Symptom recognition and treatment-seeking behaviors in women experiencing acute coronary syndrome for the first time: a qualitative study

Abstract

Background Women are more likely to delay medical help-seeking for ACS symptoms. Understanding patients’ experience of the symptoms and their response is essential in improving help-seeking behaviors and timely diagnosis and treatment for ACS. This study aimed to explore women’s experience of ACS, their response to the symptoms, and treatment-seeking decisions. Methods This qualitative descriptive study was conducted in a tertiary referral specialized heart hospital affiliated with Tabriz University of Medical Sciences, Iran. Participants included 39 women who had experienced ACS for the first time. Results Four main themes emerged from the analysis of interview transcripts: (1) the onset of symptoms, (2) the types of symptoms, (3) response to symptoms and (4) arriving at the hospital. These themes and associated sub-themes explained women’s experience of ACS symptoms, their response to the symptoms, and decision to seek medical help. Conclusions This study identified and discussed factors contributing to the prehospital delay in women and their decision-making to seek medical care for ACS symptoms. The results are consistent with previous research indicating that ACS symptoms in women are somewhat different from men, and women tend to underestimate their symptoms and attribute them to non-cardiac causes. Women should be supported to develop awareness and understanding of ACS symptoms and appreciate the importance of early treatment-seeking in the disease outcomes.

Treatment seeking experiences of ACS patients in Yogyakarta, Indonesia during COVID-19 pandemic: A qualitative study

“…Similarly, tendency to choose self-treatment by using home remedies to solve their symptoms was also found by previous study among women in Middle East country [25]. A previous review found that low intensity symptoms were considered as not serious disease then leading patients to delay for seeking medical helps [26] or just wait and believe that the symptoms will…”

“…This study provided insight into treatment seeking behaviour, barriers and enabling factors for seeking medical treatment, and experiences after entering hospitals, communicating with healthcare staffs, and receiving medical treatment for ACS patients during the COVID-19 pandemic. We found that treatment seeking decision was aligned with the evidences prior to the pandemic in that mild ACS symptoms led to the delay in seeking medical treatment [ 25 – 28 ]. When symptoms were mild, such as fatigue and tiredness, patients might misinterpret and believed that these symptoms were caused by hard work and could be fully recovered in a few days without specific medical treatment.…”

Number of comorbidities and the risk of delay in seeking treatment for coronary heart disease: a longitudinal study in Bogor City, Indonesia

“…This result is consistent with a qualitative study in Iran of 39 women with first-time ACS that found women tended to delay seeking help when their symptoms were mild and developed gradually. Women often underestimated the symptoms and attributed them to noncardiac causes, making them more likely to delay seeking treatment for CHD symptoms [ 32 , 33 ]. Our findings were also in line with a study of Pakistani society, which showed that, because women are overburdened with their family and household responsibilities, many are unaware of or fail to pay attention to symptoms.…”

Women Acute Myocardial Infarction—Identifying and Understanding the Gender Gap (WAMy-GAP): A Study Protocol

“…(*) Semi-structured interview: Interviews will last a maximum of 45 min, and will include open-ended questions regarding (1) the patient's experiences from the onset of symptoms to the decision to seek medical attention; (2) questions about patients' physical and emotional feelings during the experience, decision-making processes (e.g., who they talked to and who they asked for advice), and beliefs about what was happening at the onset of myocardial infarction symptoms. A matrix of structured interview questions was developed specifically for this study based on a literature review that examined the concepts and factors associated with women's delay in seeking medical care [24,47,48]. The interviews will be conducted during the patient's hospitalization or 2-3 months after discharge, as in the study by Blakeman et al [49].…”