title: Lay referral patterns involved in cardiac treatment decision making among middle-aged and older adults.
abstract: OBJECTIVE
  This study examined age and contextually related factors that are influential in lay referral patterns during cardiac treatment decision making.
  
  
  METHODS
  A complementary design was used. The Myocardial Infarction (MI) Onset Study identified demographic correlates of who sought medical care for 1,388 MI (heart attack) survivors. Thirty-five in-depth MI illness narratives explicated lay referral patterns.
  
  
  RESULTS
  Data revealed a linear association between older age and reliance on another person to seek medical attention for cardiac symptoms, with gender also shaping lay referral patterns. Although spouses and children were the most frequently cited decision makers for older respondents, friends and other family members also influenced care-seeking decisions. Qualitative results substantiated and provided explanations for such patterns.
  
  
  CONCLUSIONS
  Our results highlight the need for researchers to attend to the complex social processes of lay consultation and for health education messages to extend to venues where lay cardiac decisions are made, including the worksite and social gathering places such as religious institutions. Enhanced outreach includes tailoring health messages to elders and their significant others and casting a broader net to include nontraditional significant others.
authors.affiliation: Department of Behavioral Science, 125 College of Medicine Office Building, University of Kentucky, Lexington, KY 40536-0086, USA. nesch@uky.edu
authors.forename: Nancy E
authors.initials: NE
authors.lastname: Schoenberg
authors.forename: Cheryl H
authors.initials: CH
authors.lastname: Amey
authors.forename: Eleanor Palo
authors.initials: EP
authors.lastname: Stoller
authors.forename: Susan B
authors.initials: SB
authors.lastname: Muldoon
mesh_terms: D000367:Age Factors; D000368:Aged; D001294:Attitude to Health; D003657:Decision Making; D005260:Female; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000628:therapy*; D012017:Referral and Consultation; D012737:Sex Factors; D012961:Sociology