Recognising women’s responses to heart disease symptoms: different groups respond in different ways

Abstract

This study explored the recognition and understanding of angina or heart attack symptoms and the reasons for delay in seeking appropriate care with particular reference to women and Maori. The study population consisted of European and Maori people aged between 45 and 85 years either diagnosed as being at high risk of having a heart attack, experiencing angina, or requiring admission to hospital with their first heart attack. The study methodology is a qualitative analysis of 30 individual interviews (nine European women, nine European men, five Maori women and seven Maori men) conducted using grounded theory. A semi-structured interview schedule followed the sequence of events that led to seeking medical care. Interviews were audio taped, transcribed and coded using a computer software programme. The data analysis included collaboration with Maori. Delay times from symptom onset to hospital admission were: five participants delayed less than two hours (range 1 hour to 1 hour 30 minutes), and six participants delayed more than 2 hours (range 2 hours 30 minutes to 10 hours). Delay times from symptom onset until attending a medical clinic were: four participants delayed less than 2 hours (range 1-2 hours) and fourteen participants delayed more than 2 hours (range 4-24 hours). Reasons for delay, common to both European and Maori were: difficulties recognising their symptoms, self treatment, obtaining reassurance, differences in symptom descriptions between the participants and doctors, and several participants’ symptoms were initially misdiagnosed. In the European group specific reasons related to delay were: a lack of knowledge, and consultations with general practitioners. European women reported that uncommon symptoms were disregarded in the pre-diagnosis period. For Maori, specific reasons for delay were: a greater emphasis on consulting family and minimising the symptoms. Participants had a codified set of rules within the self regulatory model that determined their actions that became the emergent theme in the overarching category – ‘Recognising Women’s Responses to Heart Disease Symptoms: Different groups respond in different ways’. The fact that people have different perceptions about symptoms, endure symptoms in different ways, obtain reassurance in different ways, and take action in different ways formed the categories that made up the theoretical concept. The rules differed according to gender and culture. The study findings will contribute to the understanding of gender and cultural differences in care seeking for heart disease symptoms.