The significance of cognitive representations of symptoms of acute coronary syndrome and coping responses to the symptoms in predicting prehospital delay in Omani patients

Abstract

The purpose of this study was to examine the significance of cognitive representations of symptoms of acute coronary syndrome (ACS) and coping responses to the symptoms, as elements of a consequential process of health care seeking behaviours, in predicting prehospital delay. Data about prehospital delay, cognitive representations and coping responses were obtained from 112 Omani patients hospitalised for acute coronary syndrome during a 6-month period using an interview technique. Indicators of cognitive representations of symptoms of ACS and coping responses to the symptoms significantly explained 42% of the variance in prehospital delay. Shorter prehospital delay was more likely among patients who reported greater chest pain intensity, sweating, persistent symptoms with greater overall intensity, did not perceive fear of being diagnosed with a dangerous disease as a barrier to seek care early, used ‘asked someone to take me to the hospital’ but not ‘attempted to relax’ coping responses. Indicators of cognitive representations of ACS symptoms, as well as coping responses to the symptoms significantly predicted prehospital delay. Educative-counseling programs to shorten prehospital delay should focus on informing individuals at high risk for acute coronary syndrome skills necessary to promote adaptive coping as well as accurate interpretation of the symptoms.