Illness attribution among Japanese patients with acute myocardial infarction
Yoshimi Fukuoka1, Kathleen Dracup, Fumio Kobayashi
1School of Nursing, University of California San Francisco, 94143-0604, USA.
Objective:
The purpose of this study was to describe causal attribution of acute myocardial infarction (AMI) in Japanese patients.
Design:
A cross-sectional study design was used.
Setting:
The setting for this study was 5 hospitals in urban areas in Japan.
Sample:
A convenience sample of 155 patients admitted with AMI was used.
Measures:
Causal attribution was assessed by a semi-structured interview. Known risk factors were assessed by medical record review and patient interview.
Results:
Twenty-two different primary causes for AMI were identified. Patients most commonly cited smoking, stress, and diet as risk factors. Except for smoking, Japanese patients did not identify their cardiac risk factors as a cause of their AMI. Controlling for sociodemographic characteristics, patients with a recorded history of coronary heart disease were significantly less likely to attribute their cardiac risk factors to their AMI (P <.05).
Conclusions:
Effective education and counseling of patients after an AMI must be coupled with their view of what factors put them at risk for future AMIs.
Insights
Japanese patients often don't recognize their cardiac risk factors, except smoking, as causes of acute myocardial infarction (AMI). Effective patient education must align with their understanding of AMI risk factors.
Area of Science:
- Cardiology
- Public Health
- Health Psychology
Background:
- Acute myocardial infarction (AMI) is a leading cause of mortality worldwide.
- Understanding patient attributions of causality is crucial for effective secondary prevention strategies.
- Limited research exists on causal attributions of AMI among Japanese populations.
Purpose of the Study:
- To describe how Japanese patients attribute causality for their acute myocardial infarction (AMI).
- To identify commonly perceived causes of AMI among Japanese patients.
- To explore the relationship between recognized cardiac risk factors and patient-attributed causes of AMI.
Main Methods:
- Cross-sectional study conducted in 5 urban Japanese hospitals.
- Convenience sample of 155 patients admitted with AMI.
- Causal attributions assessed via semi-structured interviews; risk factors verified through medical records and interviews.
Main Results:
- Twenty-two distinct primary causes for AMI were identified by patients.
- Smoking, stress, and diet were the most frequently cited causes.
- Except for smoking, patients rarely attributed their AMI to known cardiac risk factors; those with prior coronary heart disease were less likely to do so.
Conclusions:
- Patient education and counseling post-AMI should incorporate patients' perceived causes of AMI.
- Addressing patient beliefs about AMI risk factors is essential for improving adherence to preventive measures.
- Future interventions should bridge the gap between clinical understanding of risk factors and patient attributions.
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