Delay in Seeking Health Care for Acute Coronary Syndromes in a Lebanese Sample

Abstract

Early treatment of patients with acute coronary syndromes (ACS) is crucial to reduce morbidity and mortality. The purpose of this study was to examine delay in seeking care for ACS symptoms in a Lebanese sample and identify predictors of delay. Medical record reviews and interviews using the Response to Symptoms Questionnaire were conducted with 204 ACS patients in coronary care within 72 hours of admission. Median time from symptom onset to hospital arrival was 4.5 hours. Higher education, presence of dyspnea, intermittent symptoms, and waiting for symptoms to go away predicted longer delays, whereas intensity of symptoms and active response (going to the hospital) predicted shorter delays. The findings suggest lack of knowledge of ACS symptoms and the need for public education in this regard.

Predictors of pre-hospital delay among patients with acute myocardial infarction

“…Median delay was often reported due to distribution skewness resulting from extremely prolonged delay values. While the majority of authors who described the distribution of delay times reported skewness toward longer delay values [16][17][18][19][20][21][22][23][24], McKinley et al [25], who studied treatment seeking behavior among a cohort of Australians and North Americans, reported skewness toward short values.…”

“…Of the ones that reported using a conceptual framework, eight [18,21,23,25,[36][37][38][39] have used Leventhal's model [40]. Leventhal's model was used in conjunction with another conceptual framework in three of the studies: Grounded Theory [36], Thematic Framework [37], and Dispositional Optimism [23].…”

Sex and age specific time patterns and long term time trends of pre-hospital delay of patients presenting with acute ST-segment elevation myocardial infarction

“…Comparison data from other parts of the world, however, indicate much longer median PHDT such as a median of 195 min in Denmark, observed in a study including 5978 patients [17], 210 min in Greece [27] including 2172 acute coronary syndrome patients and -assessed with substantially smaller sample sizes -of 264 min in South Korea [28]; 270 min in Japan [28] , 271 min in Lebanon [29] and even 384 min in Australia [30].…”

Female gender doubles pre-hospital delay times for patients experiencing ST segment elevation myocardial infarction in Saudi Arabia

“…The period of pre-hospital delay in the KSA in this study is twice as long as in the UK or USA and is also considerably longer than in other Asian or Middle Eastern countries. 11,17,22,29,41,[56][57][58] Participants' interviews show that transfer delay is the major contributing factor especially for women. However in 2011, the Saudi Project for the Assessment of Coronary Events registry (SPACE), showed a much lower median total pre-hospital delay of 2.5 h (interquartile range: 223 min) for 5055 ACS patients.…”

“…5 The CSM was judged to be the most appropriate theoretical framework by which to consider the extensive range of physical and emotional responses that patients experience when coping with STEMI symptoms and to help explain the rationale for these. 8,[25][26][27][28][29][30][31][32][33][34] This study used a non-experimental, survey design, sequentially combining both quantitative and qualitative methods to achieve the study objectives. Explanatory mixed methods are frequently used to gain greater insight into the topic of investigation than that which one method would achieve in isolation.…”