Journal of Transcultural Nursing

 

Advanced Search

Journal Navigation

Journal Home

Subscriptions

Archive

Contact Us

Table of Contents

The Diabetes Educator

Click here for more information

Sign In to gain access to subscriptions and/or personal tools.
This Article
Right arrow Abstract Freely available
Right arrow Free Full Text (Free PDF) Free
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Saved Citations
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Request Reprints
Right arrow Add to My Marked Citations
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Noureddine, S.
Right arrow Articles by Abchee, A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Noureddine, S.
Right arrow Articles by Abchee, A.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati  
What's this?
Journal of Transcultural Nursing, Vol. 17, No. 4, 341-348 (2006)
DOI: 10.1177/1043659606291544

Delay in Seeking Health Care for Acute Coronary Syndromes in a Lebanese Sample

Samar Noureddine, PhD, RN

American University of Beirut

Marina Adra, MSc, RN

American University of Beirut

Mary Arevian, MPH, RN

American University of Beirut

Nuhad Yazbik Dumit, MA, RN

American University of Beirut

Houry Puzantian, MSc, RN

American University of Beirut Medical Center

Dina Shehab, MA, RN

American University of Beirut

Antoine Abchee, MD, FACP

American University of Beirut Medical Center

Early treatment of patients with acute coronary syndromes (ACS) is crucial to reduce morbidity and mortality. The purpose of this study was to examine delay in seeking care for ACS symptoms in a Lebanese sample and identify predictors of delay. Medical record reviews and interviews using the Response to Symptoms Questionnaire were conducted with 204 ACS patients in coronary care within 72 hours of admission. Median time from symptom onset to hospital arrival was 4.5 hours. Higher education, presence of dyspnea, intermittent symptoms, and waiting for symptoms to go away predicted longer delays, whereas intensity of symptoms and active response (going to the hospital) predicted shorter delays. The findings suggest lack of knowledge of ACS symptoms and the need for public education in this regard.

