Graduate School of Nursing Dissertations

Publication Date


Document Type

Dissertation, Doctoral


Graduate School of Nursing

Dissertation Committee Chair

James A. Fain


Myocardial Infarction, Women’s Health, Mind-Body Relations (Metaphysics), Disease Management, Sex Factors, Social Behavior

Subject Categories



Cardiovascular disease is the number one cause of death for women in the United States. Acute myocardial infarction (AMI) carries a more negative prognosis for women than men. Women with AMI have both increased mortality and disability. All researchers who have documented a difference in delay times between men and women note that women delay longer in seeking treatment. In the case of an evolving AMI, women who delay in seeking medical attention will often place themselves outside the limits of reperfusion therapies such as angioplasty and thrombolysis, thereby increasing their risk of an out-of-hospital sudden cardiac death.

Several investigators have reported that reasons for delay to treatment may include the presence or absence of “somatic awareness”, that is, how a woman perceives body activity and physiological functioning. The inability of women to disregard social roles and place primacy of caring over their own health issues may limit them from seeking formal care. Social roles and obligations in a women’s life are often influenced by everyday, ordinary happenings which may have a negative impact on decision making. These everyday, ordinary happenings have been defined as “daily hassles”.

The Leventhal self-regulatory model of illness behavior, which has been used to study treatment seeking behavior in response to symptoms, provides a coherent framework for interpreting the problem of delayed treatment of myocardial infarction. The Leventhal model proposes that the patients’ belief about their health is structured in a hierarchical fashion and that these structures are based on previous illness experiences and information presented in the social environment. Utilizing a descriptive design, this study examined the relationship between somatic awareness and daily hassles and how these variables influenced a women’s treatment seeking behavior in AMI.

The Modified Somatic Perception Questionnaire (MSPQ) was used to measure somatic awareness; and daily hassles were measured through the Daily Hassles and Uplift Scale (DHUS). The questionnaires were administered at least 24 hours post admission to women with AMI. Though there were no significant relationships found between somatic awareness, daily hassles and time to treatment for AMI, the study revealed other pertinent findings. A significant relationship was found between daily hassles and age; revealing that younger participants revealed a higher daily hassle score. Also, a significant relationship was found between total MSPQ and prior cardiac events; indicating infrequent occurrence of intense symptoms experienced by women with a positive cardiac history. Though it is unknown what impact this new knowledge will have on treatment of women with AMI, these findings hold promise for clarifying these areas of research. Keywords: somatic awareness, daily hassles, treatment seeking behavior, women with acute myocardial infarction (AMI).



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