Missed opportunities to impact fast response to AMI symptoms

Jane G. Zapka, J. Michael Oakes, Denise G. Simons-Morton, N. Clay Mann, Robert Goldberg, Deborah E. Sellers, Barbara Estabrook, Janice Gilliland, Adriana C. Linares, Ruby Benjamin-Garner, Paul McGovern

Research output: Contribution to journalArticlepeer-review

20 Scopus citations


The potential for reducing cardiovascular disease mortality rates lies both in prevention and treatment. The earlier treatment is administered, the greater the benefit. Thus, duration of time from onset of symptoms of acute myocardial infarction to administration of treatment is important. One major factor contributing to failure to receive efficacious therapy is the delay time from acute myocardial infarction (AMI) symptom onset to hospital arrival. This paper examines the relationship of several factors with regard to intentions to seek care promptly for symptoms of AMI. A random-digit dialed telephone survey (n=1294) was conducted in 20 communities located in 10 states. People who said they would wait until they were very sure that symptoms were a heart attack were older, reported their insurance did not pay for ambulance services, and reported less confidence in knowing signs and symptoms in themselves. When acknowledging symptoms of a heart attack, African-Americans and people with more than a high school education reported intention to act quickly. No measures of personal health history, nor interaction with primary care physicians or cardiologists were significantly related to intention to act fast. The study confirms the importance of attribution and perceived self-confidence in symptom recognition in care seeking. The lack of significant role of health history (i.e. those with chronic conditions or risk factors) and clinician contact highlights missed opportunities for health care providers to educate and encourage patients about their risk and appropriate action. Copyright (C) 2000 Elsevier Science Ireland Ltd.

Original languageEnglish (US)
Pages (from-to)67-82
Number of pages16
JournalPatient Education and Counseling
Issue number1
StatePublished - Apr 2000

Bibliographical note

Funding Information:
Supported by cooperative agreements (UOIs) from the National Heart, Lung, and Blood Institute. HL53141, HL53142, HL53149, HL54517, HL53211, and HL53135.


  • Care-seeking
  • Coronary heart disease
  • Patient-physician communication


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