Key result
An integrated theoretical model of perceptual-cognitive processes and contextual influences explained 46% of the variance in care-seeking delay among patients with acute myocardial infarction.
Observational (n=301)
Effect estimate: 46% variance explained
p-value: p=0.72
An integrative theoretical model successfully explains 46% of the variance in care-seeking delay among AMI patients, highlighting the importance of symptom attribution, disease awareness, and social cues.
May inform interventions targeting AMI care-seeking delay; hypothesis-generating and requires prospective validation before practice change.
BACKGROUND: Extensive research has been conducted to examine the factors affecting care-seeking decisions in patients with acute myocardial infarction (AMI). Such a decision-making process is multifactorial, and its underlying mechanism is yet to be determined. OBJECTIVES: Our aim was to test a theoretically integrated model to identify the mechanisms underlying patients' care-seeking decisions in the context of AMI. METHODS: On the basis of both empirical and theoretical evidence, we proposed that patients' care-seeking decisions are driven by 2 sequential perceptual-cognitive processes concerned with illness labeling and interpretation, as well as the contextual influences of perceived barriers to care seeking and cues from others. A sample of 301 patients was recruited to test this model using structural equation modeling. RESULTS: The model testing revealed good fit with the data (χ = 38.48, df = 30, P = .72; root-mean-square error of approximation = 0.03, normed fit index = 0.96, nonnormed fit index = 0.98, and comparative fit index = 0.99) and explained 46% of the variance in AMI care-seeking delay. Successful action relied on whether patients could correctly attribute the symptom experience to AMI, were aware of their own susceptibility to the condition, and had a good understanding of how the disease manifested itself. Lowering perceived barriers and positive cues from others in advising care seeking played favorable roles to promote care-seeking behaviors. CONCLUSIONS: This integrative theoretical model is shown to be valid in explaining care-seeking delay among AMI patients and can guide the development of interventions to promote appropriate care-seeking behaviors among high-risk individuals.
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Li et al. (2016) conducted an observational in acute myocardial infarction (n=301). Perceptual-cognitive processes and contextual influences was evaluated on AMI care-seeking delay (46% variance explained, p=0.72). An integrated theoretical model of perceptual-cognitive processes and contextual influences explained 46% of the variance in care-seeking delay among patients with acute myocardial infarction.
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