LAY CHD REPRESENTATIONS AND WOMEN'S SELF REFERRAL FOR MI

这项申请寻求三年的支持，以调查非专业人士对冠心病(CHD)的认知表征如何导致延迟寻求心肌梗死(MI)症状的医疗服务，重点是女性患者。在一项相关研究中，1114名心肌梗塞后患者和大约777名支持提供者将接受采访。分析将(1)确定院前症状知觉、症状归因、自我护理活动、寻求治疗行为和对冠心病易感性的知觉的性别差异，以及这些性别差异在急性心肌梗死自我转诊中的影响；(2)检查社会影响过程在心脏症状层级评估中的影响，包括在信息寻求、从支持提供者那里获得的建议以及院前与具有医疗专业知识的个人的互动方面的性别差异；以及(3)确定即使在控制了患者的年龄、种族、教育程度、先前的冠心病知识和经验、社会经济地位、医疗状况、生活安排、社会支持网络和其他个人差异之后，对急性心肌梗死症状的反应是否存在性别差异。这项拟议的研究将侧重于普通人CHD认知表征的差异，这可能是心脏相关症状出现后进行干预的原因。拟议的项目将向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，从拟议项目中获得的知识可能对制定旨在促进自我转诊行为和为有冠心病风险的女性和男性提供最佳医疗保健的程序性护理干预措施作出重要贡献。

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.