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See Latest ArticlesUnderstanding why patients delay seeking care for acute coronary syndromes
Circulation: Cardiovascular Quality and Outcomes, 06/04/09
Sullivan MD et al. – Intention to delay seeking care for acute coronary syndromes is associated with a pt's view of the trustworthiness of others, previous experience with revascularization, and functional limitations, even after adjustment for objective and perceived acute coronary syndromes risk. These findings provide insight into novel factors contributing to longer delay times and may inform future interventions to reduce delay time.
Methods- Questionnaires on psychological distress and attachment styles (worthiness to receive care, trustworthiness of others to provide care)
- Subjects: 796 pts with suspected ischemic heart disease scheduled for clinically indicated imaging stress tests
- Primary dependent variable: response to a question from the rapid early action for coronary treatment trial concerning intention to "wait until very sure" before seeking care for a possible "heart attack"
- Question responses for primary dependent variable: strongly associated with actual emergency department-reported and self-reported care delay in rapid early action for coronary treatment trial
- On multivariable regression, a more negative view of others' trustworthiness, greater physical limitations from angina, and no previous revascularization were independently associated with increased intention to wait to seek care for myocardial infarction
- Intention to wait was not associated with inducible ischemia or self-perceived risk of myocardial infarction
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