Pre-Hospital Delay in Patients with Acute Coronary Syndrome: Factors Associated with Patient Decision Time and Home-To-Hospital Delay

Perkins-Porras, Linda; Whitehead, Daisy L.; Strike, Philip C.; Steptoe, Andrew

doi:10.1016/j.ejcnurse.2008.05.001

Cited by 132 publications

(156 citation statements)

References 27 publications

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“…5.6 Cognitive and emotional factors related to the perception of both the individual and his/her associates regarding the AMI and its implications in everyday life 7 can influence attitudes towards the cardiovascular event in progress. 8 In Brazil, there are few data available on pre-hospital care 9 and on decision making to seek care for people who have suffered this cardiovascular event. Furthermore, many studies are inconclusive about the reasons why men and women delay in seeking care when there are symptoms of the disease.…”

Section: Introductionmentioning

confidence: 99%

Pre-hospital delay in acute myocardial infarction: judgement of symptoms and resistance to pain

Mussi

Mendes²,

Queiroz³

et al. 2014

Rev. Assoc. Med. Bras.

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Objective: To estimate the time of decision (TD) to look for medical care and the time of arrival (TA) at the health service for men (M) and women (W) suffering from acute myocardial infarction and to analyze the influence of the interpretation of pain and pain resistance behaviors during these times. Methods: This is an exploratory research, performed at the university hospital in Salvador/Bahia. 43 W and 54 M were interviewed. To study the dependence among sociodemographic and gender variables, the Fisher Exact Test was used. To analyze times, a geometric mean (GM) was used. In order to verify the association between the GM of TD and TA and the judgment of pain, and between the GM of TD and TA and the behavior of resistance to pain, as well as to test the time of interaction between the gender variable and other variables of interest, the robust regression model was used. The statistical significance adopted was 5%. Results: The GM of the TD for M was 1.13 h; for W, 0.74 h. The GM of the TA was 1.74 h for M and 1.47 h for W. Those who did not recognize the symptoms of AMI and presented behavior of resistance to pain had higher TD and TA, being the associations significant. Gender did not change the associations of interest. Conclusion:The findings demonstrate the importance of health education aiming at the benefits of early treatment.

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Section: Introductionmentioning

confidence: 99%

Pre-hospital delay in acute myocardial infarction: judgement of symptoms and resistance to pain

Mussi

Mendes²,

Queiroz³

et al. 2014

Rev. Assoc. Med. Bras.

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“…(16) The mean times investigated showed delay in the access to health services, mainly for women, which remains long. (6) Women may underestimate the risk of heart disease (17) and experience symptoms that are not always typical of the disease, (18) reasons that contribute to a greater delay.…”

Section: Discussionmentioning

confidence: 99%

“…The SAMU is recommended because it possesses human and material resources to administer initial care, contributing to reduce the pre-hospital delay. (6) The population needs orientation on the importance of summoning the service, which should readily respond to the calls. Educational strategies by nurses can be extremely valuable and can take place at primary care services, at home and at community centers.…”

Section: Discussionmentioning

confidence: 99%

“…(5) Overall, pre-hospital delay in case of infarction is defined as the period between the onset of the symptoms and the admission to a health service and can be divided in two main components. (6) The first is the decision time, the period between the onset of the symptoms and the decision to seek care, with influence from sociodemographic, clinical, cognitive, emotional and environmental factors. The second component is the period between the dislocation and the arrival to a referral service in cardiology for specific treatment.…”

Section: Introductionmentioning

confidence: 99%

“…In this component, mainly the influence of the transportation means and the healthcare networks' possible response has been observed. (6) In addition, evidence exists that the gender can influence the medical conduct, in that women who receive interventions have reached a more advanced stage of the coronary disease. (7) Nevertheless, depending on the configuration of the care network for myocardial infarction, with particularities according to the countries and regions, various time fractions can make up the period between the onset of the symptoms and the admission to a referral hospital in cardiology.…”

