This is some information on a survey study that Yale is currently conducting. It is about patients who delay getting medical help during acute myocardial infarctions (AMI) and acute coronary syndrome (ACS) events. The study team knows that there isn't an effective intervention for getting people to the hospital much earlier than the typical median time of around 4 hours, even though it is known that one gets the most therapeutic benefit if they are in the hospital emergency department within the first hour of acute symptoms onset.
The difference between this study and others is that this one emphasizes:
1. the behavior of the individual; and,
2. the behavior of those around her or him in getting care.
This study focuses on:
1. a broad range of behavioral variables of :
a. decision making;
b. perception and interpretation of symptoms;
c. situational setting;
d. the advice and perceptions of lay others helping the individual;
e. the day and time of day;
f. prior experience with EMS systems and the health care system; and,
g. how the individual’s evaluation and level of concern changed over the care-seeking period.
2. trying to compile a national sample of individuals rather than one taken from one hospital or community.
The study team knows, from generally accepted data, that people delay on the second and subsequent events. This is known as ‘cumulative adversity’. People seem to delay a bit longer before seeking help because:
1. they do not want to repeat the same experiences;
2. they want to make certain that the event is real; and,
3. they don’t want to burden family or friends if unwarranted.
The problem being studied in this effort is how do you get someone to drop all of their social activities to get medical care. If you ask anyone what they would do if they had an AMI and they all say that they would seek care immediately. But few people drop everything and go.
1. have to be certain it is a real problem;
2. have to finish the task at hand;
3. need to make arrangements if they are to be hospitalized;
4. have to cancel appointments
5. make sure they are clean enough for a doctor visit;
6. don’t want to bother others, especially the hard working doctor in the middle of the night; and,
7. don’t want to be taken out of their office or home by EMS personnel.
They only agree to go when the signs and symptoms become so overwhelming that they have few choices or when someone takes charge of the situation and calls 911.
The text for this blog is from a previous interview with Angelo A. Alonzo, PhD, Research Scientist, at Yale University in New Haven, Connecticut and it is copied here as an encouragement for you to join the study. It will take, at most, 30 minutes of your time. For me, it was only 16 minutes. So, please go to: