The long term objective of this research is to develop an educational intervention to facilitate individuals' abilities to recognize the symptoms of acute myocardial infarction (AMI) and reduce delay in seeking treatment during AMI. Existing studies have demonstrated that individuals during AMI delay prior to accessing the Emergency Medical System a median of 2 hours, with women and minorities delaying significantly longer. There is a need for studies which can interpret delay behavior and develop interventions based on theoretical explanations. The purposes of Phase 1 of this study are to examine the relationship between expected and experienced symptoms and delay during AMI, and to examine whether these relationships differ for women and minorities. The purpose of Phase 2 is to develop and test an educational intervention to assist individuals in forming an accurate representation of the symptoms associated with AMI. The sample in Phase 1 will include 125 women and 125 men who have been hospitalized after their first AMI. At least one-third of the sample recruited will be African-Americans. Subjects will be interviewed 2 days post-myocardial infarction using a structured interview to gather data about the symptoms they had associated with AMI prior to the onset of their symptoms and the symptoms they had experienced prior to and during their AMI. Medical records will be reviewed to gather data about the patients' presentation to the Emergency Department and their course during hospitalization. These data will be analyzed to determine whether a match between expected and experienced symptoms was associated with shorter delays and whether the relationships differed based on gender and ethnicity. The educational intervention for Phase 2 will be based on data collected in Phase 1 on expectations and actual experience. A prospective randomized block design will be used with the blocking variables of gender and ethnicity. The convenience sample will include 75 men and 75 women and at least one-third of the recruited sample will be African-Americans. Subjects will be randomly assigned to either the experimental or control groups. The experimental group will listen to a tape-recorded message and receive a pamphlet focusing on the symptoms and sensations commonly experienced during AMI. The control group will listen to a tape-recorded message and receive a pamphlet about general health information. Subject's expectations about AMI symptoms will be measured immediately before and after receiving the experimental or control information and one month later.
| Hwang, Seon Young; Ryan, Cathy; Zerwic, Julie Johnson (2006) The influence of age on acute myocardial infarction symptoms and patient delay in seeking treatment. Prog Cardiovasc Nurs 21:20-7 |
| DeVon, Holli A; Zerwic, Julie Johnson (2004) Differences in the symptoms associated with unstable angina and myocardial infarction. Prog Cardiovasc Nurs 19:6-11 |
| DeVon, Holli A; Ryan, Catherine J; Zerwic, Julie Johnson (2004) Is the medical record an accurate reflection of patients' symptoms during acute myocardial infarction? West J Nurs Res 26:547-60 |
| Zerwic, Julie Johnson; Ryan, Catherine J; DeVon, Holli A et al. (2003) Treatment seeking for acute myocardial infarction symptoms: differences in delay across sex and race. Nurs Res 52:159-67 |
