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Blakeman JR, Calderon SJ, Watkins S, Kim M, Peterson K, Prasun MA. A cross-sectional study of Hispanic and Latina/o/x/e individuals' acute coronary syndrome symptom knowledge, attitudes, and beliefs. Heart Lung 2024; 67:100-107. [PMID: 38744181 DOI: 10.1016/j.hrtlng.2024.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Revised: 04/26/2024] [Accepted: 05/09/2024] [Indexed: 05/16/2024]
Abstract
BACKGROUND Little attention has been placed on language proficiency as a potential variable affecting ACS symptom knowledge, attitudes, and beliefs. OBJECTIVES To compare the ACS symptom knowledge, attitudes, and beliefs of Hispanic and Latina/o/x/e individuals proficient in English and in those only proficient in Spanish. Secondary aims were to determine if there were differences in ACS symptom knowledge, attitudes, or beliefs based on participants' previous exposure to ACS symptom information and to evaluate instrument characteristics of the new Spanish version of the ACS Response Index. METHODS This cross-sectional, comparative study included participants (N = 99) from a community-based clinic in Illinois. Knowledge, attitudes, and beliefs related to ACS symptoms were measured using the ACS Response Index. RESULTS The average participant was 39.8 (SD 15.6) years of age, female (n = 56, 56.6 %), and had a high school education or less (n = 61, 61.6 %). Participants correctly classified a mean 57.5 % (SD 12.8) of symptoms and had mean attitude and belief scores of 12.1 (SD 3.3) and 17.5 (SD 2.9), respectively. There were no significant differences in knowledge, attitudes, and beliefs based on language proficiency. However, there were some statistically significant differences for knowledge and attitude scores based on exposure to ACS symptom information. The ACS Response Index (Spanish Version) also demonstrated favorable internal consistency. CONCLUSIONS Overall knowledge, attitude, and belief scores were modest in this sample. Higher knowledge and attitude scores were observed for some types of ACS information exposure, supporting the importance of future educational efforts in this population.
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Affiliation(s)
- John R Blakeman
- Mennonite College of Nursing, Illinois State University, Campus Box 5810, Normal, IL 61790-5810, USA.
| | - Susana J Calderon
- Mennonite College of Nursing, Illinois State University, Campus Box 5810, Normal, IL 61790-5810, USA
| | - Susie Watkins
- Mennonite College of Nursing, Illinois State University, Campus Box 5810, Normal, IL 61790-5810, USA
| | - MyoungJin Kim
- College Statistician, and Director of Mennonite College of Nursing's Office of Nursing Research, Scholarship, and Innovation, Mennonite College of Nursing, Illinois State University, Campus Box 5810, Normal, IL 61790-5810, USA
| | - Kate Peterson
- Mennonite College of Nursing, Illinois State University, Campus Box 5810, Normal, IL 61790-5810, USA
| | - Marilyn A Prasun
- Mennonite College of Nursing, Illinois State University, Campus Box 5810, Normal, IL 61790-5810, USA
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Abed MA, Khalil AA, Moser DK. Patient Denial of Myocardial Infarction in the Prehospital Phase: Prevalence and Correlates. J Cardiovasc Nurs 2024; 39:456-464. [PMID: 37738318 DOI: 10.1097/jcn.0000000000001042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/24/2023]
Abstract
BACKGROUND Limited knowledge exists regarding patients' denial of myocardial infarction (MI) before hospitalization for an MI. OBJECTIVE The aim of this study was to determine the prevalence and correlates of denial of MI in the prehospital phase of a confirmed MI. METHODS This secondary analysis included 166 hospitalized patients (mean [SD] age, 54.1 [10.5] years) who developed MI outside a healthcare facility and had high congruence between their experienced and expected symptoms. Measurements included the Denial subscale of the Brief COPE Inventory, the modified Response to Symptoms Questionnaire, and a Likert scale measuring perceived risk for MI. Patients who arrived at a hospital at least 1 hour after the onset of their symptoms were considered to have prolonged prehospital delay. RESULTS Despite their high symptom congruence, 77% of patients denied the possibility of having an MI before hospitalization. The lower denial group was characterized by cardiac history, whereas the higher denial group was distinguished by nonsmoking, a lower perceived risk of MI, less anxiety at symptom onset, and more concerns about seeking medical help. Compared with the lower denial group, patients in the higher denial group were more likely to underestimate the seriousness of their symptoms and delay seeking medical help. The higher denial group responded to symptoms in a more passive manner (eg, waiting), whereas the lower denial group showed a more problem-solving approach (eg, contacting emergency services). CONCLUSIONS Denial of MI is highly prevalent in the prehospital phase and is negatively linked with cognitive, emotional, and behavioral responses to MI symptoms.
