The perceptions and understanding of healthcare professionals about SCAD

Background Over the last decade there has been an increase in research investigating spontaneous coronary artery dissection (SCAD). However, people with SCAD seem to perceive a lack of awareness of healthcare professionals (HCPs) regarding SCAD that impacts the level of care they receive.

Aim To investigate HCPs’ level of understanding and perceptions of SCAD.

Methods Twenty-three participants (13 nurses, 6 physiotherapists, 2 clinical exercise physiologists, 1 general practitioner and 1 cardiologist) consented to join a semi-structured online interview. Transcripts were analysed following the thematic framework of Braun and Clarke, using NVivo™ v12. This study was approved by the Health Research Ethics Committee at Edge Hill University (ETH2223-0225).

Results Six themes were identified in this study (figure 1): 1) Knowledge and education: Some participants were not aware of SCAD and mentioned first learning about SCAD when encountering patients in clinical practice. 2) Cardiovascular rehabilitation (CR) components and delivery: Some participants explained how they modify CR for SCAD. 3) Perceived benefits of CR for SCAD: Participants perceived CR as the most appropriate service to support people with SCAD, improve confidence, physical and mental wellbeing 4) Challenges encountered with SCAD: Participants mentioned how SCAD symptoms, poor information, and patients‘ barriers impact CR delivery. 5) Issues in CR impacting SCAD: Participants recognised that general issues surrounding CR such as lack of funding, capacity and resources impact SCAD. 6) Improvements in CR: Peer-support, SCAD awareness, CR access and resources were mentioned as improvements needed in CR for SCAD.
Conclusion This study highlights a clear knowledge gap for HCPs regarding SCAD and the need of CR to be better designed to accommodate this patient group. From the perspective of HCPs, CR seems to benefit SCAD, but SCAD-specific and general issues in CR impact the service. Therefore, CR services are not well-established for SCAD and require improvements.