Abstract 8728: Intentions versus Reality: Pre-Hospital Patient Response to Acute Cardiac Symptoms
Background: Clinicians and researchers depend on patients′ expression of their intentions to engage in behavior as a marker of what they will do when faced with a health risk. Yet, there is little evidence to suggest that intentions predict behavior in acute coronary syndrome (ACS). Purpose: To determine whether coronary artery disease (CAD) patients′ intention to respond quickly to ACS symptoms predicts actual response time when patients are faced with acute ACS symptoms.
Methods: A total of 3522 CAD patients were enrolled in this prospective study. Data were collected on patients′ intentions to respond quickly to ACS symptoms using ACS Response Index, which also measured knowledge, attitudes and beliefs about heart disease. Patients were grouped based on their stated intentions: 1) strongly agree will respond immediately; 2) agree; 3) disagree; and 4) strongly disagree. Patients were followed for 2 years for occurrence of ACS, when their actual response time from acute symptom onset to arrival at the hospital for treatment was measured. Multiple regression was used to determine whether intention to respond quickly to ACS symptoms independently predicted actual response time.
Results: Most patients stated strong (44.3%) or very strong (51.9%) intentions to respond quickly by going immediately to the hospital when faced with ACS symptoms. Only 4.8% stated they would be reluctant to respond quickly. During follow-up, 565 patients (16.0%) were admitted to an emergency department with ACS symptoms. Median delay time was 2.25 hours (25th percentile=1.18 hours, 75th percentile=5.0 hours). There were no significant differences in actual time from symptom onset to arrival at the hospital (medians 2.4, 2.7, 3.0, and 1.6 hours) based on patients′ stated intentions to respond immediately or not (strongly agree, agree, disagree, and strongly disagree, respectively, p= .49). Intentions did not predict actual delay time in either simple regression or in a multiple regression model including age, gender, education, previous medical history, and knowledge, attitudes and beliefs about cardiac disease.
Conclusion: Patients' stated intentions to respond to ACS symptoms are not a valid surrogate of future behavior and should be avoided in research and practice.
- © 2010 by American Heart Association, Inc.