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Ninomiya R, Koeda Y, Nasu T, Ishida M, Yoshizawa R, Ishikawa Y, Itoh T, Morino Y, Saito H, Onodera H, Nozaki T, Maegawa Y, Nishiyama O, Ozawa M, Osaki T, Nakamura A. Effect of Patient's Symptom Interpretation on In-Hospital Mortality in Acute Coronary Syndrome. Circ J 2024; 88:1225-1234. [PMID: 38880608 DOI: 10.1253/circj.cj-24-0113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/18/2024]
Abstract
BACKGROUND The association between symptom interpretation and prognosis has not been investigated well among patients with acute coronary syndrome (ACS). As such, the present study evaluated the effect of heart disease awareness among patients with ACS on in-hospital mortality. METHODS AND RESULTS We performed a post hoc analysis of 1,979 consecutive patients with ASC with confirmed symptom interpretation on admission between 2014 and 2018, focusing on patient characteristics, recanalization time, and clinical outcomes. Upon admission, 1,264 patients interpreted their condition as cardiac disease, whereas 715 did not interpret their condition as cardiac disease. Although no significant difference was observed in door-to-balloon time between the 2 groups, onset-to-balloon time was significantly shorter among those who interpreted their condition as cardiac disease (254 vs. 345 min; P<0.001). Moreover, the hazard ratio (HR) for in-hospital mortality was significantly higher among those who did not interpret their condition as cardiac disease based on the Cox regression model adjusted for established risk factors (HR 1.73; 95% confidence interval 1.08-2.76; P=0.022). CONCLUSIONS This study demonstrated that prehospital symptom interpretation was significantly associated with in-hospital clinical outcomes among patients with ACS. Moreover, the observed differences in clinical prognosis were not related to door-to-balloon time, but may be related to onset-to-balloon time.
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Affiliation(s)
- Ryo Ninomiya
- Division of Cardiology, Department of Internal Medicine, Iwate Medical University
| | - Yorihiko Koeda
- Division of Cardiology, Department of Internal Medicine, Iwate Medical University
| | - Takahito Nasu
- Division of Cardiology, Department of Internal Medicine, Iwate Medical University
| | - Masaru Ishida
- Division of Cardiology, Department of Internal Medicine, Iwate Medical University
| | - Reisuke Yoshizawa
- Division of Cardiology, Department of Internal Medicine, Iwate Medical University
| | - Yu Ishikawa
- Division of Cardiology, Department of Internal Medicine, Iwate Medical University
| | - Tomonori Itoh
- Division of Cardiology, Department of Internal Medicine, Iwate Medical University
| | - Yoshihiro Morino
- Division of Cardiology, Department of Internal Medicine, Iwate Medical University
| | - Hidenori Saito
- Department of Cardiology, Iwate Prefectural Chubu Hospital
| | | | - Tetsuji Nozaki
- Department of Cardiology, Iwate Prefectural Isawa Hospital
| | - Yuko Maegawa
- Department of Cardiology, Iwate Prefectural Miyako Hospital
| | | | - Mahito Ozawa
- Department of Cardiology, Japanese Red Cross Morioka Hospital
| | - Takuya Osaki
- Department of Cardiology, Iwate Prefectural Kuji Hospital
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Su J, Xiong JM, Ke QQ, Yu HY, Zhao ZR, Yang QH. Experiences and perceptions of acute myocardial infarction patients with a prolonged decision-making phase of treatment seeking: A meta-synthesis. J Clin Nurs 2023; 32:7891-7908. [PMID: 37353965 DOI: 10.1111/jocn.16802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 06/06/2023] [Accepted: 06/08/2023] [Indexed: 06/25/2023]
