The experience of internet-delivered cognitive behavioural therapy among patients with non-cardiac chest pain

Type of funding sources: Foundation. Main funding source(s): Kamprad Family Foundation

Region Östergötland

Non-cardiac chest pain (NCCP) is a common health problem at emergency departments. Many patients are discharged with no further explanation regarding the cause of their chest pain. Recurring chest pain, functional limitations and cardiac anxiety affect lives of patients with NCCP and lead to increased healthcare use. Hence, we developed and tested a five-week, nurse-led iCBT program adapted to patients with NCCP in order to improve psychological distress and other patient-reported outcomes. This study was aimed to explore the experiences of patients with NCCP and cardiac anxiety regarding their participation in the iCBT program.

A qualitative interview study using content analysis to explore the experiences of patients participating in the iCBT program. The data was collected by individual face-to-face interviews with 16 patients after their participation in the iCBT using a semi-structured interview guide.

The study resulted in three categories and eight subcategories, presented in Table 1. "Driving factors for participation in the iCBT program" was the first category and described the impact of pain on patients´ lives and their struggle before participating in the program. The second, "The program facilitates change", described how the program helped them make changes regarding pain, fear and anxiety. The last category, "Learning to live with chest pain", described the program as a tool for gaining the strength and skills to live a normal life despite chest pain.

The life impacted by recurrent chest pain, anxiety and feeling of being disregarded by healthcare was commonly experienced by participants. The invitation to the program was perceived as an opportunity to return to a normal life, without fear or chest pain. By being trustworthy, supportive and encouraging, the program helped participants to challenge their fear, and gain the strength and new insights they needed to live a normal life.