Abstract 17635: Symptom Representation and Treatment-Seeking Prior to Diagnosis of Atrial Fibrillation

Abstract

Background: Improving early treatment of atrial fibrillation (AF) is critical because untreated AF is a major contributor to disabling strokes,tachycardia-induced heart failure, and recurrent AF. Vital, early treatment in symptomatic patients could be accelerated if patients sought treatment at symptom onset. However, little is known about symptom representation which may influence treatment-seeking for AF. Purpose: The purpose of this study, based on Leventhals’ Model of Self-Regulation, was to describe symptom representation in patients prior to diagnosis of AF.

Methods: A descriptive design was used. Participants (N = 150) at a Midwest medical center were interviewed using a semi-structured format. Symptom characteristics, beliefs about the symptoms (cause, seriousness, controllability) and behavioral and emotional responses to symptoms were assessed.

Results: Participants were 51% female, with a mean age of 66.5 (± 11.1) years. The most frequently reported symptoms were: fatigue (73%), dyspnea (68%), and rapid heartbeats (67%). Symptoms were perceived as intermittent and increasing in severity by 62% and 50% of participants respectively. The plurality (46%) reported symptoms at first onset,lasted minutes. The most common causal attributions for symptoms were: physical deconditioning (37%), stress (29%), being overtired (28%) and overwork (27%). Although 42% believed their symptoms were serious, 20% did not know if symptoms were serious, and 16% were unconcerned about symptoms. Although 63% of participants worried about their symptoms, a majority (82%) believed symptoms did not require medical attention. Participants chose to wait to see what would happen (73%), work through (71%) and ignore (55%) symptoms rather than engage in active symptom management. Resting was the most common (55%) symptom management response. Only 31% of participants sought treatment for symptoms within a week of symptom onset.

Conclusion: Although some participants believed their symptoms were serious, many attributed the symptoms to non-illness related factors and did not seek immediate treatment. Further research is needed to identify the influence of symptom representation on treatment-seeking behaviors for symptoms of AF.