Overview :
Finnegan et al evaluated patients after a
heart attack to identify reasons why they delayed seeking
care. This can help identify ways of educating patients so
they seek care sooner. The authors are from the Universities
of Minnesota, Washington, Massachusetts, Harvard, Texas at
Houston and Alabama.
Reasons varied for a number of factors,
including gender, race, age, expectations and past
history.
Reasons people delayed seeking medical
care:
(1) They
were expecting a heart attack to present differently or in a
clear cut manner.
(2) They
thought the symptoms were caused by another condition.
(3) They did
not think that they were at risk for a heart attack, or if
they were aware they thought the risk was lower than it
was.
(4) They did
not want to bother people or be considered a whiner, so
delayed reporting until symptoms were moderate or severe.
(5) They
wanted to discuss the problem with someone (family member,
friend, physician) and to get permission or tell them to seek
care.
(6) They did
not trust the Emergency Medical Services or 911 responders (to
give proper care, to take them to the hospital of preference,
other reasons).
(7) They
waited for family or friends to take them to the hospital
rather than calling for an ambulance.
(8) They
were unaware of the benefits of early diagnosis and
therapy.
(9) They
were the primary caregiver in a family and they felt unable to
get away.
(10) They
waited to groom and dress themselves so not to be embarassed
by going as they were.
Interventions to improve timeliness of
seeking care:
(1) Educate
a person about the different ways that an acute coronary event
can present and that initial symptoms may be vague.
(2) Educate
the person about risk factors for the acute coronary syndromes
and identify the patient's level of risk.
(3) Instruct
them to contact family, friend or others immediately after the
first symptoms.
(4) Work to
improve trust between the community and emergency care
responders.
(5) Educate
the patients and families about the benefits of early
treatment.
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