Symptom presentation and time to seek care in women and men with acute myocardial infarction

• Published in: Heart & lung Vol. 36; no. 4; pp. 235 - 243
• Main Authors: King, Kathleen B., RN, PhD, FAAN, McGuire, Mary Ann, RN, MS
• Format: Journal Article
• Language: English
• Published: United States Mosby, Inc 01.07.2007; Elsevier Science Ltd
• Subjects: Adult; Aged; Aged, 80 and over; Cardiology; Cardiovascular; Critical Care; Delivery of Health Care - standards; Diagnosis, Differential; Female; Fibrinolytic Agents - therapeutic use; Follow-Up Studies; Gender differences; Health care; Heart attacks; Humans; Male; Middle Aged; Myocardial Infarction - diagnosis; Myocardial Infarction - drug therapy; Prognosis; Pulmonary/Respiratory; Risk Factors; Sex Factors; Thrombolytic Therapy - methods; Time Factors
• ISSN: 0147-9563; 1527-3288
• DOI: 10.1016/j.hrtlng.2006.08.008

Background Leventhal’s commonsense model of illness representation was used to examine symptom presentation, time to seek care, and expectations about the experience of having an acute myocardial infarction (AMI). Hypotheses (1) Women with AMI will report a different symptom set than men, (2) women’s expectations about AMI, for level of risk and symptoms, will be different than men’s, (3) women will take longer to seek care than men, and (4) as suggested by the commonsense model, a match between expected and actual symptoms will be related to shorter time to seek care. Method A descriptive, correlational design was used. Thirty woman and 30 men diagnosed with AMI or an evolving MI treated with thrombolytic therapy or primary percutaneous coronary intervention were interviewed using the Symptom Representation Questionnaire. Results Gender differences in symptom presentation were limited. The majority of women and men reported that their symptoms were different from what they expected an AMI would be like. Most stated that their pain was less than expected, whereas some reported either the location of discomfort or associated symptoms as different then expected. There was no gender difference in time to seek care. Logistic regression and survival analysis demonstrated that participants who reported a match between symptoms expected and actual symptoms experienced arrived in the emergency department sooner than those whose symptoms did not match their expectations. Conclusion The findings provide support for the use of the commonsense model to explain care-seeking behavior in AMI.