Delay Times and Decision Making Processes in Acute Myocardial Infarction: A Qualitative Literature Review

Background: High morbidity and mortality rates in patients with Acute Myocardial Infarction (AMI) worldwide are usually related to delays in Seeking Medical Care (SMC). Improper patient s perceptions and decision making processes contributed to this delay. Aims: (1) To review the subjective experiences and decision making processes in patients who delayed in reporting AMI symptoms; (2) To review the gender role regarding the decision making process in regards to delays in SMC for AMI. Methods: A literature review search was conducted using CINAHL and MEDLINE. The search was limited to full text, peer reviewed, qualitative studies from 2002 to 2009. Results: Patients with AMI symptoms tended to delay in their decisions to SMC. Decision making processes to SMC were influenced by the experienced symptoms. Patients experienced atypical symptoms were more delayers than those experienced the classical symptoms. When patients perceived their symptoms of cardiac origin they seek medical care with shorter delay times than those perceived them of non cardiac origins. The laypersons and context of the event influenced patients interpreting and responses to these symptoms. Women predromal and atypical symptoms of AMI, and improper responses toward these symptoms contributed to being more delayers than men. Conclusion: It is substantial to raise public awareness to the factors that impact decision making processes in regards to SMC when experiencing AMI symptoms. Further research is needed to understand the phenomenon of delay from an Arabic cultural and ethnic value.