BEYOND SOCIODEMOGRAPHICS - FACTORS INFLUENCING THE DECISION TO SEEK TREATMENT FOR SYMPTOMS OF ACUTE MYOCARDIAL-INFARCTION

OBJECTIVE: To determine the impact of sociodemographic, clinical, cogn itive, emotional, and social factors on patient delay in seeking treat ment for symptoms of acute myocardial infarction. DESIGN: Multicenter descriptive survey. SETTING: Forty-three hospitals in North America. S UBJECTS: Two hundred and seventy-seven patients with confirmed acute m yocardial infarction enrolled in a thrombolytic clinical trial. OUTCOM E MEASURES: Time from symptom onset to arrival at the hospital for tre atment. RESULTS: Patients with longer delays were older, had lower inc omes, had diabetes, experienced their symptoms at home, did not apprai se their symptoms as serious or originating from the heart, had sympto ms that were intermittent in nature, waited to see whether symptoms di sappeared, 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.