Knowledge and attitudes toward seeking medical care for AMI-symptoms ☆ Catrin Henriksson a, ⁎, Margareta Larsson b , Judy Arnetz c,j , Marianne Berglin-Jarlöv d , Johan Herlitz d , Jan-Erik Karlsson e , Leif Svensson f , Marie Thuresson g , Crister Zedigh h , Lisa Wernroth a , Bertil Lindahl a,i a Uppsala Clinical Research Center, Uppsala University, Sweden b Department of Women's and Children's Health, Uppsala University, Sweden c Department of Family Medicine and Public Health Sciences, Wayne State University, Detroit, USA d Institution of Medicine, Sahlgrenska University hospital, Gothenburg, Sweden e Department of Cardiology, Ryhov hospital, Jönköping, Sweden f Department of Clinical Science and Education, Karolinska Institute, Stockholm, Sweden g Department of Cardiology, Örebro University Hospital, Sweden h Department of Cardiology, Falu Hospital, Falun, Sweden i Department of Cardiology, Uppsala University hospital, Sweden j Department of Public Health and Caring Sciences, Uppsala University, Sweden abstract article info Article history: Received 16 April 2009 Received in revised form 16 July 2009 Accepted 20 August 2009 Available online 23 October 2009 Keywords: Myocardial infarction Knowledge Attitude Decision making Patient Family Background: Time is crucial when an acute myocardial infarction (AMI) occurs, but patients often wait before seeking medical care. Aim: To investigate and compare patients' and relatives' knowledge of AMI, attitudes toward seeking medical care, and intended behaviour if AMI-symptoms occur. Methods: The present study was a descriptive, multicentre study. Participants were AMI-patients ≤75 years (n = 364) and relatives to AMI-patients (n = 319). Questionnaires were used to explore the participants' knowledge of AMI and attitudes toward seeking medical care. Results: Both patients and relatives appeared to act more appropriate to someone else's chest pain than to their own. Patients did not have better knowledge of AMI-symptoms than relatives. Women would more often contact someone else before seeking medical care. A greater percentage of elderly (65–75 years), compared to younger individuals, reported that they would call for an ambulance if chest pain occurred. Conclusions: There were only minor differences between patients and relatives, regarding both knowledge and attitudes. It seems easier to act correctly as a bystander than as a patient. Therefore, in order to decrease patients' delay time it is important to educate relatives as well as patients on how to respond to symptoms of an AMI. © 2009 Elsevier Ireland Ltd. All rights reserved. 1. Introduction The first few hours are of utmost importance for limiting infarction size and to prevent cardiac death in patients with acute myocardial infarction (AMI) [1–3]. Therefore, it is important to decrease the time from symptom onset until start of treatment for patients with AMI- symptoms. However, the focus has often been on reducing “doctor's delay” [4,5], rather than “patient's delay”. The patients' decision time is a crucial part of the total delay, and has not changed for decades [6]. One reason for patient delay might be insecurity about how to interpret and respond to symptoms of an AMI [7,8]. In one study only about 35% of all AMI-patients initially attribute their symptoms to the heart [8]. Those patients have a shorter decision time than those who believe their symptoms are caused by other disorders [8,9] and patients who perceive their symptoms as serious have a shorter delay time [8–10]. The majority of patients consult another person at symptom onset, before contacting any medical professional [11–13]. That person often has influence on the decision to seek medical care [12,13]. Both patients' and relatives' knowledge about possible AMI-symptoms and their attitudes toward seeking medical care affect delay time. The aim of the present study was to investigate and compare patients' and relatives' knowledge of AMI, their attitudes toward seeking medical care in case of symptoms suggestive of AMI, and how they intend to act in case of AMI-symptoms. 2. Method 2.1. Design This was a cross sectional multi-centre study with a descriptive and comparative design. International Journal of Cardiology 147 (2011) 224–227 ☆ The study was supported by the Uppsala County Association against Heart and Lung Diseases, The Swedish Society of Nursing and the Department of Cardiology at Uppsala University Hospital, Sweden. ⁎ Corresponding author. 751 85 Uppsala, Sweden. Tel.: +46 186119513. E-mail address: catrin.henriksson@ucr.uu.se (C. Henriksson). 0167-5273/$ – see front matter © 2009 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.ijcard.2009.08.019 Contents lists available at ScienceDirect International Journal of Cardiology journal homepage: www.elsevier.com/locate/ijcard