Women's interpretation of cardiac symptoms at the time of their cardiac event: the effect of co-occurring illness.

BACKGROUND

Women tend to access medical help for a myocardial infarction later than men and are at a disproportionate risk of dying or of suffering disability as a consequence. Co-morbidity is associated with delay but little is known how this affects decision making.

AIM

To examine the effect of co-occurring chronic illness or infections on women's interpretation of their symptoms and action at the time of their cardiac event.

METHODS

Semi-structured interviews with 44 women admitted to 3 district hospitals following a cardiac event. For the purposes of analysis they were divided into those who arrived at the hospital within 12 h of onset of symptoms (<12 hour group) and those who took more than 12 h (>12 hour group).

FINDINGS

Women utilised their mental records of knowledge and experiences to make sense of their cardiac symptoms. The mental records of the <12 hour group contained knowledge of symptoms and previous experiences relevant to cardiac problems. Those of the >12 hour group contained knowledge and experience of recent and co-occurring chronic illnesses, this provided persuasive 'evidence' to suggest that their symptoms were normal or typical for their current state of health and resulted in delay.

CONCLUSION

Women's decision making and timely access to medical help at the time of a cardiac event is influenced by their repertoire of knowledge and experience. Interventions need to be designed to capture the process of symptom recognition and the influence of co-morbidity.