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Inability to act was associated with an extended delay prior to care-seeking, in patients with an acute myocardial infarction
Karolinska Institutet.
Karolinska Institutet.
Karolinska Institutet.
The Swedish Red Cross University College, Department of Health Sciences. Karolinska Institutet.ORCID iD: 0000-0001-5376-5048
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2019 (English)In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 18, no 6, p. 512-520Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The out-of-hospital mortality in patients with acute myocardial infarction remains unchanged in contrast to a decrease in inhospital mortality. Interventions aiming to shorten patient delay have been largely unsuccessful. A deeper understanding is apparently needed on patients' appraisal prior to care-seeking.

AIM: To investigate whether appraisal processes influence patient delay, and if the questionnaire 'Patients' appraisal, emotions and action tendencies preceding care seeking in acute myocardial infarction' (PA-AMI) could discriminate between patients with prolonged care-seeking and those with a short delay.

METHODS: A cross-sectional study including 326 acute myocardial infarction patients filling out the validated questionnaire PA-AMI. The impact of subscales on delay was analysed by projection to latent structures regression. Discrimination opportunities between patients with short and long delays were analysed by projection to latent structures discriminant analysis.

RESULTS: The subscales 'perceived inability to act' and 'symptom appraisal' had a major impact on patient delay ( P<0.0001). 'Perceived inability to act' had its main influence in patients with a delay exceeding 12 hours, and 'symptom appraisal' had its main influence in patients with a delay shorter than one hour.

CONCLUSION: Appraisal processes influence patient delay. Acute myocardial infarction patients with a prolonged delay were, besides a low perceived symptom severity and urgency to seek medical care, characterised by a perceived loss of control and ability to act. Therefore, future interventions aimed at decreasing delay should pay attention to appraisal processes, and perceived inability to act may be a sign of a health threat and therefore a signal to seek medical care.

Place, publisher, year, edition, pages
2019. Vol. 18, no 6, p. 512-520
Keywords [en]
Acute myocardial infarction, PLS regression analysis, appraisal process, patient delay, questionnaire
National Category
Nursing
Identifiers
URN: urn:nbn:se:rkh:diva-2839DOI: 10.1177/1474515119844654PubMedID: 31132880OAI: oai:DiVA.org:rkh-2839DiVA, id: diva2:1323697
Funder
Swedish Heart Lung FoundationStockholm County CouncilAvailable from: 2019-06-12 Created: 2019-06-12 Last updated: 2019-08-14Bibliographically approved

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Saboonchi, Fredrik

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