Public Knowledge about Risk Factors, Symptoms, and First Decision-making in Response to Symptoms of Heart Attack among Lay People

Authors

  • Samoraphop Banharak RN, PhD, Lecturer, Khon Kaen University, Thailand
  • Tyler Zahrli MD, PhD Candidate, School of Medicine, Saint Louis University, St. Louis, MO, USA
  • Hisako Matsuo PhD, Department of Sociology and Anthropology, Saint Louis University, USA

Keywords:

Lay people, Decision making, Acute myocardial infarction, Cardiovascular diseases, Heart attack, Symptoms, Risk factors

Abstract

                  Lack of knowledge of acute myocardial infarction symptoms and coronary artery disease risk factors is associated with delayed treatments and significant comorbidities. Calling an emergency medical service (i.e., in the USA calling 9-1-1) is the most appropriate first decision to survive this critical situation. This study explored public knowledge and determined socio-demographic variables related to knowledge of coronary artery disease risk factors, acute myocardial infarction symptoms, and first decision-making in acute myocardial infarction situation. This cross-sectional study involved collecting data from 345 lay people from the Midwestern United States. The research team used t-tests to compare cardiovascular disease knowledge in relation to socio-demographic variables. Associations between first decision-making and demographic characteristics were tested using Chi-squared testing.
                  We found that participants recognized classic acute myocardial infarction symptoms more readily than atypical symptoms. Participants who were younger, college educated, had higher household income and health insurance had greater knowledge of symptoms. Older adults were less informed about acute myocardial infarction symptoms. Approximately half of the participants misidentified specific typical coronary artery disease risk factors, especially diabetes mellitus. Over 90% of respondents indicated “Calling 9-1-1” for their first decision in an acute myocardial infarction situation. Older adults and people with lower income and education displayed the greatest lack of knowledge. Nurses should provide health education programs about atypical cardiovascular symptomology and promote calling emergency medical services when experiencing acute myocardial infarction to address the concerning lack of knowledge and awareness in this population.

References

1. American Heart Association. Heart disease and stroke statistics—2016 update: a report from the American Heart Association. Circulation. 2016A; 132, 1-323. doi:10.1161/CIR.0000000000000366

2. Youssef, G.S., Kassem, H.H., Ameen, O.A., Al Taaban, H.S., & Rizk, H.H. Pre-hospital and hospital delay in patients with non-ST elevation acute coronary syndroms in tertiary care. The Egyptian Heart Journal. 2017; 69, 177-181.

3. Beig, J.R., Tramboo, N.A., Kumar, K., Yaqoob, I., Hafeez, I., Rather, F.A.,…, & Rather, H.A. Components and determinants of therapeutic delay in patients with acute ST-elevation myocardial infarction: a tertiary care hospital-based study. Journal of Saudi Arabia Heart Association. 2017; 29, 7-14.

4. Xie, L., Huang, S.F., & Hu, Y.Z. Factors influencing pre-hospital patient delay in patients with acute myocardial infarction. Chinese Nursing Research. 2015; 2, 75-79.

5. Fathi, M., Rahiminiya, A., Zare, M.A., & Tavakoli, N. Risk factors of delayed pre-hospital treatment seeking in patients with acute coronary syndrome: A prospective study. Turkish Journal of Emergency Medicine. 2015;15, 163-167.

6. Magid, D. J., Wang, Y., Herrin, J., McNamara, R. L., Bradley, E. H., Curtis, J. P., …, & Krumholz, H.M. Relationship between time of day, day of week, timeliness of reperfusion, and in-hospital mortality for patients with acute ST-segment elevation myocardial infarction. The Journal of the American Medical Association. 2005; 294, 803-812.

7. Albarqouni, L., Smenes, K., Meinertz, T., Schunkert, H. Fang, X., & Ronel, J. Patient’s knowledge about symptoms and adequate behavior during acute myocardial infarction and its impact on delay time: Findings from the multicentre MEDEA study. Patient Education and Counseling. 2016; 99, 1845-1851.

8. Gillis, N.K., Arslanian, C., & Strube, L.M. Acute coronary syndromes in older adults: A review of literature. Journal of Emergency Nursing. 2014; 40(3), 270-275.

9. Ryan, C. J., & Zerwic, J. J. Knowledge of symptom clusters among adults at risk for acute myocardial infarction. Nursing Research. 2004; 53, 363-369.

10. Greenlund, K. J., Keenan, N. L., Giles, W. H., Zheng, Z. J., Neff, L. J., Croft, J. B., & Mensah, G. A. Public recognition of major signs and symptoms of heart attack: Seventeen states and the US Virgin Islands, 2001. American Heart Journal. 2004; 147(6), 1010-1016. doi: 10.1016/j.ahj.2003.12.036

11. Swanoski, M. T., Lutfiyya, M. N., Amaro, M. L., Akers, M. F., & Huot, K. L. Knowledge of heart attack and stroke symptomology: A cross-sectional comparison of rural and non-rural US adults. Bio Medical Center Public Health Journal. 2012; 12, 283. doi: 10.1186/1471-2458-12-283

12. Hwang, S. Y., & Jeong, M. H. Cognitive factors that influence delayed decision to seek treatment among older patients with acute myocardial infarction in Korea. European Journal Cardiovascular Nursing. 2012; 11(2), 154-159.

