title: Accustomed to enduring: experiences of African-American women seeking care for cardiac symptoms.
abstract: OBJECTIVE
  Understand the meaning of delayed treatment seeking in African-American women with unstable angina and myocardial infarction.
  
  
  METHODS
  Phenomenologic analysis of in-depth interview data and field notes on 12 African-American women hospitalized with unstable angina or myocardial infarction.
  
  
  RESULTS
  Women's interpretation of and response to symptoms were informed by experiences of marginalization and their self-understanding as people who were strong and who had endured life's hardships. When hospitalized, some women experienced trivialization of their complaints by clinicians and a focus on technological procedures over respectfully attending to their concerns, which provided further disincentives to seeking care. Three major themes emerged: misrecognition and discounting of symptoms, enduring, and influence of faith.
  
  
  CONCLUSIONS
  Experiences of marginalization shape responses to symptoms, care-seeking behavior, and interpretation of subsequent care experiences for African-American women with cardiac disease, who may experience different symptoms as well as interpret them differently than members of other groups.
authors.affiliation: Department of Physiological Nursing, University of California, San Francisco, USA.
authors.forename: Angela D
authors.initials: AD
authors.lastname: Banks
authors.forename: Ruth E
authors.initials: RE
authors.lastname: Malone
mesh_terms: D000328:Adult; D000368:Aged; D000789:Angina, Unstable / Q000175:diagnosis* / Q000523:psychology; D044383:Black People / Q000523:psychology*; D002140:California / Q000453:epidemiology; D005260:Female; D006760:Hospitalization; D006801:Humans; D007407:Interviews as Topic; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000523:psychology; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D012067:Religion; D013997:Time Factors; D014930:Women / Q000523:psychology*; D001741:Black or African American