Journal ArticleDOI
Accessing emergency care at the time of a heart attack: why people do not dial 999 for an ambulance:
TLDR
Public campaigns to encourage people to call 999 for an ambulance in the event of symptoms of a heart attack may be ineffective unless they address lay understandings and concerns about accessing emergency services.Abstract:
Coronary heart disease (CHD) is the most important cause of death in the UK. Evidence suggests that between 5,000 and 10,000 deaths per year could be prevented if thrombolytic therapy were to be administered within 12 hours of the onset of symptoms of a heart attack. As part of the requirements of the National Service Framework for CHD, health authorities will be expected to produce detailed plans and protocols which describe pre-hospital service care models. Included in these will be public education campaigns aimed at encouraging people to call 999 for an ambulance in the event of symptoms suggestive of a heart attack. The aim of this study was to explore lay decision-making at the time of a cardiac event and address the question of why people do not call 999 for an ambulance. A sample of 43 patients, admitted to two district general hospitals who had survived a cardiac event, and 21 relatives or bystanders who were present at the time of the event, were interviewed. The interviews were tape-recorded, transcribed verbatim and analysed using the constant comparative method. There was variation in who made the decision to call for medical help and even after the decision was made, delays occurred due to interaction between patients and relatives or bystanders. An ambulance was called by informants in only two cases, two drove or were driven to hospital, 34 asked the general practitioner (GP) to call and five visited the GP at the surgery. Factors influencing these actions included a perception that GP services were faster and more accessible than ambulance services, misconceptions about the seriousness of the situation, misconceptions about the correct 'procedure' or way to access emergency services and a range of personal and contextual factors. The data suggest that public campaigns to encourage people to call 999 for an ambulance in the event of symptoms of a heart attack may be ineffective unless they address lay understandings and concerns about accessing emergency services.read more
Citations
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Journal ArticleDOI
Systematic review of interventions to reduce delay in patients with suspected heart attack
A Kainth,A Hewitt,Amanda Sowden,S Duffy,Jill Pattenden,Robert J. P. Lewin,Ian Watt,David R. Thompson +7 more
TL;DR: In this article, the authors conducted a systematic review to evaluate the effectiveness of interventions aiming to reduce the time from onset of signs and symptoms of acute myocardial infarction (AMI) to seeking medical help/arrival at hospital.
Journal ArticleDOI
Rural/urban differences in accounts of patients’ initial decisions to consult primary care
Jane Farmer,Lisa Iversen,Neil C Campbell,Clare Guest,Rosemary Chesson,George Deans,John M. MacDonald +6 more
TL;DR: Examination of rural/urban differences in accounts of patients' intentions around initial decisions to consult general practice suggests 'relationships' between doctors and patients and easier access to appointments could affect consulting in rural areas, while decision-making for urban patients tended to be more consumerist.
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A qualitative study in rural and urban areas on whether – and how – to consult during routine and out of hours
TL;DR: Whether and how patients' consulting intentions take account of their perceptions of health service provision on decision-making processes is explored.
DissertationDOI
Paramedic Clinical Judgement and Decision-Making of Mental Illness in the Pre-Hospital Emergency Care Setting: A Case Study of Accounts of Practice
TL;DR: The preparedness of paramedics to recognise, assess, and manage mental illness in everyday practice and the sufficiency of education and training programs, clinical standards, policy, and legislation for ensuring quality practice and accountability in the field are at issue.
Journal ArticleDOI
Death and dying in prehospital care: what are the experiences and issues for prehospital practitioners, families and bystanders? A scoping review.
Michelle Myall,Alison Rowsell,Susi Lund,Joanne Turnbull,Mick Arber,Robert Crouch,Robert Crouch,Robert Crouch,Helen Pocock,Charles D. Deakin,Alison Richardson,Alison Richardson,Alison Richardson +12 more
TL;DR: The review found substantial evidence of PHP experiences, except call handlers, and papers reporting family and bystander experiences were limited, in what is believed to be the first review that explores the experiences of PHPs, families and bystanders.
References
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Book
Beginning Qualitative Research: A Philosophical and Practical Guide
TL;DR: This paper focused on the serious, beginning, qualitative researcher and provided a strong theoretical base for the understanding of competing research paradigms, and a "methods" section consistent with the non-linear nature of naturalistic inquiry, yet it allowed the beginner to see direction.
Journal Article
急性心筋梗塞の疑いのある17187症例におけるストレプトキナーゼ静脈内投与,アスピリン経口投与,上記2つの併用または無処置の無作偽試験 isis-2
Journal ArticleDOI
Causes of delay in seeking treatment for heart attack symptoms
Kathleen Dracup,Debra K. Moser,Mickey S. Eisenberg,Hendrika Meischke,Angelo A. Alonzo,Allan Braslow +5 more
TL;DR: The literature is reviewed and variables that increase patient delay are identified and a theoretical model based on the health belief model, a self regulation model of illness cognition, and interactionist role theory is proposed to explain the response of an individual to the signs and symptoms of acute myocardial infarction.
Book
Health and Illness: The Lay Perspective
TL;DR: How consumers define health and illness, how and when they decide to seek medical help and what their expectations of services are are are shown.
Journal ArticleDOI
The association between cardiac events and myocardial ischaemia following thrombolysis in acute myocardial infarction and the impact of carvedilol
TL;DR: It is demonstrated that reversible myocardial ischaemia detected by TI-201 imaging is present in a large proportion of clinically stable patients following thrombolysis, and in these patients, there is an increased cardiac event rate which is significantly reduced by carvedilol.