LAY CHD REPRESENTATIONS AND WOMEN'S SELF REFERRAL FOR MI

该申请寻求三年的支持，以调查普通人对冠心病（CHD）的认知表现如何导致因心肌梗死（MI）症状而延迟就医，重点是女性受害者。在一项相关性研究中，将对1,114名MI后患者和大约777名支持提供者进行采访。分析将（1）确定入院前症状感知、症状归因、自我护理活动、寻求治疗行为和CHD脆弱性感知的性别差异，以及这种性别差异在急性MI自我转诊中的意义;（2）检查社会影响过程对非专业人员评估心脏症状的影响，包括信息寻求方面的性别差异，从支持提供者那里得到的建议，以及与拥有医疗专业知识的个人进行的院前互动;和（3）确定即使在控制了受害者年龄、种族、教育、先前的CHD知识和经验、社会经济地位、医疗状况、生活安排、社会支持网络之后，对急性MI症状的反应是否表现出性别差异，以及其他的个体差异。拟议的研究将集中在非专业冠心病认知表征的差异，这可能是心脏相关症状发作后进行干预的原因。拟议的项目将为护士和其他卫生保健提供者提供基本信息，说明受害者的性别、年龄和其他因素如何影响对心脏症状的非专业解释。最后，从拟议的项目中获得的知识很可能是一个重要的贡献，在发展的规划护理干预措施，旨在促进自我转诊行为和提供最佳的医疗保健，以妇女和男子的冠心病风险。

This application seeks three years of support to investigate how lay people's cognitive representations of coronary heart disease (CHD) contribute to delays in seeking medical are for symptoms of myocardial infarction (MI), with an emphasis on female victims. In a correlational study, 1,114 post-MI patients and approximately 777 support providers will be interviewed. Analyses will (1) identify gender differences in pre- hospital symptom perceptions, symptom attributions, self-care activities, treatment-seeking behaviors, and perceptions of CHD vulnerability and the implications of such gender differences in self-referral for acute MI; (2) examine the impact of social influence processes in the lay evaluation of cardiac symptoms, including gender differences in information- seeking, advice received from support providers, and pre-hospital interactions with individual possessing medical expertise; and (3) determine whether gender differences in the response to acute MI symptoms are manifested even after controlling for victim age, ethnicity, education, prior CHD knowledge and experience, socioeconomic status, medical status, living arrangements, social support network, and other individual differences. The proposed research will focus on differences in lay CHD cognitive representations that may account for intervention after the onset of cardiac-related symptoms. The proposed project will provide fundamental information to nurses and other health care providers about how the lay interpretation of cardiac symptoms is influenced by the victim's gender, age, and other factors. Finally, the knowledge gained from the proposed project is likely to represent a vital contribution in the development of programmatic nursing interventions targeted at the facilitation of self-referral behaviors and the provision of optimal health care to both women and men at risk of CHD.