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J Emerg Nurs. 2008 Dec;34(6):509-15. doi: 10.1016/j.jen.2007.09.016. Epub 2008 Jul 21.

Reducing delay for women seeking treatment in the emergency department for symptoms of potential cardiac illness.

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  • 1British Columbia Institute of Technology, Burnaby, British Columbia.



Despite more than 2 decades of research, delay in seeking treatment is a persistent clinical issue. Because of the often time-limited efficacy of therapies for acute myocardial infarction, nowhere is this of more concern than in the case of seeking treatment for symptoms indicative of potential cardiac illness. Women are frequently reported to delay longer than their male counterparts when seeking treatment for similar symptoms of cardiac nature. Women may be at particular risk of delay because they often live alone and are a decade older then men at the onset of their heart disease.


In this grounded theory study, women's experiences of emergency department care as they relate to seeking treatment for the symptoms of a potential cardiac event were explored. Seventeen interviews were carried out with 16 women who sought care in 1 of 2 Canadian, urban, emergency departments between June 2005 and June 2006, and 100 hours of naturalistic observation were completed.


The core category was maintaining personal, social, and physical integrity. The participants strove to make sense of their symptoms and to act on those symptoms in ways congruent with maintaining integrity. The results of this study indicate that some concrete strategies can be used by emergency nurses to influence women's decisions about seeking treatment for the symptoms of a potential cardiac event.


Health care professionals draw on the scientific model to understand and interpret the meaning of symptoms. In contrast, women draw on personal experience. Understanding how women make decisions about their symptoms will help health care providers intervene to minimize delay.

[PubMed - indexed for MEDLINE]
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