2.50
Hdl Handle:
http://hdl.handle.net/10755/158356
Type:
Presentation
Title:
Time to Treatment for Acute Coronary Syndromes: The Cost of Indecision
Abstract:
Time to Treatment for Acute Coronary Syndromes: The Cost of Indecision
Conference Sponsor:Midwest Nursing Research Society
Conference Year:2010
Author:DeVon, Holli, PhD, RN
P.I. Institution Name:Loyola University Chicago
Title:Nursing
Contact Address:2160 S. First Ave., Bldg 105, room 2875, Maywood, IL, 60153, USA
Contact Telephone:708-216-4148
Co-Authors:H.A. DeVon, N. Hogan, School of Nursing, Loyola University Chicago, Chicago, IL; A.L. Ochs, Northwestern Medical Faculty Foundation, Northwestern University, Chicago, IL; M. Shapiro, Mount Sinai School of Medicine, Mount Sinai School of Medicine, New York
Purpose: Objectives of the study were to explore individual factors influencing a decision to seek care for symptoms of acute coronary syndromes (ACS) and to describe patient characteristics associated with time to presentation. Background: Sociodemographic and environmental factors have been associated with urgent treatment seeking behaviors for patients experiencing ACS. Individual and behavioral variables are less well-defined. Methods: A cross-sectional, descriptive design was used. The sample included 256 patients admitted to the hospital with ACS. Data were collected on cardiac step-down units at two large urban medical centers. Reasons for seeking care were elicited during structured interviews in the patient's room. These factors and other patient characteristics were treated as predictor variables in an analysis of time from symptom onset to arrival in the emergency department. Results: Five categories of decision-making were identified through descriptive content analyses and were labeled new onset of chest pain; ongoing evaluation of symptom severity; symptoms other than chest pain that worsened or were unrelieved; externally motivated; and internally motivated. Median times from symptom onset to arrival in the emergency department were 9.5 hours for women and 6 hours for men. Patients who experienced constant pain (Hazard Ratio = 1.44, p=.01) and those with ST-elevation myocardial infarction (Hazard Ratio = 1.59, p=.004) sought treatment significantly sooner than patients with intermittent pain. Older patients sought treatment later (Hazard Ratio =.99, p =.02). Conclusions: Patients who are older and experience intermittent pain should be encouraged to seek emergency treatment for symptoms that may represent ACS. New evidence of patients' decision-making processes and dangerous delay in time to treatment provide knowledge needed to counsel patients about the benefits of seeking care quickly when symptoms begin.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Midwest Nursing Research Society

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleTime to Treatment for Acute Coronary Syndromes: The Cost of Indecisionen_GB
dc.identifier.urihttp://hdl.handle.net/10755/158356-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Time to Treatment for Acute Coronary Syndromes: The Cost of Indecision</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Midwest Nursing Research Society</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2010</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">DeVon, Holli, PhD, RN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Loyola University Chicago</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Nursing</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">2160 S. First Ave., Bldg 105, room 2875, Maywood, IL, 60153, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">708-216-4148</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">hdevon@luc.edu</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">H.A. DeVon, N. Hogan, School of Nursing, Loyola University Chicago, Chicago, IL; A.L. Ochs, Northwestern Medical Faculty Foundation, Northwestern University, Chicago, IL; M. Shapiro, Mount Sinai School of Medicine, Mount Sinai School of Medicine, New York</td></tr><tr><td colspan="2" class="item-abstract">Purpose: Objectives of the study were to explore individual factors influencing a decision to seek care for symptoms of acute coronary syndromes (ACS) and to describe patient characteristics associated with time to presentation. Background: Sociodemographic and environmental factors have been associated with urgent treatment seeking behaviors for patients experiencing ACS. Individual and behavioral variables are less well-defined. Methods: A cross-sectional, descriptive design was used. The sample included 256 patients admitted to the hospital with ACS. Data were collected on cardiac step-down units at two large urban medical centers. Reasons for seeking care were elicited during structured interviews in the patient's room. These factors and other patient characteristics were treated as predictor variables in an analysis of time from symptom onset to arrival in the emergency department. Results: Five categories of decision-making were identified through descriptive content analyses and were labeled new onset of chest pain; ongoing evaluation of symptom severity; symptoms other than chest pain that worsened or were unrelieved; externally motivated; and internally motivated. Median times from symptom onset to arrival in the emergency department were 9.5 hours for women and 6 hours for men. Patients who experienced constant pain (Hazard Ratio = 1.44, p=.01) and those with ST-elevation myocardial infarction (Hazard Ratio = 1.59, p=.004) sought treatment significantly sooner than patients with intermittent pain. Older patients sought treatment later (Hazard Ratio =.99, p =.02). Conclusions: Patients who are older and experience intermittent pain should be encouraged to seek emergency treatment for symptoms that may represent ACS. New evidence of patients' decision-making processes and dangerous delay in time to treatment provide knowledge needed to counsel patients about the benefits of seeking care quickly when symptoms begin.</td></tr></table>en_GB
dc.date.available2011-10-26T20:58:07Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T20:58:07Z-
dc.description.sponsorshipMidwest Nursing Research Societyen_GB
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