title: Predictors of decision delay to seeking health care among Jordanians with acute myocardial infarction.
abstract: OBJECTIVE
  To identify predictors of decision delay time for health care seeking among Jordanians with acute myocardial infarction (AMI).
  
  
  METHODS
  The study was a cross-sectional descriptive survey. A convenience sample of Jordanians with AMI were interviewed at the coronary care units of two teaching hospitals in Jordan.
  
  
  METHODS
  The Arabic version of the modified Response to Symptom Questionnaire was used to assess predictors of decision delay and patterns of health care-seeking behaviors. Decision delay was evaluated by assisting patients to triangulate time of symptom onset and time of decision to seek professional health care by placing both times in context of daily activities that participants could easily remember. Regression analysis was conducted to elicit predictors of decision delay.
  
  
  RESULTS
  Decision delay time among Jordanian men (n=110) and women (n=24) with AMI was alarmingly long (medians 3.5 and 3.6 hours, respectively). Variables that correspondingly predicted decision delay among men and women were age, waiting for symptoms to go away, anxiety due to symptom presentation, and others' responses to patients' symptoms. While 16 other variables (cognitive, emotional, and clinical) independently predicted delay among men, equivalent evidence was not established among women due to the relatively small sample size.
  
  
  CONCLUSIONS
  Similarities and differences existed between Jordanian men's and women's decision delay to seek health care for AMI. Decision delay time among Jordanians with AMI requires intervention that incorporates awareness of delay predictors. Future research needs to utilize adequate sample sizes of both sexes to obtain a better understanding of sex differences.
  
  
  CONCLUSIONS
  To reduce decision delay among Jordanians, health educators should emphasize early symptom recognition and the value of prompt health care-seeking behaviors.
authors.affiliation: School of Nursing, State University of New York at Buffalo, NY, USA. fadikhraim@sandiego.edu
authors.forename: Fadi M
authors.initials: FM
authors.lastname: Khraim
authors.forename: Yvonne K
authors.initials: YK
authors.lastname: Scherer
authors.forename: Joan M
authors.initials: JM
authors.lastname: Dorn
authors.forename: Mary G
authors.initials: MG
authors.lastname: Carey
mesh_terms: D000367:Age Factors; D000368:Aged; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D003657:Decision Making; D015438:Health Behavior / Q000208:ethnology; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007297:Inpatients / Q000193:education / Q000523:psychology*; D007597:Jordan; D008571:Men / Q000193:education / Q000523:psychology*; D008875:Middle Aged; D009203:Myocardial Infarction / Q000208:ethnology*; D015404:Nursing Methodology Research; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D012044:Regression Analysis; D012737:Sex Factors; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013997:Time Factors; D014930:Women / Q000193:education / Q000523:psychology*