Abstract
AIMS To describe the experiences and perceptions of acute myocardial infarction (AMI) patients with a prolonged decision-making phase of treatment-seeking. BACKGROUND Previous attempts to reduce the treatment-seeking time of AMI have been less than optimal. Due to the coronavirus disease 2019 (COVID-19) pandemic, the situation of prehospital delay is possibly worse. Decisions to seek treatment are influenced by multiple factors and need individualised interventions. Understanding patients' external and internal experiences and psychological perceptions is essential. DESIGN Meta-synthesis. DATA SOURCES We searched PubMed, Embase, Cochrane Library, Web of Science, Scopus and four Chinese databases from inception to April 2022. METHODS We screened the retrieved articles with predetermined inclusion and exclusion criteria, and reviewed articles using Thomas and Harden's (BMC Medical Research Methodology, 2008 8, 45) qualitative thematic synthesis approach. The Joanna Briggs Institute critical appraisal tool for qualitative research was used to assess the quality of studies. RESULTS Twenty-one studies were included, identifying four themes and nine sub-themes. The four primary themes were difficulty recognising and attributing symptoms, attempt to act, unwillingness to change and self-sacrifice. CONCLUSION Deciding to seek treatment is a complex social and psychological process, which needs comprehensive interventions considering personal and sociocultural factors and factors related to the COVID-19 pandemic. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE Details of interventions for decisions to seek treatment in AMI patients need to be further designed and evaluated. IMPACT Results would help healthcare professionals to implement individualised management of decision-making of treatment-seeking among AMI patients, and improve medical records of patients' prehospital experiences. REPORTING METHOD The Preferred Reporting Items for Systematic Reviews 2020 checklist was used to report the findings. PATIENT OR PUBLIC CONTRIBUTION Two AMI patients contributed to the data synthesis by giving simple feedback about the final themes.
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Affiliation(s)
- Jin Su
- School of Nursing, Jinan University, Guangzhou, China
| | | | - Qi-Qi Ke
- School of Nursing, Jinan University, Guangzhou, China
| | - Hong-Yu Yu
- School of Nursing, Jinan University, Guangzhou, China
| | - Zhuo-Rui Zhao
- School of Nursing, Jinan University, Guangzhou, China
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Blakeman JR, Eckhardt AL. Cardiovascular Disease in Women: An Update for Nurses. Nurs Clin North Am 2023; 58:439-459. [PMID: 37536791 DOI: 10.1016/j.cnur.2023.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/05/2023]
Abstract
Cardiovascular disease (CVD) is the leading cause of death in women but is often underrecognized and undertreated. Women are more likely to experience delay in treatment and worse outcomes, even though they experience similar symptoms as men. Women are more likely to experience ischemia related to microvascular dysfunction, which is not readily diagnosed by commonly used diagnostic tests. Nurses are ideally positioned to be patient advocates and use evidence-based guidelines to encourage primary prevention and ensure prompt treatment. This paper provides an update on CVD in women for clinical nurses based on the latest research evidence.
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Affiliation(s)
- John R Blakeman
- Mennonite College of Nursing, Illinois State University, Campus Box 5810, Normal, IL 61790, USA.
