Health  Vol.8 No.15 , December 2016
Knowledge, Attitudes, Beliefs and Perceived Risk of Acute Coronary Syndrome among Jordanian Patients
Abstract: Background: Acute Coronary Syndrome (ACS)-associated mortality is considered high and still raising, where outcomes can be improved through immediate treatment initiation. Knowledge, attitudes, beliefs and perceived risk are cognitive factors that can affect patient’s decision to seek care immediately. Therefore, this study aimed to explore knowledge, attitudes, beliefs, and perceived risk for future ACS event among Jordanian ACS patients. Methods: A descriptive, cross-sectional, correlational design was used to conveniently recruit 160 ACS patients from CCUs and medical floors at three Jordanian hospitals using the Modified ACS Response Questionnaire. Results: Almost, 65% of participants had low level of ACS knowledge, specifically regarding untraditional ACS symptoms. Some negative attitudes and beliefs toward ACS were found. There was a moderate positive correlation between knowledge score and all of attitudes, beliefs and perceived risk score (r = 0.549, p < 0.01, r = 0.563, p < 0.01, r = 0.545, p < 0.01). Conclusion: Inadequate ACS knowledge, negative attitudes and beliefs toward ACS were associated with low perceived risk for future ACS event. Therefore, it is a priority to develop strategies that consider improving ACS patients’ knowledge, attitudes, beliefs and perceived risk. This could be effective to enhance patient’s decision to seek care and reduce ominous outcomes.
Cite this paper: Alfasfos, N. , Darawad, M. , Nofal, B. , Samarkandi, O. and Abdulqader, B. (2016) Knowledge, Attitudes, Beliefs and Perceived Risk of Acute Coronary Syndrome among Jordanian Patients. Health, 8, 1830-1844. doi: 10.4236/health.2016.815175.

[1]   Nichols, M., Townsend, N., Luengo-Fernandez, R., et al. (2012) European Cardiovascular Disease Statistics. European Heart Network, Brussels, European Society of Cardiology, Sophia Antipolis.

[2]   American Heart Association (2010) Heart Disease & Stroke Statistics 2010 Update At-Aglance. Circulation, 121, 246-215.

[3]   Ramah, T. (2010) Cardiovascular Disease in the Asia Middle East Region: Global Trends and Local Implications. Asia Pacific Journal of Public Health, 22, 83-89.

[4]   Jordanian Ministry of Health (2010) Mortality Report.

[5]   World Health Organization (2012) Jordan: WHO Statistical Profile.

[6]   Lloyd-Jones, D., Adams, R., Carnethon, M., et al. (2009) Heart Disease and Stroke Statistics—2009 Update a Report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation, 119, e21-e181.

[7]   McKinley, S., Moser, D. and Dracup, K. (2000) Treatment-Seeking Behavior for Acute Myocardial Infarction Symptoms in North America and Australia. Heart & Lung, 29, 237-247.

[8]   Moser, D., Kimble, L., Alberts, M., et al. (2006) Reducing Delay in Seeking Treatment by Patients with Acute Coronary Syndrome and Stroke a Scientific Statement from the American Heart Association Council on Cardiovascular Nursing and Stroke Council. Circulation, 114, 168-182.

[9]   Taylor, D., Garewal, D., Carter, M., Bailey, M. and Aggarwal, A. (2005) Factors That Impact upon the Time to Hospital Presentation Following the Onset of Chest Pain. Emergency Medicine Australasia, 17, 204-211.

[10]   Noureddine, S., Adra, M., Arevian, M., et al. (2006) Delay in Seeking Health Care for Acute Coronary Syndromes in a Lebanese Sample. Journal of Transcultural Nursing, 17, 341-348.

[11]   Thuresson, M., Jarlöv, M., Lindahl, B., Svensson, L., Zedigh, C. and Herlitz, J. (2007) Thoughts, Actions, and Factors Associated with Prehospital Delay in Patients with Acute Coronary Syndrome. Heart & Lung, 36, 398-409.

