title: Circumstances around the onset of a myocardial infarction. A study of factors relevant to the perception of symptoms and to the delay in arriving at a coronary care unit.
abstract: Psychosocial factors, experienced pain and anxiety in relation to patient delay were studied in 100 patients admitted for suspected acute myocardial infarction (AMI). More severe pain was reported by women, by those who had recently consulted a physician, who experienced severe anxiety, who fell ill away from their place of work, or who possessed little medical knowledge. These patients tried to get relief from pain by resting. Patients experiencing more severe anxiety were younger, had not consulted a physician recently, had poor medical knowledge, belonged to lower socio-economic groups or were impatient. These patients also sought relief from pain by resting. Pain, but not anxiety, was related to delay. Long delay was seen more often in patients who did not believe they had suffered an AMI and who were psychologically inactive prior to the onset of pain. Recent physician consultation, failure to call for help and belonging to lower socio-economic groups were also related to long delay. Medical knowledge was unrelated to patient delay. Patients with a low degree of pain rarely reported considerable anxiety, whereas several patients with severe pain had little or no anxiety.
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D001007:Anxiety; D003325:Coronary Care Units; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000523:psychology* / Q000628:therapy; D010146:Pain; D010343:Patient Admission; D013997:Time Factors