| | - Ann L Eckhardt
- Department of Graduate Nursing, College of Nursing and Health Innovation, University of Texas at Arlington, Pickard Hall 516, 411 S. Nedderman Dr, Arlington, TX 76019, USA
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Blakeman JR, Eckhardt AL, Kim M. Initial development of the chest pain conception questionnaire. Heart Lung 2023; 61:98-106. [PMID: 37209537 DOI: 10.1016/j.hrtlng.2023.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 04/21/2023] [Accepted: 05/09/2023] [Indexed: 05/22/2023]
Abstract
BACKGROUND Even though "chest pain" is often highlighted as a key heart attack symptom for which individuals should seek care, little is known about the ways that the lay public conceives of chest pain related to acute coronary syndrome (ACS). OBJECTIVES The purpose of this four-step process was to develop an instrument to measure the lay public's conceptions of chest pain related to ACS. METHODS The Chest Pain Conception Questionnaire (CPCQ) was drafted based on the Theory of Unpleasant Symptoms and findings from the published literature. We then leveraged two rounds of expert feedback to calculate item-level and scale-level content validity indices. Two rounds of pilot testing (N = 51 and N = 300) were conducted with members of the target population. Psychometric testing was also conducted, including exploratory factor analysis. RESULTS The multi-step development process resulted in an instrument that is comprised of 23 items (2 open-ended questions, 13 short scenarios with Likert-type ratings, and 8 multiple-choice questions) and written at a 7th grade level. The scale-level content validity index was 0.99. Exploratory factor analysis findings also supported construct validity. CONCLUSIONS This paper provides preliminary evidence of the CPCQ's validity.
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Affiliation(s)
- John R Blakeman
- Assistant Professor, Mennonite College of Nursing, Illinois State University, Campus Box 5810, Normal, IL 1790-5810, United States.
| | - Ann L Eckhardt
- Associate Chair of Clinical Education College of Nursing and Health Innovation, Department of Graduate Nursing, University of Texas at Arlington, Pickard Hall 516, 411 S. Nedderman Dr., Arlington, TX 76019, United States
| | - MyoungJin Kim
- Professor College Statistician and Director of the Office of Nursing Research Scholarship and Innovation, Mennonite College of Nursing, Illinois State University, Campus Box 5810, Normal, Illinois 61790-5810, United States
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Blakeman JR, Prasun MA, Kim M. Predictors of acute coronary syndrome symptom knowledge, attitudes, and beliefs in adults without self-reported heart disease. Heart Lung 2023; 60:102-107. [PMID: 36947932 DOI: 10.1016/j.hrtlng.2023.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 03/06/2023] [Accepted: 03/10/2023] [Indexed: 03/22/2023]
Abstract
BACKGROUND The time of symptom onset to the time an individual decides to seek care is the most significant contributor to total treatment delay. OBJECTIVES To explore predictors of ACS symptom knowledge, attitudes, and beliefs in adults without diagnosed heart disease. METHODS We used a cross-sectional, descriptive, and correlational design, employing an online survey including the ACS Response Index and the avoidance subscale of the Coping Strategy Indicator. We leveraged social media platforms and a university email list-serv to enroll participants. Stepwise hierarchical linear regressions were used. RESULTS We analyzed responses from 981 participants, with a mean age of 35.2 years (SD 16.5) and 75% female. The regression analyses yielded models that explained 14%, 23%, and 25% of the variance for knowledge, beliefs, and attitudes, respectively. Ethnicity, race, exposure to ACS symptom information (in the media or by teaching), and perceived health were the predictors of ACS symptom knowledge, attitudes, and beliefs with the largest effect, though others were statistically significant. CONCLUSIONS The findings underscore the importance of community education to raise awareness of ACS symptoms while considering social determinants of health. Future research and clinician interventions for ACS symptom knowledge, attitudes and beliefs should be expanded with a focus on ethnicity and gender.
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Affiliation(s)
- John R Blakeman
- Mennonite College of Nursing, Illinois State University, Campus Box 5810, Normal, IL 61790-5810, USA.