Key Words: acute coronary syndromes • delay in seeking care • Lebanon

References

  • Al-Hassan, M. A., & Omran, S. M. (2005). The effects of health beliefs on health care-seeking decisions of Jordanian patients with myocardial infarction symptoms. International Journal of Nursing Practice, 11, 13-20.[CrossRef][Medline] [Order article via Infotrieve]
  • Alonzo, 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.
  • Ashton, K. C. (1999). How men and women with heart disease seek care: The delay experience. Progress in Cardiovascular Nursing, 14, 53-60, 74-74.
  • Berton, G., Cordiano, R., Palmieri, R., Guarnieri, G., Stefani, M., & Palatini, P. (2001). Clinical features associated with pre-hospital time delay in acute myocardial infarction. Italian Heart Journal, 2, 766-771.
  • Braunwald, E., Antman, E. M., Beasley, J. W., Califf, R. M., Cheitlin, M. D., Hochman, J. S., et al. (2000). ACC/AHA guideline for the management of patients with unstable angina and non ST-segment elevation myocar-dial infarction: Summary article. A report of the American College of Cardiology/American Heart Association task force on practice guidelines (Committee on the Management of Patients With Unstable Angina). Journal of the American College of Cardiology, 36, 970-1062.[Free Full Text]
  • Braunwald, E., Antman, E. M., Beasley, J. W., Califf, R. M., Cheitlin, M. D., Hochman, J. S., et al. (2002). ACC/AHA 2002 guideline update for the management of patients with unstable angina and non ST-segment elevation myocardial infarction: Summary article. A report of the American College of Cardiology/American Heart Association task force on practice guidelines (Committee on the Management of Patients With Unstable Angina). Journal of the American College of Cardiology, 40, 1366-1374.[Free Full Text]
  • Brown, A. L., Mann, C., Daya, M., Goldberg, R., Meischke, H., Taylor, J., et al. (2000). Demographic, belief, and situational factors influencing the decision to utilize emergency medical services among chest pain patients. Circulation, 102, 173-178.[Abstract/Free Full Text]
  • Burnett, R. E., Blumenthal, J. A., Mark, D. B., Leimberger, J. D., & Califf, R. M. (1995). Distinguishing early and late responders to symptoms of acute myocardial infarction. American Journal of Cardiology, 75, 1019-1022.[CrossRef][Medline] [Order article via Infotrieve]
  • Canto, J. G., Shlipak, M. G., Rogers, W. J., Malmgren, J. A., Frederick, P. D., Lambrew, C. T., et al. (2000). Prevalence, clinical characteristics, and mortality among patients with myocardial infarction presenting without chest pain. Journal of the American Medical Association, 283, 3223-3229.[Abstract/Free Full Text]
  • Diefenbach, M., & Leventhal, H. (1996). The common-sense model of illness representation: Theoretical and practical considerations. Journal of Social Distress and the Homeless, 5, 11-38.
  • Dracup, K., & Moser, D. (1997). Beyond sociodemographics: Factors influencing the decision to seek treatment for symptoms of acute myocardial infarction. Heart & Lung, 26, 253-262.[CrossRef][Medline] [Order article via Infotrieve]
  • Dracup, K., Moser, D., Eisenberg, M., Meischke, H., Alonzo, A. A., & Braslow, A. (1995). Causes of delay in seeking treatment for heart attack symptoms. Social Science Medicine, 40, 379-392.
  • Dracup, K., Moser, D., McKinley, S., Ball, C., Yamasaki, K., Kim, C. J., et al. (2003). An international perspective on the time to treatment for acute myocardial infarction. Journal of Nursing Scholarship, 35, 317-323.[CrossRef][Medline] [Order article via Infotrieve]
  • Finnegan, J. R., Meischke, H., Zapka, J. G., Leviton, L., Meshack, A., Benjamin-Garner, R., et al. (2000). Patient delay in seeking care for heart attack symptoms: Findings from focus groups conducted in the five U.S. regions. Preventive Medicine, 31, 205-213.[CrossRef][Medline] [Order article via Infotrieve]
  • Gruppo Italiano per lo Studio Della Supravivenza Nell Infarcto—Avoidable Delay Group. (1995). Epidemiology of avoidable delay in the care of patients with acute myocardial infarction in Italy: A GISSI-generated study. Archives of Internal Medicine, 155, 1481-1488.[Abstract]
  • Gurwitz, J. H., McLaughlin, T. J., Willison, D. J., Guadagnoli, E., Hauptman, P. J., Gao, X., et al. (1997). Delayed hospital presentation in patients who have had acute myocardial infarction. Annals of Internal Medicine, 126, 593-599.[Abstract/Free Full Text]
  • Ho, P. M., Rumsfeld, J. S., Lyons, E., Every, N. R., & Magid, D. J. (2002). Lack of association between Medicare supplemental insurance and delay in seeking emergency care for patients with myocardial infarction. Annals of Emergency Medicine, 40, 381-387.[CrossRef][Medline] [Order article via Infotrieve]
  • Johansson, I., Strömberg, A., & Swahn, E. (2004). Factors related to delay times in patients with suspected acute myocardial infarction. Heart & Lung, 33, 291-300.[CrossRef][Medline] [Order article via Infotrieve]
