'<i>It is just a big question mark</i>': a qualitative interview study of patient experiences of the initial assessment of transient loss of consciousness.

Abstract

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. ED, Acute Medical Unit and Syncope and Neurology clinics in a single tertiary teaching hospital in the north of England. 20 adult patients (60% female, age range 17-90 years) attending or referred with a first presentation of TLOC. Exploratory thematic analysis of semistructured qualitative interviews. 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. 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.