Abstract 4067: Responses to Symptoms among Older Patients with Acute Myocardial Infarction in Korea
Background: Older patients’ delay in seeking treatment for symptoms is longer than younger patients with acute myocardial infarction (AMI), and results in increased higher rates of mortality and medical expenses.
Objectives: To identify their personal and cognitive responses to symptoms and related actions among older patients aged over 65 years with the first attack of AMI in Korea.
Methods: Study sample included 89 older patients hospitalized at a University Hospital, a principal site of Korea Acute Myocardial Infarction Registry. Semi-structured interviews were conducted, after approval of institutional review board, on the 2nd to 5th day of their stay in the hospital following coronary intervention, lasted 30 – 40 min and tape-recorded.
Results: Median delay time from symptom onset to hospital was 24 ± 136.6 hours and mean age was 73 ± 5.7 years. About 70% had an elementary school education or lower and chronic illnesses such as hypertension or diabetes. The 30% presented to hospital for their atypical symptoms rather than chest pain. Average length of hospital stay was 13 ± 8.3 days. Lower education, intermittent or progressive development of symptoms, and no attribution as cardiac problems increased patient delay. Many patients showed great patience with self-management to alleviate their discomfort in various ways, such as self-medication, letting blood from their finger, and laying down at home. Four describing themes for the delay behaviors emerged from the qualitative data that they had
never imagined that they could have a heart attack because they were not sick even if they had hypertension or diabetes,
attributed their symptoms to their chronic illnesses or natural complaints of older age,
already attempted a medical help for their non-typical symptoms like a flu, and
did not want to burden their families or medical expenses with their problems.
Conclusions: The findings demonstrated unique coping responses to symptoms in Korean elders. Educational intervention for the elders at high risk group for AMI is needed to increase knowledge of AMI and facilitate their decision to seek immediate help following chest discomfort.