Section: Introductionmentioning

confidence: 99%

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Tempos de acesso a serviços de saúde face ao infarto do miocárdio

et al. 2016

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Objective: To analyze the access times of men and women who are having a myocardial infarction to referral hospitals in cardiology and the correlation between them. Methods: Cross-sectional research, involving 100 victims of a myocardial infarction who were interviewed at referral hospitals in cardiology. To analyze the data, descriptive and inferential statistics were used with statistical significance. Results: The access times were long (decision to seek care, arrival to first health service, time in care network and admission to referral hospitals in cardiology), except for the transportation time, mainly for women. The decision time contributed more to the time it took to arrive at the first health service and the time in the care network contributed more to the time to arrive at the referral hospitals in cardiology. Conclusion: The long time waiting for specialized care reflects the lack of structure of the health services and the long decision time reflects the participants' lack of recognition of the myocardial infarction. ResumoObjetivo: Analisar os tempos relacionados ao acesso de homens e mulheres com infarto do miocárdio a hospitais referência em cardiologia e a correlação entre eles. Métodos: Pesquisa transversal, com 100 pessoas com infarto entrevistadas em hospitais referência em cardiologia. Dados analisados por estatística descritiva e inferencial, adotando-se significância estatística. Resultados: Os tempos foram elevados (decisão para atendimento, chegada ao primeiro serviço de saúde, permanência na rede de atenção e admissão em hospitais referência em cardiologia), exceto o de transporte, sobretudo para mulheres. Houve maior contribuição do tempo de decisão na composição do tempo de chegada ao primeiro serviço de saúde e do tempo de permanência na rede na composição do tempo de chegada aos hospitais referência em cardiologia. Conclusão: A longa espera por atenção especializada reflete a falta de estrutura dos serviços de saúde, e o tempo de decisão elevado reflete a falta do não reconhecimento do infarto pelos participantes. KeywordsHealth services accessibility; Public health nursing; Education, nursing; Myocardial infarction Descritores Acesso aos serviços de saúde; Enfermagem em saúde pública; Educação em enfermagem; Infarto do miocárdio

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Marital Status and Outcome of Patients Presenting with Acute Coronary Syndrome: An Observational Report

Khafaji

Habib

Asaad

et al. 2012

Clinical Cardiology

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Background & hypothesis:Data on the clinical characteristics and outcome of patients presenting with acute coronary syndrome (ACS) according to their marital status is not clear.Methods:A total of 5334 patients presenting with ACS in 65 hospitals in 6 Middle East countries in the 2nd Gulf Registry of Acute Coronary Events (Gulf RACE‐2) were studied according to their marital status (5024 married, 100 single, and 210 widowed patients).Result:When compared to married patients, widowed patients were older and more likely to be female. Widowed patients were more likely to have diabetes mellitus, hypertension, history of heart failure, and peripheral vascular disease and were less likely to be tobacco users when compared to the other groups. Widowed patients were also more likely to present with atypical symptoms and have advanced Killip class. Widowed patients were more likely to present with non‐ST‐elevation myocardial infarction (NSTEMI) when compared to the other 2 groups. Widowed patients were more likely to have heart failure (P = 0.001), cardiogenic shock (P = 0.001), and major bleeding (P = 0.002) when compared to the other groups. No statistically significant difference was observed in regard to duration of hospital stay, door to needle time in STEMI patients, or cardiac arrhythmias between the various groups. Widowed patients had higher in‐hospital, 30‐day, and 1‐year mortality rates (P = 0.001). Marital status was an independent predictor for in‐hospital mortality.Conclusion:Widowed marital status was associated with worse cardiovascular risk profile, and worse in‐hospital and 1‐year outcome. Future work should be focused on whether the provision of psychosocial support will result in improved outcomes among this high‐risk group. Clin. Cardiol. 2011 DOI: 10.1002/clc.22034Gulf RACE is a Gulf Heart Association (GHA) project and was financially supported by the GHA, Sanofi Aventis, and the College of Medicine Research Center at King Khalid University Hospital, King Saud University, and Riyadh, Saudi Arabia.The authors have no other funding, financial relationships, or conflicts of interest to disclose.

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Pre-Hospital Delay in Patients with Acute Coronary Syndrome: Factors Associated with Patient Decision Time and Home-To-Hospital Delay

Cited by 132 publications

References 27 publications

Pre-hospital delay in acute myocardial infarction: judgement of symptoms and resistance to pain

Pre-hospital delay in acute myocardial infarction: judgement of symptoms and resistance to pain

Tempos de acesso a serviços de saúde face ao infarto do miocárdio

Marital Status and Outcome of Patients Presenting with Acute Coronary Syndrome: An Observational Report

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