  • Kentsch, M., Rodemerk, U., Müller-Esch, G., Schnoor, U., Münzel, T., Ittel, T.-H., et al. (2002). Emotional attitudes towards symptoms and inadequate coping strategies are major determinants of patient delay in acute myocardial infarction. Zeitschrift für Kardiologie, 91, 147-155.[Medline] [Order article via Infotrieve]
  • Kenyon, L. W., Ketterer, M. W., Gheorghiade, M., & Goldstein, S. (1991). Psychological factors related to prehospital delay during acute myocar-dial infarction. Circulation, 84, 1969-1976.[Abstract/Free Full Text]
  • Kulwicki, A. D. (2003). People of Arab heritage. In L. D. Purnell & B. J. Paulanka (Eds.), Transculatural health care: A culturally competent approach (2nd ed., pp. 90-105). Philadelphia: F. A. Davis.
  • Lee, H., Bahler, R., Chung, C., Alonzo, A., & Zeller, R. A. (2000). Prehospital delay with myocardial infarction: The interactive effect of clinical symptoms and race. Applied Nursing Research, 13, 125-133.[CrossRef][Medline] [Order article via Infotrieve]
  • Leitch, J. W., Birbara, T., Freedman, B., Wilcox, I., & Harris, P. J. (1989). Factors influencing the time from onset of chest pain to arrival at the hospital. Medical Journal of Australia, 150, 6-8.[Medline] [Order article via Infotrieve]
  • Leslie, W. S., Urie, A., Hooper, J., & Morrison, C. E. (2000). Delay in calling for help during myocardial infarction: Reasons for the delay and subsequent pattern of accessing care. Heart, 84, 137-141.[Abstract/Free Full Text]
  • McKinley, S., Moser, D., & Dracup, K. (2000). Treatment-seeking behavior for acute myocardial infarction symptoms in North America and Australia. Heart & Lung, 29, 237-247.[CrossRef][Medline] [Order article via Infotrieve]
  • National Heart Attack Alert, Program Coordinating Committee, 60 Minutes to Treatment Working Group. (1994). Emergency department: Rapid identification and treatment of patients with acute myocardial infarction. Annals of Emergency Medicine, 23, 311-329.[Medline] [Order article via Infotrieve]
  • Nawfal, H. (2004). Resident issues in Lebanon ten years after the world conference on residents and development: The national report 2004. Beirut, Lebanon: Dar El Koutoub.
  • Reilly, A., Dracup, K., & Dattolo, J. (1994). Factors influencing prehospital delay in patients experiencing chest pain. American Journal of Critical Care, 3, 300-306.[Abstract]
  • Sawaya, J. I., Jazra, C., Eid, E. V., & Sabra, R. (1999). Gender differences in the diagnosis and treatment of acute myocardial infarction in Lebanon. Lebanese Medical Journal, 47, 2-6.
  • Sawaya, J. I., Jazra, C., Farhat, F., Alam, S., Eid, E., & Sabra, R. (2000). Inhospital mortality after acute myocardial infarction in Lebanon: Incidence, associations, and influence of newer treatment regimens. Lebanese Medical Journal, 48, 63-69.
  • Schroeder, J. S., Lamb, I. H., & Hu, M. (1978). The pre-hospital course of patients with chest pain: Analysis of the prodromal, symptomatic, decision-making, transportation, and emergency room periods. American Journal of Medicine, 64, 742-748.[CrossRef][Medline] [Order article via Infotrieve]
  • Simoons, M. I., Serruys, P. W., van den Brand, M., Verheugt, F., Res J., Krauss, H., et al. (1986). Early thrombolysis in acute myocardial infarction: Limitation of infarct size and improved survival. Journal of the American College of Cardiology, 7, 717-728.[Abstract]
  • Smith, S. C., Jr., Dove, J. T., Jacobs, A. K., Kennedy, J. W., Kereiakes, D., Kern, J. M., et al. (2001). ACC/AHA guidelines for percutaneous coronary intervention (revision of the 1993 PTCA guidelines)—Executive summary: A report of the American College of Cardiology/American Heart Association task force on practice guidelines (Committee to Revise the 1993 Guidelines for Percutaneous Transluminal Coronary Angioplasty) endorsed by the Society for Cardiac Angiography and Interventions. Circulation, 103, 3019-3041.[Free Full Text]
  • Wu, Y., Zhang, Y., Li, Y. Q., Hong, B. L., & Huang, C. X. (2004). Factors associated with the extent of care-seeking delay for patients with acute myocardial infarction in Beijing. Chinese Medical Journal, 117, 1772-1777.[Medline] [Order article via Infotrieve]
  • Zerwic, J. J., Ryan, C., DeVon, H. A., & Drell, M. J. (2003). Treatment seeking for acute myocardial infarction symptoms: Differences in delay across sex and race. Nursing Research, 52, 159-167.[CrossRef][Medline] [Order article via Infotrieve]

Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati    What's this?



This Article
Right arrow Abstract Freely available
Right arrow Free Full Text (Free PDF) Free
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Saved Citations
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Request Reprints
Right arrow Add to My Marked Citations
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Noureddine, S.
Right arrow Articles by Abchee, A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Noureddine, S.
Right arrow Articles by Abchee, A.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati  
What's this?