Beyond sociodemographics: factors influencing the decision to seek treatment for symptoms of acute myocardial infarction.

OBJECTIVE

To determine the impact of sociodemographic, clinical, cognitive, emotional, and social factors on patient delay in seeking treatment for symptoms of acute myocardial infarction.

DESIGN

Multicenter descriptive survey.

SETTING

Forty-three hospitals in North America.

SUBJECTS

Two hundred and seventy-seven patients with confirmed acute myocardial infarction enrolled in a thrombolytic clinical trial.

OUTCOME MEASURES

Time from symptom onset to arrival at the hospital for treatment.

RESULTS

Patients with longer delays were older, had lower incomes, had diabetes, experienced their symptoms at home, did not appraise their symptoms as serious or originating from the heart, had symptoms that were intermittent in nature, waited to see whether symptoms disappeared, worried about troubling others, feared what might happen if they sought treatment, and did not realize the importance of symptoms.

CONCLUSION

Patient appraisal of seriousness of symptoms is related to delay, whereas severity, nature, and knowledge of symptoms are not related. Cognitive and emotional responses affect patients' decisions to seek treatment.