Causes of delay in seeking treatment for heart attack symptoms

Dracup, Kathleen; Moser, Debra K.; Eisenberg, Mickey S.; Meischke, Hendrika; Alonzo, Angelo; Braslow, Allan

doi:10.1016/0277-9536(94)00278-2

Cited by 273 publications

(238 citation statements)

References 46 publications

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“…Severity of symptoms and degree of incapacitation also reduced delay times in previous studies of AMI. 15 We cannot explain why delay time was doubled among patients seen by primary care physicians as opposed to a cardiologist because of the retrospective design of the study. However, we can hypothesize that cardiologists instruct patients to go to the emergency department, whereas primary care physicians request that patients call with symptoms.…”

Section: Discussionmentioning

confidence: 95%

“…Consequently, when these patients consult their physicians, increases in delay may be caused by a variety of reasons, including physicians who don't perceive the symptoms as cardiac in nature or physician recommendations to try self-medication. 15,16 Limitations of the study include the retrospective design of the research and the nature of the data about delay. We were forced to rely on the interviewing skills of the health care provider and the patient's or family member's memory of symptom onset during an emotional and stressful time in the emergency department.…”

Section: Discussionmentioning

confidence: 99%

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Treatment-seeking delays in heart failure patients

Evangelista

Dracup

Doering

2000

The Journal of Heart and Lung Transplantation

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Treatment-seeking delays in heart failure patients

Evangelista

Dracup

Doering

2000

The Journal of Heart and Lung Transplantation

Self Cite

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“…Pattenden et al (2002) found that patients experiencing the symptoms of AMI were often reluctant to relinquish control to healthcare professionals, and frequently attributed their symptoms to a benign, non-cardiac cause. As other researchers have described (Clark, 2001;Dracup et al, 1995;Galdas et al, 2007;Pattenden et al, 2002;), several participants in our study had waited until their attempts at self-treatment had failed, or their symptoms were viewed as being persistent or more severe, until they decided that their condition was serious and they required health care. This observed pattern of behavior is consistent with Clark's (2001) analysis of the role of the body and self as an important part of the interpretive frames used to understand the meaning of AMI symptoms and the action to take thereon.…”

Section: Beyond the Masculine-feminine Binarymentioning

confidence: 99%

Help seeking for cardiac symptoms: Beyond the masculine–feminine binary

Galdas

Johnson

Percy

et al. 2010

Social Science & Medicine

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Empirical and theoretical literature suggests that stereotypical gender roles shape men's and women's health help-seeking behavior, and plays an important role in the treatment seeking delays of cardiac patients. We were interested in exploring the ways in which gender informs the experiences and help-seeking behavior of men and women who experienced the symptoms associated with acute cardiac events. We undertook 20 in-depth interviews between October 2007 and July 2008 with 11 men and 9 women recently diagnosed with an acute coronary syndrome in British Columbia, Canada. Participants were encouraged to tell their 'story' of the event that led to hospitalization and diagnosis, with a focus on the symptoms and decision making processes that occurred before and during the activation of health services: seeking the advice of others including colleagues, family members and healthcare professionals; calling 911; and attending an emergency department. Although we anticipated that distinctive patterns of help-seeking behavior aligned with stereotypical masculine and feminine ideals might emerge from our data, this was not always the case. We found some evidence of the influence of gender role ideology on the help-seeking behavior of both male and female participants. However, men's and women's experiences of seeking health care were not easily parsed into distinct binary gender patterns. Behavior that might stereotypically be considered to be 'masculine' or 'feminine' gender practice was shared by both male and female participants. Our findings undermine simple binary distinctions about gendered help-seeking prevalent in the literature, and contribute towards setting the direction of the future health policy and research agenda addressing the issue of gender and health help-seeking behavior.

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“…Although the majority of studies that have examined extent of prehospital delay among patients presenting with AMI in the United States have found median delays of ≈2 to 3 hours7, 8, 17, 20, 21, 22, 23 with most of these studies showing higher delay times in elderly than in younger patients,8, 24 few studies have examined the magnitude of, and factors associated with, prolonged delay in seeking medical care after onset of acute coronary symptoms in elderly patients presenting with AMI 9. Furthermore, we were unable to find any published studies that examined the extent of prehospital delay within different age strata of elderly patients hospitalized with an AMI.…”

Section: Discussionmentioning

confidence: 99%

Decade Long Trends (2001–2011) in Duration of Pre‐Hospital Delay Among Elderly Patients Hospitalized for an Acute Myocardial Infarction

Makam

Erskine

Yarzebski

et al. 2016

JAHA

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BackgroundEarly intervention with medical and/or coronary revascularization treatment approaches remains the cornerstone of the management of patients hospitalized with acute myocardial infarction (AMI). However, several patient groups, especially the elderly, are known to delay seeking prompt medical care after onset of AMI‐associated symptoms. Current trends, and factors associated with prolonged prehospital delay among elderly patients hospitalized with AMI, are incompletely understood.Methods and ResultsData from a population‐based study of patients hospitalized at all 11 medical centers in central Massachusetts with a confirmed AMI on a biennial basis between 2001 and 2011 were analyzed. Information about duration of prehospital delay after onset of acute coronary symptoms was abstracted from hospital medical records. In patients 65 years and older, the overall median duration of prehospital delay was 2.0 hours, with corresponding median delays of 2.0, 2.1, and 2.0 hours in those aged 65 to 74 years, 75 to 84 years, and in patients 85 years and older, respectively. There were no significant changes over time in median delay times in each of the age strata examined in both crude and multivariable adjusted analyses. A limited number of patient characteristics were associated with prolonged delay in this patient population.ConclusionsThe results of this community‐wide study demonstrate that delay in seeking prompt medical care continues to be a significant problem among elderly patients hospitalized with AMI. The lack of improvement in the timeliness of patients’ care‐seeking behavior during the years under study remains of considerable clinical and public health concern.

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Causes of delay in seeking treatment for heart attack symptoms

Cited by 273 publications

References 46 publications

Treatment-seeking delays in heart failure patients

Treatment-seeking delays in heart failure patients

Help seeking for cardiac symptoms: Beyond the masculine–feminine binary

Decade Long Trends (2001–2011) in Duration of Pre‐Hospital Delay Among Elderly Patients Hospitalized for an Acute Myocardial Infarction

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