Knowledge about Acute Myocardial Infarction (AMI) and attitudes to medical care seeking—A comparison between patients and the general public

Catrin Henriksson, Margareta Larsson, Judy Arnetz, Johan Herlitz, Jan-Erik Karlsson, Leif Svensson, Marie Thuresson, Crister Zedigh, Lisa Wernroth, Bertil Lindahl

Department of Cardiology, Falu Hospital, Falun, Sweden.
Department of Cardiology, Orebro University Hospital, Orebro, Sweden.
Department of Cardiology, Ryhov Hospital, Jonkoping, Sweden.
Department of Clinical Science and Education, Karolinska Institute, Stockholm, Sweden.
Department of Family Medicine and Public Health Sciences, Wayne State University, Detroit, USA.
Department of Medical Sciences and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden.
Department of Women’s and Children’s health, Uppsala University, Uppsala, Sweden.
Institution of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden.

DOI: 10.4236/ojn.2012.24055                

Abstract

Background: Patients with acute myocardial infarction often have long decision times before seeking medical care. The decision time is influenced by knowledge of AMI-symptoms, psychological factors and the response of people near the patient to the symptoms. Aim: To investigate and compare the knowledge of AMI, intended actions in response to AMI-symptoms and attitudes toward seeking medical care of patients and the general public. Method: This was a multicentre study with descriptive and comparative design, using questionnaires as an instrument. The population consisted of AMI-patients and representatives of the general public. Results: There was good knowledge about typical AMI-symptoms among the participants. The majority thought an AMI always starts suddenly. Patients did not know more about the time-dependency of treatment outcome than the general public. A greater proportion of the general public would contact an additional person before consulting medical professionals. Conclusions: Patients had no better knowledge about AMI than the general public, but would more commonly act appropriately in case of AMI-symptoms.

Keywords

Acute Myocardial Infarction; Decision Making; Patient; General Public; Knowledge and Attitudes

