Tuesday, November 6, 2007

This presentation is part of : Critical Care Health Models
Response to Symptoms of Acute Coronary Syndromes: The Influence of Past Experience in a Sample of Lebanese Patients
Samar Noureddine, PhD, RN, School of Nursing, American University of Beirut, Beirut, Hamra, Lebanon
Learning Objective #1: Identify the common cognitive, affective and emotional responses to symptoms of acute coronary syndromes, and subsequent time to hospital arrival.
Learning Objective #2: Appreciate the relationship between responses to symptoms, delay time and past experience with similar symptoms of acute coronary syndromes.

Background: Heart disease remains the leading cause of morbidity and mortality in many countries. The initial response to a cardiac event influences the speed of seeking health care and receiving treatment, which in turn impacts patient outcomes. The literature is equivocal regarding the relation between past history of heart disease and the time to seeking care (delay time). Nevertheless, experiencing cardiac symptoms that are expected was found to be negatively related to delay time. Purpose: To examine the influence of past experience with similar symptoms on delay in seeking care and related patterns of response in patients with acute coronary syndromes. Design: Descriptive study using survey methodology. Sample: A convenience sample of 212 patients admitted with acute coronary syndromes to coronary care in Lebanon. Method: Medical records were reviewed for demographic, clinical and treatment variables. Face to face interviews were conducted using the Response to Symptoms questionnaire, which asks about symptoms, and related cognitive, affective and behavioral responses. Results: Sixty-one percent of the patients reported having experienced similar symptoms in the past; their delay time did not differ significantly from those without past experience (median delays of 5 and 4.78 hours, respectively). As expected, those with prior symptoms experience were significantly more likely to have history of myocardial infarction than their counterparts. Also prior symptom experience was associated with higher knowledge of myocardial infarction symptoms, recognition of symptoms as cardiac, fear of what may happen and appraisal of symptom seriousness. Participants in the symptom experience group responded to cardiac symptoms this time significantly differently from in the past, with interesting trends reflected in the data. Conclusion: People’s experience with a cardiac event influences their subsequent coping with such symptoms, but their delay time is not reduced. The findings may inform interventions for reducing delays in seeking care in this population.