Causal beliefs, cardiac denial and pre-hospital delays following the onset of acute coronary syndromes.

Full Abstract

Reducing pre-hospital delay is crucial in reducing mortality from acute coronary syndrome (ACS). Patient's causal beliefs and coping styles may affect symptom appraisal and help-seeking behavior. We examined whether patient's beliefs about the causes of their ACS and denial of impact were associated with pre-hospital delay. Pre-hospital delay data were collected from 177 patients with ACS. Retrospective causal beliefs and cardiac denial of impact were assessed using questionnaires. Factor analysis of causal beliefs produced 3 factors; beliefs in stress and emotional state, behavioral and clinical risk factors, and in heredity as causal influences. Patients with strong beliefs that stress and emotional state caused their ACS were more likely to have long pre-hospital delays (>130 min). There were no significant associations between pre-hospital delay and the other two causal belief factors. Patients with greater denial scores were also more likely to have long delays than those with low scores. These effects were independent of age, gender, education, previous myocardial infarction, history of depression and negative affectivity. Cognitive and emotional factors including patient's beliefs about causes and avoidant coping help to explain variations in pre-hospital delay.

Author information

Author/s: Perkins-Porras, Linda (L); Whitehead, Daisy L (DL); Strike, Philip C (PC); Steptoe, Andrew (A);

Affiliation: Department of Community Health Sciences, Cranmer Terrace, St. George's University of London, London, SW17 0RE, UK. lperkins(-atsign-)sgul.ac.uk

Grants: (Agency:British Heart Foundation) ; (Agency:Medical Research Council)

Journal and publication information

Publication Type: Journal Article; Research Support, Non-U.S. Gov't

Journal: Journal of behavioral medicine (J Behav Med), published in United States. (Language: eng)

Reference: 2008-Dec; vol 31 (issue 6) : pp 498-505

Dates: Created 2008/11/05; Completed 2009/01/22;

PMID: 18830812, status: MEDLINE (last retrieval date: 2/18/2009, IMS Date: )

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