Schalkwijk, Dinah L., Widdershoven, Jos W. M. G., Elias‐Smale, Suzette, Hartzema‐Meijer, Marielle, Den Oudsten, Brenda L., Slatman, Jenny, Mommersteeg, Paula M. C.
• Format: Article
• Language: English
• Subjects: Cardiovascular disease; Coronary vessels; Health care; health care quality improvement; Ischemia; ischemia with non‐obstructive coronary arteries (INOCA); patient journey map; Patient-centered care; Patients; patients experiences; Qualitative research; qualitative study
• ISSN: 0962-1067; 1365-2702
• DOI: 10.1111/jocn.16409

Aims and objectives To visualise the health care experiences and needs of patients with ischemia with non‐obstructive coronary arteries in a patient journey map. As such, future design challenges can be provided, and it can be used for future healthcare optimization. Background Ischemia with non‐obstructive coronary arteries is a chronic cardiac condition caused by vascular dysfunctions. Ischemia with non‐obstructive coronary arteries is often unrecognised, significantly impairs daily functioning, and is more prevalent among women. Patients' experiences remain unexplored, and a clear patient‐centered care pathway is lacking. Design A qualitative interpretative research design was performed and the standards for reporting qualitative research (SRQR) has been used. Methods In total, 36 women were included and participated in eight semi‐structured focus group interviews. Thematic analysis was used, and identified themes were further classified using ‘patient journey mapping.’ Additionally, Picker's ‘eight principles of patient‐centered care’ were linked to the results and integrated in the patient journey map. Results Participants experienced a lack of familiarity with the specific cardiac condition by healthcare providers, repeated hospitalisation, testing and referrals, shortage of specialised cardiologists, and feelings of not being heard. In addition, needs for a multidisciplinary treatment program (including physical and psychological support), better information provision, and an easily accessible contact person were expressed. Conclusions The resulting patient journey map shows how patients experienced and interacted with the current healthcare system. Overall, the results show a complex and long healthcare pathway and important themes for healthcare experiences and needs were identified. Future research could focus on the development and implementation of a patient‐centered evidence‐based clinical pathway optimising experiences and quality of life. Relevance to clinical practice The visual tool can help health care professionals, policy makers, and researchers improve healthcare provision which is patient‐centered and tailored to the preferences of patients with ischemia with non‐obstructive coronary arteries.