Gender Differences in Factors Associated With Prehospital Delay Among Acute Coronary Syndrome Patients in Pakistan

Saleema Allana, Khurshid Khowaja, Tazeen Saeed Ali, Debra Kay Moser, Aamir Hameed Khan

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


Purpose: To identify gender differences in prehospital delay time (PDT) and its associated factors among acute coronary syndrome (ACS) patients. Design: Descriptive cross-sectional comparative study. Methods: This study was conducted among 249 ACS patients at two tertiary care hospitals of a large metropolitan city of Pakistan. Data were collected through the modified Response to Symptoms Questionnaire. Results: The median PDT of women was found to be 7 hours, compared to 3.5 hours among men (p =.001). Results of the regression analysis indicated that most women delayed because of social factors, such as attendants’ responses to their symptoms (p =.002), and because they were worried about expenses required for the treatment (p =.002); yet, most men delayed owing to individual factors, such as waiting for symptoms to subside (p<.001), and not recognizing the symptoms as being cardiac related (p<.001). Having anxiety and lack of knowledge about symptoms was associated with extended PDT among both genders. Conclusion: Women delayed longer than men in seeking treatment for their ACS symptoms. Different factors were associated with PDT in women and men. This study may provide important insights for designing interventional studies to reduce PDT in Pakistani ACS patients.

Original languageEnglish
Pages (from-to)480-490
Number of pages11
JournalJournal of Transcultural Nursing
Issue number5
StatePublished - Nov 2015

Bibliographical note

Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The authors would like to acknowledge Sigma Theta Tau International Rho Delta Chapter for awarding the proposal with Chapter Research Award worth PKR 10,000.


  • acute coronary syndrome
  • associated factors
  • gender differences
  • prehospital delay

ASJC Scopus subject areas

  • General Nursing


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