Patient Denial of Myocardial Infarction in the Prehospital Phase: Prevalence and Correlates
Background:
Limited knowledge exists regarding patients' denial of myocardial infarction (MI) before hospitalization for an MI.
Objective:
The aim of this study was to determine the prevalence and correlates of denial of MI in the prehospital phase of a confirmed MI.
Methods:
This secondary analysis included 166 hospitalized patients (mean [SD] age, 54.1 [10.5] years) who developed MI outside a healthcare facility and had high congruence between their experienced and expected symptoms. Measurements included the Denial subscale of the Brief COPE Inventory, the modified Response to Symptoms Questionnaire, and a Likert scale measuring perceived risk for MI. Patients who arrived at a hospital at least 1 hour after the onset of their symptoms were considered to have prolonged prehospital delay.
Results:
Despite their high symptom congruence, 77% of patients denied the possibility of having an MI before hospitalization. The lower denial group was characterized by cardiac history, whereas the higher denial group was distinguished by nonsmoking, a lower perceived risk of MI, less anxiety at symptom onset, and more concerns about seeking medical help. Compared with the lower denial group, patients in the higher denial group were more likely to underestimate the seriousness of their symptoms and delay seeking medical help. The higher denial group responded to symptoms in a more passive manner (eg, waiting), whereas the lower denial group showed a more problem-solving approach (eg, contacting emergency services).
Conclusions:
Denial of MI is highly prevalent in the prehospital phase and is negatively linked with cognitive, emotional, and behavioral responses to MI symptoms.
Insights
Most patients deny myocardial infarction (MI) before hospitalization, even with clear symptoms. This denial impacts how patients respond to symptoms and seek medical help, highlighting a critical gap in prehospital cardiac care.
Area of Science:
- Cardiology
- Psychology
Background:
- Limited understanding exists regarding patient denial of myocardial infarction (MI) prior to hospital admission.
- Investigating prehospital denial is crucial for improving timely medical intervention.
Purpose of the Study:
- To determine the prevalence of MI denial in the prehospital phase.
- To identify factors associated with MI denial in patients experiencing symptoms.
Main Methods:
- Secondary analysis of 166 hospitalized MI patients with high symptom congruence.
- Utilized Brief COPE Inventory, Response to Symptoms Questionnaire, and perceived risk assessment.
- Defined prolonged prehospital delay as arrival at hospital ≥1 hour after symptom onset.
Main Results:
- 77% of patients denied the possibility of MI despite high symptom congruence.
- Higher denial was associated with nonsmoking, lower perceived MI risk, less anxiety, and concerns about seeking help.
- Denial correlated with underestimating symptom severity, delaying help-seeking, and passive symptom response.
Conclusions:
- Prehospital denial of MI is highly prevalent.
- Denial is negatively associated with cognitive, emotional, and behavioral responses to MI symptoms.
- Addressing denial may improve prehospital delay and patient outcomes.
More Related Videos
18:11A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
Published on: December 28, 2012
06:16Signal Acquisition, Score Interpretation, and Economics of a Non-Invasive Point-of-Care Test for Coronary Artery Disease
Published on: August 9, 2024
Related Concept Videos
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:28Acute Coronary Syndrome IV: Interprofessional Care
01:19Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
01:30Acute Coronary Syndrome I: Introduction
01:30Introduction Cardiac Emergencies
01:30Coronary Artery Disease III: Clinical Manifestations