| | - Marilyn A Prasun
- Mennonite College of Nursing, Illinois State University, Campus Box 5810, Normal, IL 61790-5810, USA
| | - MyoungJin Kim
- Mennonite College of Nursing, Illinois State University, Campus Box 5810, Normal, IL 61790-5810, USA
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Zhang H, Liang C, Zhang X, Yu H, Yan X, Wang L, Tong T, Zhang H, Dai H, Tong H. Factors influencing patient delay in individuals with obstructive sleep apnoea: a study based on an integrated model. Ann Med 2022; 54:2828-2840. [PMID: 36259469 PMCID: PMC9586697 DOI: 10.1080/07853890.2022.2132417] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Obstructive sleep apnoea (OSA) is the most common sleep-related breathing disorder, yet it remains undiagnosed in a large proportion of adults. OBJECTIVE This study aims to investigate the status of patient delay and provider delay in OSA patients and examine related factors affecting patient delay in OSA individuals in China. METHODS A cross-sectional design was conducted on a sample of 309 OSA patients (aged from 18 to 76, median age of 47 years, 84.8% male) in Northeast China. Participants were required to complete the sociodemographic questionnaire, the symptom characteristics questionnaire, the help-seeking attitude scale (HSAS), the social support rating scale and the chronic disease self-efficacy scales (CDSES) to test the hypothesis. Binary logistic regression analysis was conducted to explore factors that account for the patient delay. RESULTS The median patient delay among OAS patients in this study was 22 months, the median provider delay was one month, and the median total delay was 26 months. As shown by multivariate analysis results, patients who have snored for over 6 years (OR = 3.377, 95%CI: 1.175-9.702) were more likely to experience prolonged patient delays. Per capita monthly family income above 3000 RMB (OR = 0.172, 95%CI: 0.052-0.571), taking up residence in cities or towns (OR = 0.484, 95%CI: 0.248-0.946), higher self-recognition of the disease (OR = 0.793, 95%CI: 0.647-0.972), higher objective support (OR = 0.825, 95%CI: 0.739-0.921) and stronger self-efficacy (OR = 0.674, 95%CI: 0.525-0.867) were significantly associated with shorter patient delays. CONCLUSION Patient delay is common in Chinese OSA patients. The upstream factors affecting the patient delay in individuals with OSA include income, place of residence, and objective support; midstream factors include self-recognition of the disease and self-efficacy; downstream factors include years of snoring.KEY MESSAGESDespite being a high-prevalence disease, many obstructive sleep apnoea (OSA) patients are not clearly diagnosed and treated.The factors affecting the delay in seeking medical treatment in individuals with OSA included income, place of residence, objective support, self-recognition of the disease, self-efficacy and years of snoring.Investigations into OSA patients' care-seeking behaviours can better reflect the secondary prevention of OSA, and it is crucial to pay attention to the delayed phase of patients.
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Affiliation(s)
- Hui Zhang
- School of Nursing, Jinzhou Medical University, Jinzhou, PR China
| | - Chunguang Liang
- School of Nursing, Jinzhou Medical University, Jinzhou, PR China
| | - Xin Zhang
- Department of Respiratory Medicine, Zibo Central Hospital, Zibo, PR China
| | - Haitao Yu
- School of Nursing, Jinzhou Medical University, Jinzhou, PR China
| | - Xiangru Yan
- School of Nursing, Jinzhou Medical University, Jinzhou, PR China
| | - Liying Wang
- School of Nursing, Jinzhou Medical University, Jinzhou, PR China
| | - Tong Tong
- School of Nursing, Jinzhou Medical University, Jinzhou, PR China
| | - Huiying Zhang
- Department of Otolaryngology Head & Neck Surgery, First Affiliated Hospital of Jinzhou Medical University, Jinzhou, PR China
| | - Hongliang Dai
- School of Nursing, Jinzhou Medical University, Jinzhou, PR China
| | - Huijuan Tong
- Department of Nursing, Shenyang Medical College, Shenyang, PR China
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9
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The Lay Public's Knowledge of the Most Common Acute Coronary Syndrome Symptoms Experienced by Women and Men. J Cardiovasc Nurs 2022; 38:288-298. [PMID: 37027134 DOI: 10.1097/jcn.0000000000000931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Although extensive research and public education for the last 2 decades has focused on symptom differences experienced by men and women, little is known about what acute coronary syndrome symptoms the lay public associates with men, with women, and with both men and women. OBJECTIVE The aim of this study was to describe what acute coronary syndrome symptoms the lay public associates with men, with women, and with both men and women and to explore whether differences in participant gender affect how these symptoms are associated. METHODS A descriptive, cross-sectional survey design was used, using an online survey. We recruited women (n = 209) and men (n = 208) living in the United States from the crowdsourcing platform Mechanical Turk in April and May 2021. RESULTS Most participants (78.4%) selected a chest symptom as the most common acute coronary syndrome symptom experienced by men, compared with only 49.4% who selected a chest symptom as the most common for women. Almost half (46.9%) of women indicated that they believe men and women have "fairly different" or "very different" acute coronary syndrome symptoms, compared with 17.3% of men. CONCLUSIONS Whereas most participants associated symptoms with both men and women's experiences of acute coronary syndrome symptoms, some associated symptoms in ways that are not reflected in the literature. Additional research is needed to further understand the impact of messaging on acute coronary syndrome symptom differences between men and women and the lay public's interpretation of these messages.
