Factors influencing treatment delay for patients with first acute myocardial infarction

Abstract

People are dying of myocardial infarctions because they are not seeking treatment early enough. The time that elapses from the initial onset of symptoms during an acute myocardial infarction (AMI) to treatment has a significant effect on the morbidity and mortality. A delay in seeking treatment may increase heart damage and reduce an individual's chance of survival. To preserve heart muscle, time is crucial. Early recognition of symptoms and avoidance of delay in seeking treatment are key elements in preventing death. The purpose of this study was to identify cognitive, social, and emotional influences of individuals delaying treatment when having symptoms of an AMI. A prospective descriptive study was conducted. One hundred and five patients diagnosed with AMI at three Northeastern Pennsylvania hospitals were interviewed using the "Response to Symptoms Questionnaire." Of the 105 participants, a substudy of twenty patients was asked additional open-ended questions and a content analysis of their response was completed. The mean age of the participants was 63.92 years old. The majority of the participants were men (69.5%), while 30.5% were women. The mean prehospital delay time was 992 hours (16 hours and 53 minutes). In a multiple regression analysis, the following were associated with prolonged delay when experiencing AMI symptoms: being at home, mild to moderate pain, believing one had control over one's symptoms, and being in a public place. Qualitative results found that participants either denied that they had a heart problem or sought medical treatment during their symptom experience. Patients either did nothing during their initial symptoms onset or they did something to help themselves. Participants responded that they knew to seek treatment because they had previous experience with AMI symptoms of a family member, experienced persistent symptoms, or consulted someone else who made the decision to seek treatment for them. (Abstract shortened by UMI.)