Prehospital care pathway delays: gender and myocardial infarction

Abstract

Female gender, advancing age, referral source, insurance status and mode of transport to hospital are independent factors contributing to prehospital patient delays. Nurses who care for patients with coronary artery disease have a unique opportunity to educate people about the most appropriate action to be taken in the event of experiencing symptoms.

Predictors of pre-hospital delay among patients with acute myocardial infarction

“…Leventhal's model was used in conjunction with another conceptual framework in three of the studies: Grounded Theory [36], Thematic Framework [37], and Dispositional Optimism [23]. Other theories that were reported: Bandura's Social Cognitive Theory [24], Symbolic Interactionism (Grounded Theory) [41], Individualism-Collectivism Theory [17], feminist approach [42], and epidemiological research paradigm [43] …”

“…Several investigators reported that female gender was a significant variable in predicting delay [28,30,42,43]. In contrast, many others found no significant gender differences [16,18,20,21,25,31].…”

Women's Experiences and Behaviour at Onset of Symptoms of ST Segment Elevation Acute Myocardial Infarction

“…In contemporary clinical practice, the pre-hospital delay is greater than 2 hours for more than 50% of the patients [4][5][6][7][8], and to reduce this, most patients with European Journal of Cardiovascular Nursing 10 (2011) 241 -247 www.elsevier.com/locate/ejcnurse STEMI in Denmark are currently admitted by field triage, including teletransmission of electrocardiogram [9]. However, given that 40-60% of patients choose other means of transportation than ambulance [6,7,[10][11][12][13][14][15][16], the behaviour of patients at onset of symptoms tends to limit the effect of this well-organised pre-hospital treatment organisation. Previous studies have examined the processes by which subjects decide whether to seek care when experiencing symptoms [4,[6][7][8]10,11,13,[15][16][17][18][19][20][21][22][23] and some found that women delayed longer than men [6,8,15,[18][19][20]23], while others found no gender differences [7,11,21,22].…”

“…However, given that 40-60% of patients choose other means of transportation than ambulance [6,7,[10][11][12][13][14][15][16], the behaviour of patients at onset of symptoms tends to limit the effect of this well-organised pre-hospital treatment organisation. Previous studies have examined the processes by which subjects decide whether to seek care when experiencing symptoms [4,[6][7][8]10,11,13,[15][16][17][18][19][20][21][22][23] and some found that women delayed longer than men [6,8,15,[18][19][20]23], while others found no gender differences [7,11,21,22]. Psychological and socio-cultural factors have been linked to delay [7,10,17,24] and some researchers reported that people living alone delayed longer before seeking medical assistance than those living with someone [25], while others did not find this correlation [26].…”

Patient healthcare trajectory. An essential monitoring tool: a systematic review

“…Then there is care at admission, medication management [44] and associated costs-here the trajectory concept emerges. There is also an aspect regarding the effectiveness of the measures implemented [46][47][48][49][50][51][52] and the different treatments [53][54][55]. Another investigated aspect concerns lifestyle, with regard to dietary habits, healthy lifestyle [56], comorbidities [43,57] (smoking and/or alcohol), but also environmental factors like atmospheric pollution.…”