BACKGROUNDAcute myocardial infarction (AMI) is the leading cause of morbidity and disability among Iranian population. Pre-hospital delay is an important cause of increasing early and also late mortality in AMI. Thus the aim of the present study was to identify the factors influencing pre-hospital delay among patients with AMI in Iran.

METHODSBetween August 2010 and May 2011, a cross-sectional and single-center survey was conducted on 162 consecutive patients with ST-elevation myocardial infarction (STEMI) admitted to Cardiac Care Unit (CCU) of Dr. Heshmat Hospital, Rasht. All patients were interviewed by the third author within 7 days after admission by using a four-part questionnaire including socio-demographic, clinical, situational and cognitive factors. Data were analyzed by descriptive and Logistic regression model at P < 0.05 using SPSS 16.

RESULTSMean age was (60.11 ± 12.29) years in all patients. Majority of patients (65.4%) were male. The median of pre-hospital delay was 2 hours, with a mean delay of 7.4 hours (± 16.25 hours). Regression analysis showed that admission in weekend (P < 0.04, OR = 1.033, 95%CI = 1.187 - 2.006) and misinterpretation of symptoms as cardiac origin (P < 0.002, OR = 1.986, 95%CI = 1.254 - 3.155) and perceiving symptoms to not be so serious (P < 0.003, OR = 3.264, 95%CI = 1.492 - 7.142) were factors influencing pre-hospital delay > 2 hours.

CONCLUSIONSOur findings highlight the importance of cognitive factors on decision-making process and pre-hospital delays. Health care providers can educate the public on AMI to enable them recognize the signs and symptoms of AMI correctly and realize the benefits of early treatment.

Acute Disease ; psychology ; Aged ; Cross-Sectional Studies ; Decision Making ; Female ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; psychology ; Time Factors

Objective: The purpose of this randomized control trial study was to understand the effects of happiness training by Fordyce method on life expectancy in patient’s candidates for heart surgery. This study was conducted on 66 patients who were candidates for heart surgery referred to Heshmat Heart Hospital in Rasht. Patients were randomly divided into two groups of intervention (n=34) and control (n=32) via blocked randomized method. The instrument included a standard Miller questionnaire. The intervention method of Fordyce Happiness Model was implemented via face-to-face sessions within 7 days before surgery every day for 20 to 30 minutes. Data analysis was conducted, based on the results obtained before the intervention, there was no significant difference between the two groups in terms of mean life expectancy score (p=0.643). Life expectancy score after the intervention in the case group was significantly higher than the control group (p=0.032). The findings of this study indicate that Fordyce happiness training can effect on life expectancy in patients undergoing heart surgery.