Key result
Decision-making delay in men with acute myocardial infarction is significantly correlated with perceived threat, driven mainly by somatic awareness, and is only slightly related to subjective pain intensity.
Case-Control (n=929)
Yes
In male patients with acute myocardial infarction, somatic awareness is the main dimension affecting perceived threat, which in turn is the primary factor reducing decision-making delay.
Somatic awareness may shorten decision-making delay via perceived threat in men with AMI; hypothesis-generating and requires prospective validation before practice change.
BACKGROUND: To study the potentially avoidable decision-making delay in acute myocardial infarction (AMI) adults male with different psychological characteristics a nationwide multicentre study was conducted in Italy by the 118 Coronary Care Units (CCUs). METHOD: 929 AMI patients consecutively presented to the CCU in a conscious condition less than two hours, 2-6 hours, 6-12 hours, and more than 12 hours after symptom onset and completing the Disease Distress Questionnaire (DDQ) were enrolled in a multicentre case-control study. The DDQ collects information regarding the decision time to seek help, and includes a set of items assessing psychological factors and pain-related symptoms. The relationship between the perceived threat and the delay due to decision-making was evaluated by means of a multivariate model using LISREL 8 structural equation modelling. RESULTS: The delay significantly correlated with perceived threat, which was mainly related to somatic awareness. It was only slightly related to pain and was not associated with any of the other variables. Perceived threat was also related to psychological upset, fear and health worries, the first of which was considerably influenced by emotional instability. CONCLUSION: Somatic awareness is the main dimension affecting perceived threat, but subjective pain intensity affects the delay both directly and indirectly. The core of the model is the relationship between perceived threat and the delay due to decision-making. The importance of subjective pain intensity is well documented, but it is still not clear how subjective and objective pain interact.
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Vidotto et al. (2013) conducted a case-control in Acute Myocardial Infarction (n=929). Psychological factors and pain-related symptoms was evaluated on Decision-making delay (time to seek help). Decision-making delay in men with acute myocardial infarction is significantly correlated with perceived threat, driven mainly by somatic awareness, and is only slightly related to subjective pain intensity.
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