Determinants of decisions to seek medical treatment by patients with acute myocardial infarction symptoms.

The present study examined the type A behavior, symptom experience, and decisions to seek treatment of patients with acute myocardial infarction (MI) symptoms. Subjects were 43 patients admitted to the coronary care units of one of two hospitals for a suspected infarct. They were interviewed in the hospital, usually within 5 days of their arrival. The interview included questions about the patients' prehospital symptom experience, demographic characteristics, and Type A behaviors. Analyses revealed that the patients who delayed in the early phase of seeking treatment (i.e., excessive time between patients' noting initial symptoms and deciding they were ill) were those who reported that they characteristically exhibited some Type A behaviors, that they experienced little initial pain at a time when work was quite demanding, and that they responded to their symptoms with depression and fatigue. Moreover, they were currently quite pessimistic about their health. Those who delayed in the later phase (i.e., excessive time between patients' deciding they were ill and deciding they would seek treatment) were persons who were assessed as Type B on the Structured Interview and who talked to others to assess the meaning of their symptoms. The implications of the findings for a stage model of delay are discussed and some limitations of the present study are considered.