Women's descriptions of symptoms and delay reasons in seeking medical care at the time of a first myocardial infarction: A qualitative study
Section snippets
What is already known about the topic?
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Coronary heart disease remains the number one killer of both women and men.
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Women often experience atypical symptoms.
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Women's perceptions of their low risk for myocardial infarction greatly influence their decision-making process.
What this paper adds
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In spite of severe and evident clinical symptoms even from the chest pain, women do not see these as a potential risk for myocardial infarction.
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Although intensive and unmanageable pain, women wait at home thinking pain will disappear.
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Women have difficulties interpreting, understanding and linking the clinical symptoms to coronary heart disease.
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Women need to be communicated the consequences of delay in seeking medical care following a myocardial infarction.
Design and method description
The study had an exploratory design based on content analysis to describe women's symptoms and their decision to delay seeking medical care. The content analysis method is especially suitable to analyse situations or documented processes (Burnard, 1991). Content analysis initially dealt with the objective, systematic and quantitative description of the manifest content of a text, but over time, the method has expanded to also include interpretation of latent content (Graneheim and Lundman, 2004
Ethical considerations
Verbal and written information about the study was given to each potential participant. Participation was voluntary and the participants were informed that they could withdraw at any time and that all data would be treated confidentially. Permission for the study was obtained from the Ethics Committee at Lund University, Sweden.
Describing pain
The women described the pain in many different ways. They described the pain as coming rather acute and sudden or that the symptoms did not appear typical for MI and overly painful. They experienced the pain as having a pressure over the chest. They also had pain in the left arm and in the scapula. They also described that they had pain in the back and how the pain moved from one part of the body to another and progressed. Although the pain was difficult to manage, they wanted to wait at home
Discussion
Trustworthiness is a central concept in content analysis and is best described using the terms credibility, dependability and transferability (Graneheim and Lundman, 2004). The trustworthiness of the data collection was satisfied in terms of a well-established cardiac nurse, who conducted all the interviews at a location chosen by the participants. The main author also transcribed the interviews soon after they were conducted, thereby reducing the risk of misunderstanding (Fridlund and
Conclusions and implications
This study points out important aspects on women in relation to an MI. The women had difficulties interpreting and understanding their symptoms and linking this to MI. They also had prodromal or atypical symptoms and they often tried to find explanations for this. They used different kinds of strategies for curing themselves such as taking medication or resting for a while. The women had problems with making the final decision to seek medical care when they wanted to have support and help from
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2022, CJC OpenCitation Excerpt :The varied pattern of accompanying symptoms makes it difficult for women to interpret their chest pain as being cardiac-specific.8-10 Women also may minimize their symptoms, consult with family and friends, have caregiving responsibilities, and have concerns for their family11,12–as a result, they may delay seeking care for their chest pain.13 In the International Survey of Acute Coronary Syndromes in Transitional Countries (ISACS-TC), the time from symptom onset to emergency department arrival was longer in women (median: 270 minutes [range: 130-776 minutes]) compared with that in men (median: 240 minutes [range: 120-600 minutes]), which resulted in increased 30-day mortality for women, even after controlling for baseline variables (odds ratio: 1.58; 95% confidence interval [CI], 1.27-1.97).14
Predictors of delay in seeking treatment by Jordanian patients with acute coronary syndrome
2016, International Emergency NursingCitation Excerpt :For instance, lower income and lack of insurance are fixed variables to correlate with ACS delay time (Eshah, 2013; Peng et al., 2014) through inability to afford medical expenses, which forces patients to try other remedies or even deny symptoms. Similarly, female patients had a longer delay time, which is consistent with other studies (Eshah, 2013; Peng et al., 2014), which was explained by women's lack of perceived potential risk for ACS (Sjostrom-Strand and Fridlund, 2008). Consistent with other studies (Eshah, 2013; Peng et al., 2014), longer delay time was noted among less educated participants.
From Suspicion to Recognition—Being a Bystander to a Relative Affected by Acute Coronary Syndrome
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