Factors Related To Pre-hospital Delay In Chinese Patients With Acute Myocardial Infarction (AMI)

Objective:The purpose of this study was to examine gender difference in pre-hospital delay time among the patients with Acute Myocardial Infarction (AMI), assess the knowledge, attitude and beliefs of AMI symptoms, describe the anxiety, depression and cardiac denial level among the patients, and explore the factors related to pre-hospital delay among the patients with AMI.Method:Based on Leventhal’s Self-Regulation Theory, a descriptive, correctional cross-sectional design was used in the study. A convenience sample of115hospitalized patients with AMI participated in the interview after they were physiologically stable. Data were collected via interview using structured questionnaire and scales included Acute Coronary Syndrome (ACS) Response Index, Hospital Anxiety and Depression Scale (HADS), Cardiac Denial of Impact Scale (CDIS) and the demographic questionnaire.Result:The study findings demonstrated that the participants had a relatively longer pre-hospital delay time (M=6.64hours), there is significant gender difference in delay in seeking treatment for AMI (P<0.01), female delayed longer than male patients, with a mean pre-hospital delay time of12.49hours vs4.76hours. Among115participants, knowledge level of ACS symptoms is insufficient (M=11.51), their attitude of ACS symptoms are not positive (M=9.73) and their beliefs and prompt action of ACS symptoms is limited (M=21.37). There are statistically significant difference of knowledge level based on age and medical history(P<0.05); there are statistically significant difference of attitude scores based on educational background and living with family member or living alone (P<0.05); there are statistically significant difference of beliefs scores based on gender, age, income, educational background and first response to symptoms (P<0.05). Patients in this study reported they have low psychological distress. The mean score on cardiac denial scale is33.71, the mean score on hospital anxiety and depression scale is10.69. There were no relationships among cardiac denial score, anxiety and depression level and pre-hospital delay time. There were numerous significant positive and negative correlations found among gender, income level, educational background, living area, first response to AMI symptoms, beliefs, pain severity and pre-hospital delay time. The study findings revealed that best predictors of pre-hospital delay time were pain severity, gender, first response to AMI symptoms and living areas among the patients.Conclusion:Interventions intended to decrease patients delay should be aimed at increasing patients’perception and knowledge of AMI symptoms, treatment-seeking behavior, especially for women. The nurses and health care providers should strengthen education and counseling programs that are designed to help the patients with high risk factors to recognize early symptoms and quickly seek medical care when they experience a heart attack.