Living with unexplained chest pain

J Clin Nurs. 2005 Sep;14(8):956-64. doi: 10.1111/j.1365-2702.2005.01195.x.

Abstract

Aim: The aim was to describe patients' experience of unexplained chest pain, and how the pain affected their everyday life.

Background: Chest pain is one of the most common reasons for patients to consult the emergency department. Often no clear ischaemic heart disease or any other somatic explanation is found. Exploring the pain experience and how the pain affects everyday life may provide insights into the patients' perspective, fill the gaps in our knowledge about this condition and give needed direction for nursing practice.

Method: The study sample (n = 19) included 11 men and eight women admitted to the emergency department. An open-ended unstructured interview was conducted with each patient and the data were analysed using content analysis.

Results: The categories concerning pain include the informants' descriptions of several aspects of pain. These aspects are described in four categories and four subcategories: (i) pain location, (ii) pain duration with the subcategories 'periodic pain' and 'continuous pain', (iii) pain intensity, (iv) quality of pain with the subcategories 'sensory aspects' and 'affective aspects' . The content of pain experience in everyday life was divided into four subthemes and was further abstracted into a theme. Four subthemes, each comprising several meaning units, were created and labelled: (i) fear and anxiety, (ii) feeling of uncertainty, (iii) feeling of stress, and (iv) loss of strength. In these descriptions, it was obvious that chest pain considerably disturbed and affected the informants' lives and an overall theme 'intrusion into the everyday life world' emerged.

Conclusion: The results of this study show that unexplained chest pain intrudes into everyday life in a destructive manner that cannot be ignored.

Relevance to clinical practice: Patients are not receiving optimal care to relieve their pain and there is therefore a need for specialized nurses who can give adequate help and support.

MeSH terms

  • Activities of Daily Living
  • Adaptation, Psychological*
  • Adolescent
  • Adult
  • Anxiety / etiology
  • Attitude to Health*
  • Chest Pain / diagnosis
  • Chest Pain / etiology
  • Chest Pain / prevention & control
  • Chest Pain / psychology*
  • Chronic Disease
  • Emergency Service, Hospital / statistics & numerical data
  • Fear
  • Female
  • Hospitals, University
  • Humans
  • Male
  • Middle Aged
  • Models, Psychological
  • Narration
  • Nursing Methodology Research
  • Pain Measurement
  • Qualitative Research
  • Quality of Life
  • Stress, Psychological / etiology
  • Surveys and Questionnaires
  • Sweden
  • Uncertainty