Psychological factors associated with delay in attending hospital following a myocardial infarction

J Psychosom Res. 2001 Oct;51(4):611-4. doi: 10.1016/s0022-3999(01)00265-3.


Objective: There is wide variability in latency to attend hospital following a myocardial infarction (MI). The present study assessed possible psychological factors that may be implicated in delayed presentation.

Method: Seventy-two patients who had experienced a confirmed MI were interviewed in hospital, 3-5 days post-MI. They completed a series of psychological measures of cardiac denial, cardiac threat, alexithymia, health locus of control, neuroticism and mood.

Results: Those patients who believed that they were having a heart attack sought help quicker than those who did not, and those who waited over 4 hours prior to seeking medical help had significantly lower scores on neuroticism, and higher scores on denial and health locus of control (chance). Confirmatory multiple regression analysis using an alternative estimate of delay in seeking help confirmed that health locus of control (chance) was the best predictor of delayed attendance.

Conclusion: The present study confirms that the belief that one is having a MI is associated with prompt attendance, and additionally that the belief that health outcomes are largely due to chance factors is associated with delayed presentation following a MI. This delay could prove fatal. Modification of such beliefs may reduce response times and, thus, increase survival rates.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Denial, Psychological
  • Health Behavior
  • Hospitalization*
  • Humans
  • Internal-External Control
  • Myocardial Infarction / psychology*
  • Patient Acceptance of Health Care / psychology*
  • Personality Inventory
  • Sick Role*