Correlation Between Decision Delay And Perceived Barriers To Health-care Seeking Decision And Cognition And Coping Styles In ACS Patients

Objectives:The study aimed to understand the present situation of decision-making delay in patients with acute coronary syndrome(ACS)after symptom onset and to explore its influencing factors.To investigate the status of perceived barriers to health-care seeking decision,cognitive factors(knowledge,attitude,belief)and coping styles(positive coping,negative coping)in patients with ACS,and to analyze the correlation between decision delay and them.To explore the relationship between perceived barriers decision-making and cognition and coping styles,to provide direction for the development of health education strategies for ACS patients.Methods:By convenient sampling method,the ACS patients who were admitted to the Department of Cardiology of a tertiary general hospital in Changchun City were selected as subjects.From November 2017 to May 2018,a questionnaire survey was conducted among 260 ACS patients who met the inclusion criteria.The survey tools include the basic information questionnaire,the Chinese version of Perceived Barriers to Health-care Seeking Decision(C-PBHSD),the Chinese version of Acute Coronary Syndrome Response Index(C-ACSRI)and the Trait Coping Style Questionnaire(TCSQ).The database was built using Epidata 3.1 software and the data was analyzed by SPSS 20.0.The main statistical analysis methods include descriptive statistical analysis,nonparametric rank sum test,chi-square test,logistic regression and Spearman analysis.Results:1.A total of 260 questionnaires were distributed in this study,and 236 valid questionnaires were collected.The effective recovery rate was 90.8%.The survey population was mostly male,accounting for 64.0%;the average age was 61.48 ±10.35,the elderly(≥60)were the majority,accounting for 57.6%;the disease type was mostly UAP,accounting for 56.8%.2.The median decision delay time for patients with ACS was 62.5 h,for patients with acute myocardial infarction was 18.25 h,and for patients with unstable angina pectoris was 140.75 h.3.The score of perceived barriers,knowledge,attitude and belief in ACS patients were 33.23 ± 8.275,12.94 ± 2.995,9.68 ± 3.415 and 14.89 ± 2.786,respectively.The score of positive coping and negative coping were 30.32 ±6.956 and 29.35±7.254,respectively.4.Statistical analysis of differences in decision delay for patients with different groups of ACS showed: age≥60 years,female,living alone,junior high school and below,unemployment,medical insurance payment for medical expenses,long-term smoking and secondhand smoke environment,The first response after symptom onset was relaxation,non-first-time ACS admission,nocturnal morbidity,diabetes,family history without heart disease,and unstable angina with significantly longer decision-making delay time(P<0.05).5.Univariate analysis showed that ACS patients’ decision delay was related to disease type,work status,education level,first reaction at onset of symptoms,frequency of hospitalization of ACS,nocturnal onset of disease,hyperlipidemia,perceived barriers,attitudes,beliefs,positive coping and negative coping(P<0.05).6.Multivariate analysis showed that the type of disease,the first reaction at the onset of symptoms,and the belief were the main influencing factors of decision delay in patients with ACS.7.The decision delay of ACS patients was positively correlated with the perceived barriers and negative coping,and negatively correlated with knowledge,attitudes,beliefs and positive coping(P<0.05).The perceived barriers to health-care seeking decision were positively correlated with negative coping,and negatively correlated with belief and positive coping(P<0.05).Conclusion:1.The decision delay in ACS patients is extremely serious,and significanteffective interventions need to be developed to reduce delay time.2.The main influencing factors of decision delay in patients with ACS are the type of disease,the first response at the onset of symptoms,and the level of belief in seeking medical care in a timely manner.3.The decision delay of ACS patients was positively correlated with the perceived barriers and negative coping,and negatively correlated with knowledge,attitudes,beliefs and positive coping;the perceived barriers was positively correlated with negative coping,and negatively correlated with beliefs and positive coping.