Women's decision to seek care for symptoms of acute myocardial infarction

Objective: To describe the psychosocial processes by which women make the decision to seek care for the symptoms of Acute Myocardial Infarction (AMI). Design: The qualitative method of grounded theory was used to study the prehospital experience of women with symptoms of AMI. Participants: Sixteen women between the ages of 42 and 82 years who were hospitalized in a coronary care unit after AMI. Results: The women delayed a median of 5.4 hours (range 1.5 to 144 hours). The psychosocial processes by which they made the decision to seek treatment after symptom onset were dynamic and multidimensional. The fundamental structure involved two core categories: (1) maintaining control, and (2) relinquishing control. Within these two core categories there were five subcategories: symptom awareness, perceived insignificance, self-treatment, perceived threat, and lay consultation. Conclusion: Although these women immediately recognized their symptoms as abnormal, they did not acknowledge their seriousness until after the use of a variety of coping mechanisms and self-treatment behaviors to reduce threat and maintain control over the situation. Interventions to reduce delay should focus on the issue of perceived loss of control during symptom onset and attempt to reduce the sense of threat by describing the benefits of seeking treatment early.