Predictors of Delay in Seeking Treatment Taiwanese Patients with Acute Coronary Syndrome
Abstract Body (Do not enter title and authors here): Background: Acute coronary syndrome (ACS) requires immediate medical attention to reduce morbidity and mortality. However, prehospital delay remains a global challenge, leading to increased complications and reduced survival rates. We investigated predictors of delay in seeking treatment among Taiwanese ACS patients. Methods: A total of 163 Taiwanese ACS patients (diagnosed with STEMI, NSTEMI, or unstable angina) were recruited. Data were collected through structured questionnaires covering demographics, clinical characteristics, and symptom response based on the self-regulation model. Delay time was defined as the period from symptom onset to hospital registration. Descriptive statistics, t-tests, ANOVA, and multiple linear regression were performed using SPSS 29.0. Results: The mean delay time was 86.85 hours (SD = 187.38), ranging from 0.22 to 600 hours. Most patients (76.1%) did not experience typical chest pain as they expected. Common symptoms included chest tightness (38.7%), dyspnea (19.6%), and fatigue (6.1%). Significant predictors of longer delay included lack of recognition of symptoms as cardiac-related (β = .62, p = .04), intermittent symptom presentation (β = .22, p = .03), presence of heart failure (β = –.31, p = .01), and chronic obstructive pulmonary disease (COPD) (β = –.25, p = .01). The model explained 41% of the variance in delay time (R2 = .41). Conclusion: There are critical cognitive and clinical predictors of treatment delay in Taiwanese ACS patients. Health education emphasizing early symptom recognition, especially atypical presentations, and targeted intervention for patients with comorbidities like heart failure and COPD, may reduce prehospital delays and improve outcomes.
