title: Thoughts and behaviors of women with symptoms of acute coronary syndrome.
abstract: OBJECTIVE
  Women delay seeking care for symptoms of acute coronary syndrome (ACS) because of atypical symptoms, perceptions of invulnerability, or keeping symptoms to themselves. The purpose of this study was to explore how women recognized and interpreted their symptoms and subsequently decided whether to seek treatment within the context of their lives.
  
  
  METHODS
  Grounded theory was used to provide the methodological basis for data generation and analysis. Data were collected using in-depth interviews with 9 women with ACS.
  
  
  RESULTS
  All participants went through a basic social process of searching for the meaning of their symptoms which informed their decisions about seeking care. Stages in the process included noticing symptoms, forming a symptom pattern, using a frame of reference, finding relief, and assigning causality. The evolving MI group (n = 5) experienced uncertainty about bodily cues, continued life as usual, until others moved them toward care. The immediately recognizable MI group (n = 4) labeled their condition quickly, yet delayed, as they prepared themselves and others for their departure.
  
  
  CONCLUSIONS
  All women delayed, regardless of their ability to correctly label their symptoms. Education aimed at symptom recognition/interpretation addresses only part of the problem. Women should also be educated about the potential danger of overestimating the time they have to seek medical attention.
authors.affiliation: University of North Carolina, Greensboro, School of Nursing, 308 Moore Building, P.O. Box 26170, Greensboro, NC 27402-6170, USA. Electronic address: LLDavis4@uncg.edu.
authors.forename: Leslie L
authors.initials: LL
authors.lastname: Davis
authors.forename: Merle
authors.initials: M
authors.lastname: Mishel
authors.forename: Debra K
authors.initials: DK
authors.lastname: Moser
authors.forename: Noreen
authors.initials: N
authors.lastname: Esposito
authors.forename: Mary R
authors.initials: MR
authors.lastname: Lynn
authors.forename: Todd A
authors.initials: TA
authors.lastname: Schwartz
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis / Q000523:psychology*; D000328:Adult; D003657:Decision Making; D059026:Diagnostic Self Evaluation; D005260:Female; D006760:Hospitalization; D006801:Humans; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis*; D010342:Patient Acceptance of Health Care
keywords: Acute coronary syndrome; Help seeking behavior; Myocardial infarction; Treatment delay; Women