Why people experiencing acute myocardial infarction (AMI) delay seeking medical assistance.

AMI is a major cause of death and disability. Recently thrombolysis has emerged as an effective treatment for the condition, saving lives and improving prognosis. A major factor in the success of this treatment is how quickly thrombolysis is administered. Thus delay time from onset of symptoms of myocardial infarction to seeking medical assistance can have lifethreatening consequences. This has been termed;decision-delay;. A number of factors have been associated with decision-delay, but there is little evidence regarding the predictive value of these indices. The aim of this study was to explore potential predictors of patient delay from onset of symptoms to time medical assistance was sought. A quantitative methodology was employed, to survey a consecutive sample of 62 patients admitted to CCU with acute myocardial infarction. A combination of three questionnaires were used to gather data: • The Cardiac Denial of Impact Scale (Fowers 1992) • Health Locus of Control Scale (Wallston et al 1976) • Health Value Scale (Lau et al 1986) Data were analysed using SPSS, standard descriptive statistics and logistic regression analysis. Most patients in this study, irrespective of previous cardiac history, initially attributed their symptoms to indigestion. The median delay between onset of symptoms and seeking help was 135 minutes. Attribution of symptoms to heart disease and health locus of control had asignificant predictive effect (p=<0.05) on patients seeking help within 60 minutes, while previous experience of heart disease did not. Nurses in a wide variety of settings have the potential to educate patients on symptoms of AMI. Assisting individuals to recognise the potential for symptoms to have a cardiac origin is an important objective in terms of both primary and secondary prevention. Nursing interventions should take into account the variety of cognitive and behavioural factors involved in patients; decision making processes. Intended learning outcomes: • Identify potential factors which may predict decision delay in patients experiencing an AMI. • Understand the importance of reducing decision delay in this group of patients. • Discuss a variety of potential nursing interventions to effectively reduce decision delay