title: Women's help-seeking behaviour during a first acute myocardial infarction.
abstract: Studies indicate that the time from onset of symptoms to medical treatment has decreased in acute myocardial infarction (AMI). However, there are still variations indicating that women wait longer than men before making the decision to seek medical care. Multidimensional factors hindering and facilitating the decision have been identified in previous studies, though few have fully explored how social context affects women's expectations, interpretations and actions and so influences the decision-making process. The aim of this study was therefore to identify how women's experiences interacted and influenced the decision to seek medical care at their first AMI. Seventeen women, aged 38-75 years, were interviewed, at home or in the hospital, between June 2011 and May 2012. Grounded theory was used as a method, and data collection and analysis were carried out simultaneously. The results showed that before deciding to seek medical care, these women went through three defined but interrelated processes that together hindered their normal activities and made them act according to existential needs. The women's experiences of the progression of the disease, in terms of both symptoms and time, were very different, so they sought medical care at different times, sometimes life-threateningly late and sometimes before developing an AMI. Three mechanisms had to coincide if the women were to receive medical care. First, the women had to acknowledge their symptoms as something more than common bodily changes. Second, the healthcare system had to be accessible when the women made their decision to seek care. Third, the women must have come into contact with healthcare providers when the heart muscle had taken enough damage to measure.
authors.affiliation: Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Anna
authors.initials: A
authors.lastname: Gyberg
authors.affiliation: Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden.|Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Lena
authors.initials: L
authors.lastname: Björck
authors.affiliation: Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Susanne
authors.initials: S
authors.lastname: Nielsen
authors.affiliation: Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Sylvia
authors.initials: S
authors.lastname: Määttä
authors.affiliation: Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Kristin
authors.initials: K
authors.lastname: Falk
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D000066505:Help-Seeking Behavior; D006801:Humans; D008875:Middle Aged; D009203:Myocardial Infarction / Q000523:psychology* / Q000628:therapy
keywords: acute myocardial infarction; decision-making; gender; grounded theory; healthcare-seeking; women's health