Abstract
Background: Heart disease is a major cause of mortality in women. Women have a poorer prognosis than men after myocardial infarction (MI) and research to date has failed to find a definitive explanation. Women have been identified as late presenters for emergency care after acute myocardial infarction. The aim of this study was to discover the underlying processes that effect women's decisions to seek medical help for symptoms of MI. Methods: Qualitative analysis, of semistructured face-to-face interviews with 16 women aged between 48 and 82 years, admitted to a major teaching hospital with MI. Results: The women delayed presentation from 1 h to 168 h (median 6.25 h). The decision to seek help was influenced by beliefs about personal susceptibility to MI and beliefs about the way MI presents. Symptoms were diverse and were rarely as described in current health promotion literature. Conclusion: The pivotal factor for early presentation is that women, and their significant others, recognise the variety of signs and symptoms of MI and their personal susceptibility. A theoretical model, adapted from the Self Regulation Model of Illness Cognition of Leventhal et al. is proposed to explain the women's response and also areas of intervention.
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