Papers BMJ: first published as 10.1136/bmj.324.7344.1006 on 27 April 2002. Downloaded from Decision making processes in people with symptoms of acute myocardial infarction: qualitative study Jill Pattenden, Ian Watt, Robert J P Lewin, Neil Stanford Abstract people’s knowledge of the symptoms of heart attack Department of and the correct action to take when faced with these Health Sciences, Objective To identify the themes that influence University of York, symptoms. However, the effectiveness of public aware- Heslington, York decision making processes used by patients with ness campaigns or education for patients in decreasing YO10 5DQ symptoms of acute myocardial infarction. delays is uncertain.12 Some studies report that although Jill Pattenden Design Qualitative study using semistructured research fellow such measures may increase knowledge, they are Ian Watt interviews. 13–15 unlikely to change behaviour. Other studies report professor of primary Setting Two district hospitals in North Yorkshire. some reduction in the median time from onset of care Participants 22 patients admitted to hospital with symptoms of acute myocardial infarction to arrival in RobertJPLewin professor of confirmed second, third, or fourth acute myocardial 16 17 hospital. It has also been reported that patients with rehabilitation infarction. a second infarct take as long to seek help as those hav- Neil Stanford Main outcome measure Patients’ perceptions of their ing their first one. Not all studies agree on this point, research fellow experience between the onset of symptoms and the but there may be more to decision making than knowl- Correspondence to: decision to seek medical help. edge of the symptoms of heart attack.51418For this rea- J Pattenden
[email protected] Results Six main themes that influence the decision son, we studied patients who had had at least one making process were identified: appraisal of previous acute myocardial infarction.