DELAY AND ITS RELATED FACTORS IN SEEKING TREATMENT IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION

BACKGROUND: Early diagnosis and treatment of myocardial infarction can prevent life-threatening complications such as dysrhythmias and death. The aim of this study was to determine the length of delay and its related factors in seeking treatment among a group of patients with myocardial infarction.    METHODS: In a cross-sectional design, all the patients who had referred to a general teaching hospital (Kashan, Iran) for treatment of myocardial infarction from April 2004 to March 2005 were recruited. Demographic characteristics, the amount of delay, and the causes of having delay were recorded.    RESULTS: Two hundred patients were recruited for this study from which 131 (69%) patients had delay in seeking treatment. Factors such as gender, age, economical status, educational level, referring to a general physician before referring to the hospital, the severity of symptoms, residential place (urban vs. rural), and the time of the onset of the symptoms (day vs. night) were determined to be related to having delay. The most important causes of having delay were: "hoping the symptoms to alleviate spontaneously", "attributing the symptoms to other problems other than heart problems", and "disregarding the symptoms".    CONCLUSION: Regarding the most important causes of having delay in this study, the importance of educating people about the symptoms of myocardial infarction and the importance of early referral to the hospitals is clarified.      Keywords: Prehospital delay, Myocardial infarction, Onset-to-door time

Examining the physical structure of hospitals of Kashan university of Medical Sciences based on elderly-friendly criteria and the elderly's satisfaction

Background: Older adults are one of the large groups that use hospitals and have a longer hospitalization period than other age groups. The study aimed to examining the physical structure of hospitals affiliated to Kashan university of Medical Sciences based on elderly-friendly hospitals and the elderly's satisfaction. Materials and Methods: This cross-sectional study was conducted on hospitals affiliated to Kashan University of Medical Sciences (Shaheed Beheshti, Matini, and Naqvi) and 700 older adults who were referred to these hospitals, 1401. Data were collected using a checklist and a researcher-made questionnaire in two stages. The census sampling was for hospitals and Sequential for older adults. Data were analyzed by Pearson correlation test and one-way analysis of variance (ANOVA) in statistical Software SPSS version16. Results: The mean score of the hospital structure was in a relatively good range (42.3±1.52) with a score range of 0 to 72 and the mean score satisfaction of the elderly was 24.6±3.8 with a range of 0 to 45. There was a statistically significant difference in the satisfaction of the elderly with the physical structure of hospitals based on the type of hospital and its services (P<0.001). Conclusion: The physical structure of hospitals affiliated to Kashan university of Medical Sciences was in a relatively good range, and the satisfaction of the elderly was average, also. Therefore, they should be modified based on the criteria of the elderly-friendly hospital to increase the satisfaction of older adults, especially the eldest, and to prevent their possible injuries