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Beza L, Alemayehu B, Addissie A, Azazh A, Gary R. Treatment Seeking Behaviors and Associated Factors among Patients Experiencing Acute Coronary Syndrome Using Health Belief Model in Addis Ababa, Ethiopia. Ethiop J Health Sci 2022; 32:781-790. [PMID: 35950066 PMCID: PMC9341033 DOI: 10.4314/ejhs.v32i4.15] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 05/04/2022] [Indexed: 11/17/2022] Open
Abstract
Background Acute coronary syndrome (ACS) is a life-threatening condition. The mortality rate will be reduced if immediate treatment is provided. Patients' awareness of ACS is limited, so they do not seek help as quite often as they should. The level of treatment seeking behavior and associated factors among ACS patients admitted to three hospitals in Addis Ababa, Ethiopia, were assessed using a health belief model. Methods A cross-sectional study was conducted among 330 ACS patients from November 2019 to December 2020. Sociodemographic and clinical variables data were extracted using pre-tested checklist. The outcome and other variables data were collected using the checklist and structured questionnaire. The data were entered into Epi-data 3.1 and exported to STATA 17.1 for analysis. Descriptive statistics relevant to the variable was performed. A multivariable logistic regression was used to identify factors associated with treatment seeking behavior. Results This study revealed that the mean time from symptom onset to arrival at the emergency unit (EU) was 24 ± 19.5 hours, slightly < half of the participants (n=149, 45.1 %) had adequate treatment seeking behavior. Perceived threat (AOR=1.03,95% CI:1.01–1.06, p=0.002), perceived benefits (AOR=1.09, 95%CI: 1.02–1.0, p≤0.001), self-efficacy (AOR=1.16, 95% CI :1.01- 1.22, p≤0.001), education (AOR=2.2,95%CI:1.31–3.9, p≤0.01) self-autonomy (AOR=3.1,95%CI:1.82–5.4, p<.001) and no depression (AOR=1.9,95%CI:1.1–3.3, p≤0.05) were found to have significantly association with adequate treatment seeking behavior. Conclusion This study indicates, less than half of ACS patients had adequate treatment seeking behavior. Thus, context-specific behavioral interventions, along with public awareness campaigns about ACS, should be implemented.
