title: Gender comparisons in non-acute cardiac symptom recognition and subsequent help-seeking decisions: a mixed methods study protocol.
abstract: BACKGROUND
  Coronary heart disease (CHD) is one of the leading causes of death in both men and women worldwide. Despite the common misconception that CHD is a 'man's disease', it is now well accepted that women endure worse clinical outcomes than men following CHD-related events. A number of studies have explored whether or not gender differences exist in patients presenting with CHD, and specifically whether women delay seeking help for cardiac conditions. UK and overseas studies on help-seeking for emergency cardiac events are contradictory, yet suggest that women often delay help-seeking. In addition, no studies have looked at presumed cardiac symptoms outside an emergency situation. Given the lack of understanding in this area, an explorative qualitative study on the gender differences in help-seeking for a non-emergency cardiac events is needed.
  
  
  METHODS
  A purposive sample of 20-30 participants of different ethnic backgrounds and ages attending a rapid access chest pain clinic will be recruited to achieve saturation. Semistructured interviews focusing on help-seeking decision-making for apparent cardiac symptoms will be undertaken. Interview data will be analysed thematically using qualitative software (NVivo) to understand any similarities and differences between the way men and women construct help-seeking. Findings will also be used to inform the preliminary development of a cardiac help-seeking intentions questionnaire.
  
  
  BACKGROUND
  Ethical approvals were sought and granted. Namely, the University of Westminster (sponsor) and St Georges NHS Trust REC, and the Trust Research and Development Office granted approval to host the study on the Queen Mary's Roehampton site. The study is low risk, with interviews being conducted on hospital premises during working hours. Investigators will disseminate findings via presentations and publications. Participants will receive a written summary of the key findings.
authors.affiliation: Cardiology Department, Queen Mary's Roehampton, St Georges Healthcare NHS Trust, London, UK.
authors.forename: Nolan
authors.initials: N
authors.lastname: Stain
authors.affiliation: Faculty of Science and Technology, University of Westminster, London, UK.
authors.forename: Damien
authors.initials: D
authors.lastname: Ridge
authors.affiliation: Faculty of Science and Technology, University of Westminster, London, UK.
authors.forename: Anna
authors.initials: A
authors.lastname: Cheshire
mesh_terms: D002637:Chest Pain; D003327:Coronary Disease; D003657:Decision Making; D005260:Female; D006801:Humans; D008297:Male; D008571:Men / Q000523:psychology*; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D036301:Qualitative Research; D012737:Sex Factors; D011795:Surveys and Questionnaires; D014930:Women / Q000523:psychology*
keywords: PUBLIC HEALTH; QUALITATIVE RESEARCH