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	McGinn, A.P., Rosamond, W.D., Goff Jr., D.C., Taylor, H.A., Miles, J.S. and Chambless, L. (2005) Trends in prehospital delay time and use of emergency medical services for acute myocardial infarction: Experience in 4 US communities from 1987-2000. American Heart Journal, 150, 392-400. doi:10.1016/j.ahj.2005.03.064
[2]	Boersma, E. (2006) Does time matter? A pooled analysis of randomized clinical trials comparing primary percutaneous coronary intervention and in-hospital fibrinolysis in acute myocardial infarction patients. European Heart Journal, 27, 779-788. doi:10.1093/eurheartj/ehi810
[3]	Rasmussen, C.H., Munck, A., Kragstrup, J. and Haghfelt, T. (2003) Patient delay from onset of chest pain suggesting acute coronary syndrome to hospital admission. Scandinavian Cardiovascular Journal, 37, 183-186. doi:10.1080/14017430310014920
[4]	Perkins-Porras, L., Whitehead, D.L., Strike, P.C. and Steptoe, A. (2009) Pre-hospital delay in patients with acute coronary syndrome: Factors associated with patient decision time and home-to-hospital delay. European Heart Journal, 8, 26-33. doi:10.1016/j.ejcnurse.2008.05.001
[5]	Boersma, E., Maas, A.C., Deckers, J.W. and Simoons, M.L. (1996) Early thrombolytic treatment in acute myocardial infarction: Reappraisal of the golden hour. Lancet, 348, 771-775. doi:10.1016/S0140-6736(96)02514-7
[6]	De Luca, G., Suryapranata, H., Ottervanger, J.P. and Antman, E.M. (2004) Time delay to treatment and mortality in primary angioplasty for acute myocardial infarction: Every minute of delay counts. Circulation, 109, 1223-1225. doi:10.1161/01.CIR.0000121424.76486.20
[7]	Kainth, A., Hewitt, A., Sowden, A., Duffy, S., Pattenden, J., Lewin, R., Watt, I. and Thompson, D. (2004) Systematic review of interventions to reduce delay in patients with suspected heart attack. Emergency Medicine Journal, 21, 506-508. doi:10.1136/emj.2003.013276
[8]	Luepker, R.V., Raczynski, J.M., Osganian, S., Goldberg, R.J., Finnegan Jr., J.R., Hedges, J.R., Goff Jr., D.C., Eisenberg, M.S., Zapka, J.G., Feldman, H.A., Labarthe, D.R., McGovern, P.G., Cornell, C.E., Proschan, M.A. and Simons-Morton, D.G. (2000) Effect of a community intervention on patient delay and emergency medical service use in acute coronary heart disease: The Rapid Early Action for Coronary Treatment (REACT) Trial. JAMA, 284, 60-67. doi:10.1001/jama.284.1.60
[9]	Goff Jr., D.C., Sellers, D.E., McGovern, P.G., Meischke, H., Goldberg, R.J., Bittner, V., Hedges, J.R., Allender, P.S. and Nichaman, M.Z. (1998) Knowledge of heart attack symptoms in a population survey in the United States: The react trial. Rapid early action for coronary treatment. Archives of Internal Medicine, 158, 2329-2338. doi:10.1001/archinte.158.21.2329
[10]	Greenlund, K.J., Keenan, N.L., Giles, W.H., Zheng, Z.J., Neff, L.J., Croft, J.B. and Mensah, G.A. (2004) Public recognition of major signs and symptoms of heart attack: Seventeen states and the US Virgin Islands, 2001. American Heart Journal, 147, 1010-1016. doi:10.1016/j.ahj.2003.12.036
[11]	Khan, M.S., Jafary, F.H., Faruqui, A.M., Rasool, S.I., Hatcher, J., Chaturvedi, N. and Jafar, T.H. (2007) High prevalence of lack of knowledge of symptoms of acute myocardial infarction in Pakistan and its contribution to delayed presentation to the hospital. BMC Public Health, 7, 284. doi:10.1186/1471-2458-7-284
[12]	Ruston, A., Clayton, J. and Calnan, M. (1998) Patients’ action during their cardiac event: Qualitative study exploring differences and modifiable factors. BMJ, 316, 1060-1064. doi:10.1136/bmj.316.7137.1060
[13]	Lozzi, L., Carstensen, S., Rasmussen, H. and Nelson, G. (2005) Why do acute myocardial infarction patients not call an ambulance? An interview with patients presenting to hospital with acute myocardial infarction symptoms. Internal Medicine Journal, 35, 668-671.
[14]	Johansson, I., Stromberg, A. and Swahn, E. (2004) Ambulance use in patients with acute myocardial infarction. Journal of Cardiovascular Nursing, 19, 5-12.
[15]	Thuresson, M., Jarlov, M.B., Lindahl, B., Svensson, L., Zedigh, C. and Herlitz, J. (2007) Thoughts, actions, and factors associated with prehospital delay in patients with acute coronary syndrome. Heart Lung, 36, 398-409. doi:10.1016/j.hrtlng.2007.02.001
[16]	Henriksson, C., Lindahl, B. and Larsson, M. (2007) Patients’ and relatives’ thoughts and actions during and after symptom presentation for an acute myocardial infarction. European Journal of Cardiovascular Nursing, 6, 208-206. doi:10.1016/j.ejcnurse.2007.02.001
