Signs, symptoms and diagnosis of necrotizing fasciitis experienced by survivors and family: a qualitative Nordic multi-center study
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Signs, symptoms and diagnosis of necrotizing fasciitis experienced by survivors and family : a qualitative Nordic multi-center study. / Erichsen Andersson, Annette; Egerod, Ingrid; Knudsen, Vibeke E; Fagerdahl, Ann-Mari.
I: BMC Infectious Diseases, Bind 18, Nr. 1, 2018, s. 429.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Signs, symptoms and diagnosis of necrotizing fasciitis experienced by survivors and family
T2 - a qualitative Nordic multi-center study
AU - Erichsen Andersson, Annette
AU - Egerod, Ingrid
AU - Knudsen, Vibeke E
AU - Fagerdahl, Ann-Mari
PY - 2018
Y1 - 2018
N2 - BACKGROUND: Necrotizing soft tissue infection is the most serious of all soft tissue infections. The patient's life is dependent on prompt diagnosis and aggressive treatment. Diagnostic delays are related to increased morbidity and mortality, and the risk of under- or missed diagnosis is high due to the rarity of the condition. There is a paucity of knowledge regarding early indications of disease. The aim of the study has thus been to explore patients' and families' experiences of early signs and symptoms and to describe their initial contact with the healthcare system.METHODS: A qualitative explorative design was used to gain more knowledge about the experience of early signs and symptoms. Fifty-three participants from three study sites were interviewed. The framework method was used for data analysis.RESULTS: Most of the participants experienced treatment delay and contacted healthcare several times before receiving correct treatment. The experience of illness varied among the participants depending on the duration of antecedent signs and symptoms. Other important findings included the description of three stages of early disease progression with increase in symptom intensity. Pain experienced in necrotizing soft tissue infections is particularly excruciating and unresponsive to pain medication. Other common symptoms were dyspnea, shivering, muscle weakness, gastrointestinal problems, anxiety, and fear.CONCLUSION: Our study adds to the understanding of the lived experience of NSTI by providing in-depth description of antecedent signs and symptoms precipitating NSTI-diagnosis. We have described diagnostic delay as patient-related, primary care related, or hospital related and recommend that patient and family narratives should be considered when diagnosing NSTI to decrease diagnostic delay.
AB - BACKGROUND: Necrotizing soft tissue infection is the most serious of all soft tissue infections. The patient's life is dependent on prompt diagnosis and aggressive treatment. Diagnostic delays are related to increased morbidity and mortality, and the risk of under- or missed diagnosis is high due to the rarity of the condition. There is a paucity of knowledge regarding early indications of disease. The aim of the study has thus been to explore patients' and families' experiences of early signs and symptoms and to describe their initial contact with the healthcare system.METHODS: A qualitative explorative design was used to gain more knowledge about the experience of early signs and symptoms. Fifty-three participants from three study sites were interviewed. The framework method was used for data analysis.RESULTS: Most of the participants experienced treatment delay and contacted healthcare several times before receiving correct treatment. The experience of illness varied among the participants depending on the duration of antecedent signs and symptoms. Other important findings included the description of three stages of early disease progression with increase in symptom intensity. Pain experienced in necrotizing soft tissue infections is particularly excruciating and unresponsive to pain medication. Other common symptoms were dyspnea, shivering, muscle weakness, gastrointestinal problems, anxiety, and fear.CONCLUSION: Our study adds to the understanding of the lived experience of NSTI by providing in-depth description of antecedent signs and symptoms precipitating NSTI-diagnosis. We have described diagnostic delay as patient-related, primary care related, or hospital related and recommend that patient and family narratives should be considered when diagnosing NSTI to decrease diagnostic delay.
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Delayed Diagnosis/statistics & numerical data
KW - Denmark/epidemiology
KW - Diagnostic Errors/statistics & numerical data
KW - Family
KW - Fasciitis, Necrotizing/diagnosis
KW - Female
KW - Humans
KW - Interviews as Topic
KW - Male
KW - Middle Aged
KW - Narration
KW - Prodromal Symptoms
KW - Soft Tissue Infections/diagnosis
KW - Surveys and Questionnaires
KW - Survivors/statistics & numerical data
KW - Sweden/epidemiology
U2 - 10.1186/s12879-018-3355-7
DO - 10.1186/s12879-018-3355-7
M3 - Journal article
C2 - 30153808
VL - 18
SP - 429
JO - B M C Infectious Diseases
JF - B M C Infectious Diseases
SN - 1471-2334
IS - 1
ER -
ID: 222167169