‘It is just a big question mark’: a qualitative interview study of patient experiences of the initial assessment of transient loss of consciousness

Objectives

Transient loss of consciousness (TLOC) is one of the most common neurological complaints in the Emergency Department (ED), but little is known about the patient perspective. We aimed to explore patient perceptions of diagnostic assessment for TLOC.

Setting

ED, Acute Medical Unit and Syncope and Neurology clinics in a single tertiary teaching hospital in the north of England.

Participants

20 adult patients (60% female, age range 17–90 years) attending or referred with a first presentation of TLOC.

Primary and secondary outcome measures

Exploratory thematic analysis of semistructured qualitative interviews.

Results

We identified three themes within the data: satisfaction with care, unanswered questions and being left in limbo/no man’s land. Participants explored these themes through four topics: communication; the role of investigations; the role of authority and the social context of care.

Conclusions

Communication (including differential diagnosis, significance of investigations and further assessments, and interim safety advice) is emphasised in supporting ongoing self-management, even before a definitive diagnosis is made.