Paper
Saturday, July 14, 2007
Do African American men and women delay for different reasons when seeking medical help for a myocardial infarction?
Angela D. Banks, PhD, Department of Adult Health, University of San Francisco, San Francisco, CA, USA and Kathleen Dracup, RN, DNSc, FAAN, School of Nursing, University of California, San Francisco, San Francisco, CA, USA.
| Learning Objective #1: 1. The learner will be able to identify the reasons why African American men and women delay in seeking medical help for cardiac symptoms. |
| Learning Objective #2: 2. The learner will be able to identify the number one reason for delay among African Americans when seeking medical help for cardiac symptoms. |
Objective: The purpose of this study was to identify if there are gender differences in the reasons why African Americans delay in seeking medical care for symptoms of a myocardial infarction.
Design: A cross-sectional descriptive design
Methods: African Americans (N=61) diagnosed with an AMI, average age 60 (±12) years, more than half (n=32) were women. Patients were interviewed using structured interview guides. Independent t-tests were used to test the differences in delay times.
Findings: Median delay time was longer for women than men (4.4 hours vs. 3.5 hours), although the difference was not significant. Single women delayed significantly longer than single men (p= .03), and women who were alone when their symptoms started delayed longer than women who were with others (p= .03). Women who received advice to seek help or call 911 upon symptom onset had significantly shorter delays compared to women who were given other suggestions when symptoms began, (p= .01). Men at home delayed longer than men who experienced their symptoms outside the home (p= .01). Men with emergency room insurance delayed longer than men without emergency room insurance (p= .03), and men who took an ambulance to the hospital had shorter delay times than men who took other means of transportation (p= .04).
Conclusion: Both men and women had prolonged delay time, although there was not a difference in delay by gender. Median delay times were substantially longer than the recommended time of less than one hour, making it difficult for most patients to fully benefit from prompt intervention of medical therapies. The findings allow clinicians to target African Americans at high risk for longer delays and to tailor educational interventions to decrease prehospital delay in this population.