[17]	Alonzo, A.A. (1986) The impact of the family and lay others on care-seeking during life-threatening episodes of suspected coronary artery disease. Social Science & Medicine, 22, 1297-1311. doi:10.1016/0277-9536(86)90093-6
[18]	Perkins-Porras, L., Whitehead, D.L., Strike, P.C. and Steptoe, A. (2008) Causal beliefs, cardiac denial and pre-hospital delays following the onset of acute coronary syndromes. Journal of Behavioral Medicine, 31, 498-505. doi:10.1007/s10865-008-9174-3
[19]	Stenstrom, U., Nilsson, A.K., Stridh, C., Nijm, J., Nyrinder, I., Jonsson, A., Karlsson, J.E. and Jonasson, L. (2000) Denial in patients with a first-time myocardial infarction: Relations to pre-hospital delay and attendance to a cardiac rehabilitation programme. European Journal of Cardiovascular Prevention & Rehabilitation, 12, 568-571. doi:10.1097/01.hjr.0000186620.75733.15
[20]	Henriksson, C., Larsson, M., Arnetz, J., Berglin-Jarlov, M., Herlitz, J., Karlsson, J.E., Svensson, L., Thuresson, M., Zedigh, C., Wernroth, L. and Lindahl, B. (2011) Knowledge and attitudes toward seeking medical care for AMI-symptoms. International Journal of Cardiology, 147, 224-7. doi:10.1016/j.ijcard.2009.08.019
[21]	Limbu, Y.R., Malla, R., Regmi, S.R., Dahal, R., Nakarmi, H.L., Yonzan, G. and Gartaula, R.P. (2006) Public knowledge of heart attack in a Nepalese population survey. Heart Lung, 35, 164-169. doi:10.1016/j.hrtlng.2005.12.003
[22]	Ratner, P.A., Tzianetas, R., Tu, A.W., Johnson, J.L., Mackay, M., Buller, C.E., Rowlands, M. and Reime, B. (2006) Myocardial infarction symptom recognition by the lay public: The role of gender and ethnicity. Journal of Epidemiology & Community Health, 60, 606-615. doi:10.1136/jech.2005.037952
[23]	Brown, A.L., Mann, N.C., Daya, M., Goldberg, R., Meischke, H., Taylor, J., Smith, K., Osganian, S. and Cooper, L. (2000) Demographic, belief, and situational factors influencing the decision to utilize emergency medical services among chest pain patients. Rapid Early Action for Coronary Treatment (REACT) study. Circulation, 102, 173-178. doi:10.1161/01.CIR.102.2.173
[24]	Thuresson, M., Jarlov, M.B., Lindahl, B., Svensson, L., Zedigh, C. and Herlitz, J. (2005) Symptoms and type of symptom onset in acute coronary syndrome in relation to ST elevation, sex, age, and a history of diabetes. American Heart Journal, 150, 234-242. doi:10.1016/j.ahj.2004.08.035
[25]	Goff Jr., D.C., Mitchell, P., Finnegan, J., Pandey, D., Bittner, V., Feldman, H., Meischke, H., Goldberg, R.J., Luepker, R.V., Raczynski, J.M., Cooper, L. and Mann, C. (2004) Knowledge of heart attack symptoms in 20 US communities. Results from the rapid early action for coronary treatment community trial. Preventive Medicine, 38, 85-93. doi:10.1016/j.ypmed.2003.09.037
[26]	Herlitz, J., Thuresson, M., Svensson, L., Lindqvist, J., Lindahl, B., Zedigh, C. and Jarlov, M. (2010) Factors of importance for patients’ decision time in acute coronary syndrome. International Journal of Cardiology, 141, 236-242. doi:10.1016/j.ijcard.2008.11.176
[27]	Glanz Karen, R.B. and Viswanath, K. (2008) Health behavior and health education: Theory, research and practice. Jossey-Bass, San Francisco.
[28]	Saczynski, J.S., Yarzebski, J., Lessard, D., Spencer, F.A., Gurwitz, J.H., Gore, J.M. and Goldberg, R.J. (2008) Trends in prehospital delay in patients with acute myocardial infarction (from the Worcester Heart Attack Study). American Journal of Cardiology, 102, 1589-1594. doi:10.1016/j.amjcard.2008.07.056
[29]	Floyd, K.C., Yarzebski, J., Spencer, F.A., Lessard, D., Dalen, J.E., Alpert, J.S., Gore, J.M. and Goldberg, R.J. (2009) A 30-year perspective (1975-2005) into the changing landscape of patients hospitalized with initial acute myocardial infarction: Worcester heart attack study. Circulation: Cardiovascular Quality and Outcomes, 2, 88-95. doi:10.1161/CIRCOUTCOMES.108.811828
[30]	Goldberg, R.J., Spencer, F.A., Fox, K.A., Brieger, D., Steg, P.G., Gurfinkel, E., Dedrick, R. and Gore, J.M. (2009) Prehospital delay in patients with acute coronary syndromes (from the Global Registry of Acute Coronary Events [GRACE]). American Journal of Cardiology, 103, 598-603. doi:10.1016/j.amjcard.2008.10.038
[31]	Leventhal, H. and Cameron, L. (2003) The self-regulation of health and illness behaviour. Routledge, New York.
[32]	Lovlien, M., Schei, B. and Hole, T. (2006) Women with myocardial infarction are less likely than men to experience chest symptoms. Scandinavian Cardiovascular Journal, 40, 342-347. doi:10.1080/14017430600913199
[33]	Ryan, C.J. and Zerwic, J.J. (2003) Perceptions of symptoms of myocardial infarction related to health care seeking behaviors in the elderly. Journal of Cardiovascular Nursing, 18, 184-196.