Study On Factors Affecting The Decision Delay Of Patients With Acute Myocardial Infarction Based On The Theory Of Planned Behavior And Knowledge Attitude Practice

Objective:To find out the current situation of medical decision delay and its influence factors of patients with acute myocardial infarction(AMI),the survey of the patient's knowledge,attitudes,beliefs,social support and perceived barriers medical decisionmaking status,to analyze their relevance to medical decision-making delay,and through path analysis,to clarify the mechanism of each factor on the delay time of patients' decision making,provides references and Suggestions for improving the status of AMI patients' decision delay.Method:The convenience sampling method was adopted to select patients diagnosed with AMI in the department of cardiology of three first-class hospitals in Shenzhen city from June 2019 to December 2019 for questionnaire survey.The survey tools included general data questionnaire for AMI patients,acute coronary syndrome response Index Scale(C-ACSRI),Social support Rating Scale(SSRS),and perception of Impaired decision making(PBHSD-C).Excel was used to establish a database,and SPSS22.0 and AMOS24.0 were used to analyze the data.Result:1.A total of 230 questionnaires were distributed in this study,and 212 were effectively recovered,with the effective recovery rate of 92.17%.The majority of respondents were males(79.7%),patients over 45 years old(86.6%),and disease types were NSTEMI(58.49%).2.The median medical decision delay time of AMI patients was 6h,in which the median medical decision delay time of STEMI patients was 5.16 h and the median medical decision delay time of NSTEMI patients was 6.75 h.3.The knowledge score of AMI patients was(11.58±2.89),the attitude score was(13.28±2.36),the belief score was(17.73±4.10),the social support score was(38.66±7.04),and the perception score of the decision-making obstacle was(30.35±6.67).4.The single factor analysis showed that the AMI patients' age,gender,educational level,health care type,per capita monthly income,history of coronary heart disease,myocardial infarction,whether symptoms typical,symptoms of attribution,disease types,knowledge,attitude,belief,social support and obstacles perception level is associated with the patient's medical decision-making delay,the difference was statistically significant;5.The results of multi-factor analysis showed that the patient's age,history of myocardial infarction,disease attribution,knowledge,belief and perception of obstacles were independent influencing factors for the patient's decision delay.6.Path analysis showed that the model can explain the variance of 55% delay time,patients with AMI knowledge,attitudes,beliefs,social support,obstacles perception can directly predict decision delay time,the path coefficients were respectively 0.294,0.148,0.225,0.231,0.22,and can be used as the knowledge and attitude of social support prediction decision delay time intervening variable,a mediation effect accounted for 14.39% and 12.83% of the total effect,faith can be used as knowledge and obstacles perception forecast decision delay time intervening variable,a mediation effect accounted for 15.11% and 17.6% of the total effect.Conclusion:1.The decision-making delay time of AMI patients is still at a high level;The knowledge,attitude,belief and social support of AMI patients are at a low level,and the perception of obstacles is at a high level;2.Age,history of myocardial infarction,disease attribution and knowledge,belief,obstacle perception of AMI patients were independent predictors of decision delay;3.AMI patients' knowledge,attitude,belief,social support,and obstacle perception directly predict the delay time of medical decision making;4.AMI patients' knowledge,social support and obstacle perception can indirectly predict the patient's medical treatment delay time through their attitudes and beliefs.