title: The emergency department experience of chest pain patients and their intention to delay care seeking for acute myocardial infarction.
abstract: This study investigated how patients' emergency department experience was related to their intention to delay action in response to future symptoms of acute myocardial infarction. A sample of 426 persons admitted to the emergency department with a chief complaint of chest pain and released from the emergency department were contacted by telephone. Patients were queried about their affective response to the emergency department experience, their satisfaction with emergency department staff communication, their intention to delay prompt action for acute myocardial infarction symptoms in the future, the influence of others in the decision to seek care, and medical and demographic status. The results of a mixed model linear regression analysis showed that the less education patients had (p = 0.007), the less sure they felt that going to the emergency department had been "the right thing to do" (p = 0.004), and the greater the degree of embarrassment (p = 0.0001), the greater was the intention to delay action for future symptoms of acute myocardial infarction. The results also showed that those patients who were prompted by health professionals to go to the emergency department were less likely to report intentions to delay for future symptoms (p = 0.036). It is important that emergency department staff reassure chest pain patients who are sent home that they did the right thing by coming to the emergency department for their symptoms. Providers need to be particularly sensitive to feelings of embarrassment.
authors.affiliation: Department of Health Services, University of Washington, Seattle 98195, USA.
authors.forename: H
authors.initials: H
authors.lastname: Meischke
authors.forename: P
authors.initials: P
authors.lastname: Mitchell
authors.forename: J
authors.initials: J
authors.lastname: Zapka
authors.forename: D C
authors.initials: DC
authors.lastname: Goff
authors.forename: K
authors.initials: K
authors.lastname: Smith
authors.forename: D
authors.initials: D
authors.lastname: Henwood
authors.forename: C
authors.initials: C
authors.lastname: Mann
authors.forename: K
authors.initials: K
authors.lastname: Lovell
authors.forename: E
authors.initials: E
authors.lastname: Stone
authors.forename: J
authors.initials: J
authors.lastname: Taylor
mesh_terms: D002637:Chest Pain / Q000523:psychology; D003625:Data Collection; D004636:Emergency Service, Hospital; D004644:Emotions; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009203:Myocardial Infarction / Q000523:psychology; D016017:Odds Ratio; D010342:Patient Acceptance of Health Care; D017060:Patient Satisfaction; D011369:Professional-Patient Relations; D012044:Regression Analysis; D013997:Time Factors; D014481:United States