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Affiliation(s)
- Lemlem Beza
- Department of Emergency Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Bekele Alemayehu
- Department of Internal Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Adamu Addissie
- Addis Ababa University, College of Health Sciences, Addis Ababa, Ethiopia
| | - Aklilu Azazh
- Department of Emergency Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Rebecca Gary
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia
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Yin H, Jiang C, Shi X, Chen Y, Yu X, Wang Y, Li W, Ma H, Geng Q. Job Burnout Is Associated With Prehospital Decision Delay: An Internet-Based Survey in China. Front Psychol 2022; 13:762406. [PMID: 35496161 PMCID: PMC9045849 DOI: 10.3389/fpsyg.2022.762406] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Accepted: 03/10/2022] [Indexed: 12/05/2022] Open
Abstract
Background Prehospital delay is associated with non-modifiable factors such as age, residential region, and disease severity. However, the impact of psychosocial factors especially for job burnout on prehospital decision delay is still little understood. Method This internet-based survey was conducted between 14 February 2021 and 5 March 2021 in China through the Wechat platform and web page. Self-designed questionnaires about the expected and actual length of prehospital decision time and the Chinese version of Maslach Burnout Inventory-General Survey, Type D Personality Scale-14, and Social Support Rating Scale were applied. A total of 1,039 general participants with a history of perceptible but tolerable body discomfort were included. Results The top six reasons for prehospital decision delay were: (1) endure until self-healing (50.7%), (2) too busy to ask for leave (40.3%), (3) process for seeing a doctor too complicated (35.8%), (4) too tired after work (26.2%), (5) worry about the expenditure (16.6%), and (6) fear of being identified as with serious problem (14.5%). The univariate analyses revealed that older age (p = 0.001), type D personality (p = 0.025), job burnout (p = 0.055), and worrying about expenditure (p = 0.004) were associated with prolonged prehospital decision time, while engaged in medical-related job (p = 0.028) and with more social support (p = 0.066) would shorten the delay. The multivariate analysis using logistic regression model with forward selecting method showed that age [per 10 years, odds ratio (OR) 1.19 (1.09–1.31), p < 0.001], job burnout [per 10 points in Maslach Burnout Inventory-General Survey (MBI-GS), OR 1.17 (1.04–1.31), p = 0.007], and worrying about expenditure [OR 1.75 (1.25–2.47), p = 0.001] were the three determinants for prehospital decision delay (>7 days). Mediating effects were analyzed by using bias-corrected percentile bootstrap methods (N = 10,000). Social support was found partially mediated the relationship between the determinants and prehospital decision time. The partial mediating effect of social support accounted for 24.0% of the total effect for job burnout and 11.6% for worrying about expenditure. Conclusion Psychosocial factors have a non-negligible impact on prehospital decision delay. The crucial part of prehospital decision delay may be the lack of motivation inside. Job burnout and lack of social support, as two commonly seen features in the modern world, should be given enough consideration in disease prevention and treatment.
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Affiliation(s)
- Han Yin
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Cheng Jiang
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Xiaohe Shi
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Yilin Chen
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.,School of Medicine, South China University of Technology, Guangzhou, China
| | - Xueju Yu
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Yu Wang
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Weiya Li
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Huan Ma
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.,Department of Cardiac Rehabilitation, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Qingshan Geng
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.,School of Medicine, South China University of Technology, Guangzhou, China
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Affiliation(s)
- Ralf E Harskamp
- Department of general practice, Amsterdam UMC, location University of Amsterdam, Meibergdreef 9, Amsterdam, Netherlands
| | - Alexander C Fanaroff
- Division of Cardiology, Perelman School of Medicine, University of Pennsylvania, PA, USA
| | - Sinead Wang Zhen
- Duke-NUS family medicine, SingHealth Polyclinics, Singapore, Singapore
| | - Hendry R Sawe
- Emergency Medicine Department, Muhimbili University of Health and Allied Science, Dar es Salaam, Tanzania
| | - Ellen J Weber
- Department of Emergency Medicine, University of California, San Francisco, USA
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Roohafza H, Noohi F, Hosseini SG, Alemzadeh-Ansari M, Bagherieh S, Marateb H, Mansourian M, Mousavi AF, Seyedhosseini M, Farshidi H, Ahmadi N, Yazdani A, Sadeghi M. A Cardiovascular Risk Assessment model according to behavioral, pSychosocial and traditional factors in patients with ST-segment elevation Myocardial Infarction (CRAS-MI): review of literature and methodology of a multi-center cohort study. Curr Probl Cardiol 2022; 48:101158. [DOI: 10.1016/j.cpcardiol.2022.101158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 02/16/2022] [Indexed: 11/17/2022]
