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Effect of Incongruence of Acute Myocardial Infarction Symptoms on the Decision to Seek Treatment in a Rural Population

Morgan, Donna M. PhD, RN, CCRN

The Journal of Cardiovascular Nursing: September-October 2005 - Volume 20 - Issue 5 - p 365–371

People are advised to obtain immediate treatment for acute myocardial infarction (AMI), yet a delay occurs between the onset of symptoms and the decision to seek treatment. The objective of the study was to determine the extent of incongruence between expected and actual symptoms of AMI, effect of incongruence on decision time to seek treatment, and predictive effect of selected variables on decision time in a rural population. Ninety-eight rural patients receiving inpatient treatment for AMI at 2 hospitals in the Northeast of the United States from August 2001 through October 2002 completed the Morgan Incongruency of Heart Attack Symptoms Index and the Response to Symptoms Questionnaire. The median decision time was 93 minutes. There were differences between men and women regarding the symptoms that were expected to occur and that actually occurred. The extent to which symptoms interfered with the ability to carry out normal activities, degree of anxiety, and type of insurance coverage explained 23% of the variance in decision time. Although the expected symptoms did not match the actual symptoms, this incongruence did not affect decision time.

Donna M. Morgan, PhD, RN, CCRN Staff Nurse, Decker School of Nursing, Binghamton University, Binghamton, NY. Dr Morgan is now with Staff Nurse Skilled Nursing Facility, St Joseph's Hospital, Elmira, NY.

Corresponding author Donna M. Morgan, PhD, RN, CCRN, Skilled Nursing Facility, St Joseph's Hospital, 555 E Market St, Elmira, NY 14901 (e-mail:

The author thanks Debra K. Moser, DNSc, RN, FAAN, for her comments on an earlier draft of this manuscript.

© 2005 Lippincott Williams & Wilkins, Inc.