title: Fatigue, dyspnea, and intermittent symptoms are associated with treatment-seeking delay for symptoms of atrial fibrillation before diagnosis.
abstract: Delay in seeking treatment for symptoms of atrial fibrillation (AF) at onset results in a missed opportunity for vital early treatment of AF which is important for reducing stroke, tachycardia induced heart failure, and treatment-resistant AF. Little is known about factors that contribute to treatment-seeking delay for symptoms of AF.
  
  
  
  The purpose of this study was to identify factors associated with treatment-seeking delay for symptoms of AF before diagnosis.
  
  
  
  For this descriptive study, 150 participants with recently detected AF completed structured interviews to collect data about symptoms, symptom characteristics, symptom representation regarding cause, seriousness, controllability of symptoms, responses to symptoms before diagnosis, and time from symptom onset to treatment-seeking. Chi-square analysis was used to identify factors associated with delay (>1 week) versus no delay (⩽1 week) in treatment-seeking after symptom onset.
  
  
  
  Participants were 51% female (n=76) with a mean age of 66.5 (standard deviation (SD)±11.1) years. A majority (70%, n=105) delayed treatment-seeking. Factors associated with delay included experiencing fatigue, dyspnea, intermittent symptoms, attributing symptoms to deconditioning, overwork, inadequate sleep, and perceiving symptoms as not very serious and amenable to self-management. Responses such as a wait and see approach, working through symptoms, reporting no fear of symptoms, or attempting to ignore symptoms were associated with delay.
  
  
  
  Experiencing fatigue, dyspnea and intermittent symptoms produced symptom representations and emotional and behavioral responses associated with treatment-seeking delay. There is a critical need to develop and test educational interventions to increase awareness of the spectrum and characteristics of AF symptoms and appropriate treatment-seeking behaviors.
authors: Department of Nursing, Mayo Clinic, Rochester MN, USA mccabe.pamela2@mayo.edu.
authors: Pamela J
authors: PJ
authors: McCabe
authors: Department of Nursing, Mayo Clinic, Rochester MN, USA School of Nursing, University of Minnesota, USA.
authors: Lori M
authors: LM
authors: Rhudy
authors: Division of Epidemiology, Mayo College of Medicine, USA.
authors: Alanna M
authors: AM
authors: Chamberlain
authors: College of Nursing, University of Illinois at Chicago, USA.
authors: Holli A
authors: HA
authors: DeVon
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000523:psychology* / Q000628:therapy; D057210:Delayed Diagnosis / Q000523:psychology*; D059026:Diagnostic Self Evaluation; D004417:Dyspnea / Q000523:psychology*; D005239:Fear / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology*
keywords: Atrial fibrillation; Leventhal’s common sense model of self-regulation; patient education; symptom representation; treatment-seeking delay