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Fukuoka Y, Oh YJ. Perceived Heart Attack Likelihood in Adults with a High Diabetes Risk. Heart Lung 2021; 52:42-47. [PMID: 34856501 PMCID: PMC9675410 DOI: 10.1016/j.hrtlng.2021.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 11/12/2021] [Accepted: 11/15/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Heart disease is the leading cause of death for women and men in the United States. Yet, little is known about the motivation for care-seeking behavior for heart attack and the perception of self-risk of a heart attack in individuals, especially those at high risk for developing type 2 diabetes. OBJECTIVES This study aimed to describe knowledge and awareness of heart attacks and perceived risk for future heart attacks and evaluate factors associated with a low perceived risk of a heart attack in adults with a high risk for type 2 diabetes. METHODS In this secondary data, cross-sectional study, the screening/baseline data of 80 adults participating in the mobile phone-based diabetes prevention program trial were analyzed. Validated measures assessed knowledge, self-efficacy, and heart attack risk perception were used. Logistic regressions were performed. RESULTS The mean (standard deviation) age of participants was 55.4 (9.0) years. 32.5% of the sample failed to identify any heart attack symptoms. Half of the sample did not perceive their risk of having a heart attack in their lifetime. Older age, lower body mass index, not having a family history of heart attack, and current smokers were significantly associated with a lower perceived risk of heart attack (P < .05). CONCLUSIONS Healthcare providers need to assess the discrepancies between the individual's risk perception and the presence of actual risk factors of a heart attack in adults with a high risk for type 2 diabetes.
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Affiliation(s)
- Yoshimi Fukuoka
- Department of Physiological Nursing, UCSF, San Francisco, United States.
| | - Yoo Jung Oh
- Department of Communication, University of California Davis, Davis, United States
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Garrido D, Petrova D, Catena A, Ramírez-Hernández JA, Garcia-Retamero R. Recognizing a Heart Attack: Patients' Knowledge of Cardiovascular Risk Factors and Its Relation to Prehospital Decision Delay in Acute Coronary Syndrome. Front Psychol 2020; 11:2056. [PMID: 32982853 PMCID: PMC7477116 DOI: 10.3389/fpsyg.2020.02056] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 07/24/2020] [Indexed: 01/29/2023] Open
Abstract
In acute coronary syndromes (ACSs), longer decision delay - the time patients wait before seeking medical attention after symptoms have started - increases the risk of complications and death. However, many patients wait much longer than recommended and research is needed investigating how patient decision delay can be reduced. In a cross-sectional study of 120 ACS survivors, we investigated the relationship between knowledge of cardiovascular risk factors and decision delay. Several days after the onset of a cardiac event, patients completed a questionnaire measuring demographics, decision delay, objective knowledge of cardiovascular risks factors and of ACS symptoms, and subjective perceptions of symptoms during the cardiac episode. Relevant clinical data were extracted from patients' medical records. In a multiple linear regression analysis, controlling for demographic and clinical factors, objective knowledge of cardiovascular risk factors and ACS symptoms, and subjective attributions of symptoms to a cardiac cause were related to shorter decision delays. Among patients with relatively high knowledge of risk factors, only 5% waited more than 1 h to seek help, compared to 22% among patients with relatively low knowledge. These results suggest that knowledge of the factors that increase the risk of developing cardiovascular disease could play a role in patient decision making during an acute cardiac event. We discuss methodological issues and potential underlying mechanisms related to decision heuristics and biases, which can inform future research.
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Affiliation(s)
- Dunia Garrido
- Faculty of Health Sciences, Universidad de Castilla-La Mancha, Toledo, Spain
- Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain
| | - Dafina Petrova
- Escuela Andaluza de Salud Pública, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.Granada, Granada, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Andrés Catena
- Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain
| | - José Antonio Ramírez-Hernández
- Instituto de Investigación Biosanitaria ibs.Granada, Granada, Spain
- Cardiology Department, Virgen de las Nieves University Hospital, Granada, Spain
| | - Rocio Garcia-Retamero
- Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain
- Harding Center for Risk Literacy, Max Planck Institute for Human Development, Berlin, Germany
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