Rosenfeld Anne G, Lindauer Allison, Darney Blair G
School of Nursing, Oregon Health & Science University, Portland, OR, USA.
Am J Crit Care. 2005 Jul;14(4):285-93.
Women delay seeking treatment for symptoms of acute myocardial infarction longer than men delay. Women's delay time has not been thoroughly characterized.
To qualitatively describe the period between the onset of symptoms of myocardial infarction and enactment of the decision to seek care (decision time) and to identify common patterns of cognitive, affective, and behavioral responses to the symptoms (decision trajectories).
In this qualitative study, 52 women were asked in semistructured interviews to describe the symptoms and related thoughts, decisions, and actions from the onset of symptoms of myocardial infarction to arrival at the hospital. Narrative analysis was used to examine the stories and to identify patterns of decision-making behavior.
Six common patterns of behavior during the decision time were identified: knowing and going, knowing and letting someone take over, knowing and going on the patient's own terms, knowing and waiting, managing an alternative hypothesis, and minimizing. The patterns were further grouped as knowing or managing. Women in the 2 groups (knowing and managing) differed primarily in their awareness and interpretations of the symptoms and in their patterns of behavior in seeking treatment.
Women's delay in seeking treatment for symptoms of myocardial infarction can be categorized into distinct patterns. Clinicians can use knowledge of these patterns to detect responses and situations that can decrease decision time in future cardiac events and to educate women about how to respond to cardiac symptoms.
女性因急性心肌梗死症状而延迟寻求治疗的时间比男性更长。女性的延迟时间尚未得到充分描述。
定性描述心肌梗死症状出现至做出寻求治疗决定（决策时间）之间的时间段，并确定对症状的认知、情感和行为反应的常见模式（决策轨迹）。
在这项定性研究中，52名女性在半结构化访谈中被要求描述从心肌梗死症状出现到入院期间的症状以及相关的想法、决定和行动。采用叙事分析来审视这些故事并确定决策行为模式。
确定了决策时间内六种常见的行为模式：知晓并前往、知晓并让他人接手、知晓并按自己的方式前往、知晓并等待、处理替代假设以及最小化。这些模式进一步分为知晓或处理两类。两组（知晓和处理）女性的主要差异在于她们对症状的认知和解读以及寻求治疗的行为模式。
女性因心肌梗死症状而延迟寻求治疗可分为不同模式。临床医生可利用这些模式的知识来发现能够缩短未来心脏事件决策时间的反应和情况，并就如何应对心脏症状对女性进行教育。