13. Karayannis, G., Giamouzis, G., Cokkinos, D.V., Skoularigis, J., & Triposkiadis, F. Diabetic cardiovascular autonomic neuropathy: Clinical implications. Expert Review of Cardiovascular Therapy. 2012; 10, 747-765.

14. American Heart Association. Coronary artery disease coronary heart disease [Internet]. 2016B [cited 2016 Mar. 24]. Available from: https://www.heart.org/HEARTORG/Conditions/More/ MyHeartandStrokeNews/Coronary-Artery-Disease---Coronary-HeartDisease_UCM_436416_Article.jsp#.V0TsSZODGko

15. Williams, A., Lindsell, C., Rue, L., & Blomkalns, A.Emergency Department education improves patient knowledge of coronary artery disease risk factors but not the accuracy of their own risk perception. Preventive Medicine. 2007: 44, 520-525.

16. Nguyen, H. L., Saczynski, J. S., Gore, J. M., & Goldberg, R. J. Age and sex differences in duration of prehospital delay in patients with acute myocardial infarction: a systematic review. [Research Support, N.I.H., Extramural Review]. Circulation. Cardiovascular Quality & Outcomes. 2010; 3(1), 82-92.

17. Bird, M.W., Woods, A.G., & Warren, N.A. Factors influencing treatment delays for acute myocardial infarction. Critical Care Nursing Quarterly. 2009; 32(1), 19-23.

18. Finn, J. C., Bett, J. H., Shilton, T. R., Cunningham, C., & Thompson, P. L. Patient delay in responding to symptoms of possible heart attack: Can we reduce time to care? The Medical Journal of Australia. 2007; 187(5), 293-298.

19. United States Census Bureau. American Community Survey 1-year estimates. 2014 [cited 2016 Apr. 30]. Available from: https://factfinder.census.gov/faces/tableservices/jsf/pages/ productview.xhtml?src=bkmk

20. Centers for Disease Control and Prevention. 2011 Behavioral risk factor surveilance system questionnaire January 27, 2011. 2014 [cited 2014 Sep. 20]. Available from: https://www.cdc.gov/brfss/questionnaires/pdfques/2011brfss.pdf

21. Carbaugh, M., Gray, B., & Hoffman, T. Acute MI treatment: why do people wait? Kentucky Nurse. 2003;51(4), 10.

22. Cytryn, K. N., Yoskowitz, N. A., Cimino, J. J., & Patel, V. L. Lay public’s knowledge and decisions in response to symptoms of acute myocardial infarction. Advanced Health Science Education Theory Practice Journal. 2009;14(1), 43-59. doi: 10.1007/s10459-007 -9085-z

23. Fang, J. Public awareness of heart attack symptoms: what should we look for and how will it help? Future Cardiology. 2011; 7(6), 849-851. doi: 10.2217/fca.11.64

24. Granot, M., Dagul, P., Darawsha, W., & Aronson, D. Pain modulation efficiency delays seeking medical help in patients with acute myocardial infarction. Pain. 2015;156(1), 192-198. doi: 10.1016/j.pain.0000000000000020

25. Nielsen, C.G., Laut, K.G., Jensen, L.O., Ravkilde, J., Terkelsen, C.J., & Kristensen, S. Patient delay in patients with ST-elevetion myocardial infarction: Time patterns and predictors for a prolonged delay. European Heart Journal: Acute Cardiovascular Care. 2016; October 9, 1-9. doi: 10.1177/204887261667657

26. American Heart Association. Cardiovascular disease and diabetes [Internet]. 2016C [cited 2016 May 25]. Available from https://www.heart.org/HEARTORG/Conditions/Diabetes/ WhyDiabetesMatters/Cardiovascular-DiseaseDiabetes_UCM_313865_
Article.jsp/#.V0XDJJMrInc

27. Kim, G., Aguado Loi, C. X., Chiriboga, D. A., Jang, Y., Parmelee, P., & Allen, R. S. Limited English proficiency as a barrier to mental health service use: A study of Latino and Asian immigrants with psychiatric disorders. Journal of Psychiatric Research. 2011; 45(1), 104-110. doi:
10.1016/j.jpsychires.2010.04.031

28. Canto, J.G., Shlipak, M.G., Rojer, W.J., Malmgren, J.A., Frederick, P.D., Lambrew, C.T.,..., & Kiefe, C.I. Prevalence, clinical characteristics, and mortality among patients with myocardial infarction presenting without chest pain. Journal of the American Medical Association. 2000; 283, 3223-3229.

29. Woon, V. C., & Lim, K. H. Acute myocardial infarction in the elderly—the differences compared with the young. Singapore Medical Journal. 2003; 44(8), 414-418.

30. Katz, D.A., Graber, M., Birrer, E., Lounsbury, P., Baldwin, A., Hillis, S.L., & Christensen, A.J. Health beliefs toward cardiovascular risk reduction in patients admitted to chest pain observation units. Academic Emergency Medicine. 2009;16(5):379-387. doi:10.1111/j.1553-2712.2009.00383.x

Downloads

Published

2018-01-01

How to Cite

1.
Banharak S, Zahrli T, Matsuo H. Public Knowledge about Risk Factors, Symptoms, and First Decision-making in Response to Symptoms of Heart Attack among Lay People. PRIJNR [Internet]. 2018 Jan. 1 [cited 2024 Dec. 11];22(1):18-29. Available from: https://he02.tci-thaijo.org/index.php/PRIJNR/article/view/93505

Issue

Section

Original paper