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 embarrassed 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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