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. 2021 Apr 1;16(4):e0249389.
doi: 10.1371/journal.pone.0249389. eCollection 2021.

Chest pain presentations to hospital during the COVID-19 lockdown: Lessons for public health media campaigns

Affiliations

Chest pain presentations to hospital during the COVID-19 lockdown: Lessons for public health media campaigns

Amy V Ferry et al. PLoS One. .

Abstract

Objective: Emergency Department (ED) attendances with chest pain reduced during the COVID-19 lockdown. We performed a service evaluation project in NHS Lothian to explore how and why the COVID-19 pandemic and public health advice had affected chest pain presentations and help-seeking behaviour at an individual patient level using a qualitative interview approach.

Methods: We carried out 28 semi-structured telephone interviews with a convenience sample of patients who presented with chest pain during lockdown and in patients with known coronary heart disease under the outpatient care of a cardiologist in April and May 2020. Interviews were audio recorded and voice files listened to while making detailed notes. Salient themes and issues were documented as verbatim extracts. Interviews were analysed thematically.

Results: Patient interviews revealed three main themes. 1) pandemic help-seeking behaviour; describing how participants made the decision to seek professional healthcare assessment. 2) COVID-19 exposure concerns; describing how the subthemes of perceived vulnerability, wishing to protect others and adding pressure to the health service shaped their decision making for an episode of acute chest pain. 3) hospital experience; describing the difference between the imagined and actual experience in hospital.

Conclusions: Qualitative interviews revealed how the pandemic shaped help-seeking practices, how patients interpreted their personal vulnerability to the virus, and described patient experience of attending hospital for assessment during this time. As patient numbers presenting to hospital appeared to mirror public health messaging, dynamic monitoring of this messaging should evaluate public response to healthcare campaigns to ensure the net impact on health, pandemic and non-pandemic related, is optimised.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Emergency Department presentations to NHS Lothian per week with suspected acute coronary syndrome from January to May 2019 and 2020.
Key dates are denoted by ‘A’ first confirmed COVID-19 case in Scotland 02 March 2020 [12], ‘B’ lockdown enforcement 23 March 2020 [13], ‘C’ British Heart Foundation and media reports of decreased hospital presentation 03 April 2020 [14], ‘D’ ‘The NHS is open’ campaign launched 26 April 2020 [15].
Fig 2
Fig 2. Summary of main interview themes and lessons for practice.

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