| Summary: | 碩士 === 慈濟大學 === 公共衛生學系碩士班 === 99 === According to the statistics of the Department of Health heart disease is among the three leading causes of death in Taiwan. One of its most serious forms is the acute coronary syndrome (ACS). Although great progress has been made in diagnosis and treatment, there is no corresponding decline in mortality among ACS patients. It has been suggested that pre-hospital delay might diminish the potential effects modern treatment has on patients. Literature showed that gender and cognitive factors were strongly associated with patients’ rates of pre-hospital delay. This study aimed to investigate the relationship between illness representations and pre-hospital delay in male and female patients.
The participants were patients who visited a general hospital in Hualien due to ACS between January and November, 2010. Demographic and patient data were collected. Illness representations were measured using “The revised Illness Perception Questionnaire”.
The total participants were 78, of whom 55 males and 23 females. The response rate was 53.79%. The mean age was 68.96±12.37 years. The main findings were: (1). Medians of delay time was 1.3 hours in males, 3.5 hours in females. There was no significant gender difference in delay time. (2). The average amount of ACS symptoms reported by participants was 4.23±3.23, females reported significantly more symptoms than males (5.43±4.0 in females, 3.73±2.72 in males). (3). There was no significant gender difference in illness representations. However, factors associated with illness representations were rather different among male and female participants. Numbers of previous ACS episode, education, BMI, whether living alone, hypertension, diabetes, parents’ disease history, and occupation were associated with illness representations of male participants, whereas only BMI and occupation were associated with those of females. (4). Decision-making time was found associated with BMI, occupation and angina, and different factors were associated with decision-making in male and female participants. (5). Although the general illness representations were significantly associated with decision-making time, 2 components of illness representations were strongly related to decision-making, namely “Identity” and “Emotional representations”. Moreover, the components of illness representations associated with decision-making had different patterns in male and female participants.
Although there was no significant relationship between general disease cognition and decision-making time, two components of the disease cognition were strongly associated with decision-making, suggesting that some cognitive components played a more crucial role in the patient’s decision-making process.
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