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Updated: Jan 24, 2026
Acute Myocardial Infarction in Rats
Published on: February 16, 2011
Inability to act was associated with an extended delay prior to care-seeking, in patients with an acute myocardial
Carolin Nymark1, Peter Henriksson1, Anne-Cathrine Mattiasson2
11 Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital, Sweden.
Insights
Patient appraisal significantly impacts acute myocardial infarction care-seeking delays. Perceived inability to act and symptom appraisal are key factors, influencing prolonged or short delays respectively. Interventions should address these cognitive processes.
Area of Science:
- Cardiology
- Health Psychology
- Patient Behavior Studies
Background:
- Out-of-hospital mortality for acute myocardial infarction (AMI) remains high, contrasting with declining in-hospital rates.
- Interventions to reduce patient delay in seeking care for AMI have yielded limited success.
- A deeper understanding of patients' cognitive and emotional appraisal processes before seeking care is crucial.
Purpose of the Study:
- To investigate the influence of appraisal processes on patient delay in seeking care for AMI.
- To evaluate the 'Patients' appraisal, emotions and action tendencies preceding care seeking in acute myocardial infarction' (PA-AMI) questionnaire's ability to differentiate between prolonged and short care-seeking delays.
Main Methods:
- A cross-sectional study involving 326 AMI patients.
- Utilized the validated PA-AMI questionnaire to assess appraisal, emotions, and action tendencies.
- Employed projection to latent structures regression and discriminant analysis to examine the impact of subscales on delay and discriminate between delay groups.
Main Results:
- 'Perceived inability to act' and 'symptom appraisal' significantly impacted patient delay (P<0.0001).
- 'Perceived inability to act' was most influential in delays exceeding 12 hours.
- 'Symptom appraisal' was most influential in delays shorter than 1 hour.
Conclusions:
- Cognitive appraisal processes significantly influence delays in seeking care for AMI.
- Prolonged delays in AMI patients are associated with perceived loss of control and ability to act, alongside low perceived symptom severity and urgency.
- Future interventions to reduce AMI patient delay should target appraisal processes, recognizing 'perceived inability to act' as a potential indicator for seeking medical attention.
Background:
The out-of-hospital mortality in patients with acute myocardial infarction remains unchanged in contrast to a decrease in inhospital mortality. Interventions aiming to shorten patient delay have been largely unsuccessful. A deeper understanding is apparently needed on patients' appraisal prior to care-seeking.
Aim:
To investigate whether appraisal processes influence patient delay, and if the questionnaire 'Patients' appraisal, emotions and action tendencies preceding care seeking in acute myocardial infarction' (PA-AMI) could discriminate between patients with prolonged care-seeking and those with a short delay.
Methods:
A cross-sectional study including 326 acute myocardial infarction patients filling out the validated questionnaire PA-AMI. The impact of subscales on delay was analysed by projection to latent structures regression. Discrimination opportunities between patients with short and long delays were analysed by projection to latent structures discriminant analysis.
Results:
The subscales 'perceived inability to act' and 'symptom appraisal' had a major impact on patient delay (P<0.0001). 'Perceived inability to act' had its main influence in patients with a delay exceeding 12 hours, and 'symptom appraisal' had its main influence in patients with a delay shorter than one hour.
Conclusion:
Appraisal processes influence patient delay. Acute myocardial infarction patients with a prolonged delay were, besides a low perceived symptom severity and urgency to seek medical care, characterised by a perceived loss of control and ability to act. Therefore, future interventions aimed at decreasing delay should pay attention to appraisal processes, and perceived inability to act may be a sign of a health threat and therefore a signal to seek medical care.
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