[12]   Riegel, B., McKinley, S., Moser, D., Meischke, H., Doering, L. and Dracup, K. (2007) Psychometric Evaluation of the Acute Coronary Syndrome (ACS) Response Index. Research in Nursing & Health, 30, 584-594.

[13]   Dracup, K., McKinley, S., Doering, L., et al. (2008) Acute Coronary Syndrome: What Do Patients Know? Archives of Internal Medicine, 168, 1049-1054.

[14]   Moser, D., McKinley, S., Dracup, K. and Chung, M. (2005) Gender Differences in Reasons Patients Delay in Seeking Treatment for Acute Myocardial Infarction Symptoms. Patient Education and Counseling, 56, 45-54.

[15]   Pattenden, J., Watt, I., Lewin, R. and Stanford, N. (2002) Decision Making Processes in People with Symptoms of Acute Myocardial Infarction: Qualitative Study. British Medical Journal, 324, 1006.

[16]   Hart, P. (2005) Women’s Perceptions of Coronary Heart Disease: An Integrative Review. Journal of Cardiovascular Nursing, 20, 170-176.

[17]   Hwang, S., Ryan, C. and Zerwic, J. (2008) Korean Immigrants’ Knowledge of Heart Attack Symptoms and Risk Factors. Journal of Immigrant and Minority Health, 10, 67-72.

[18]   Henriksson, C., Larsson, M., Arnetz, J., et al. (2011) Knowledge and Attitudes toward Seeking Medical Care for AMI-Symptoms. International Journal of Cardiology, 147, 224-227.

[19]   O’Brien, F., O’Donnell, S., McKee, G., Mooney, M. and Moser, D. (2013) Knowledge, Attitudes, and Beliefs about Acute Coronary Syndrome in Patients Diagnosed with ACS: An Irish Cross-Sectional Study. European Journal of Cardiovascular Nursing, 12, 201-208.

[20]   Khan, M., Jafary, F., Faruqui, A., et al. (2007) High Prevalence of Lack of Knowledge of Symptoms of Acute Myocardial Infarction in Pakistan and Its Contribution to Delayed Presentation to the Hospital. BMC Public Health, 7, 284.

[21]   Henriksson, C., Lindahl, B. and Larsson, M. (2007) Patients’ and Relatives’ Thoughts and Actions during and after Symptom Presentation for an Acute Myocardial Infarction. European Journal of Cardiovascular Nursing, 6, 280-286.

[22]   Ammouri, A., Neuberger, G., Mrayyan, M. and Hamaidah, S. (2010) Perception Risk of Coronary Heart Disease among Jordanian. Journal of Clinical Nursing, 20, 197-203.

[23]   Mosca, L., Ferris, A., Fabunmi, R. and Robertson, R. (2004) Tracking Women’s Awareness of Heart Disease an American Heart Association National Study. Circulation, 109, 573-579.

[24]   Jordanian Department of Statistics (2012) Jordan Statistical Yearbook.

[25]   Jordanian Ministry of Health (2013) Annual Report.

[26]   Association for Community Health Improvement (2013) Trends in Hospital-Based Population Health Infrastructure: Results from an Association for Community Health Improvement and American Hospital Association Survey. Health Research and Educational Trust, Chicago.

[27]   Cohen, J. (1992) Quantitative Methods in Psychology: A Power Primer. Psychological Bulletin, 112, 155-159.

[28]   Buckley, T., McKinley, S., Gallagher, R., Dracup, K., Moser, D. and Aitken, L. (2007) The Effect of Education and Counseling on Knowledge, Attitudes and Beliefs about Responses to Acute Myocardial Infarction Symptoms. European Journal of Cardiovascular Nursing, 6, 105-111.

[29]   Leupker, R., Raczynski, J., Osganian, S., et al. (2000) Effect of a Community Intervention on Patient Delay and Emergency Medical Service Use in Acute Coronary Heart Disease: The Rapid Early Action for Coronary Treatment (REACT) Trial. JAMA, 284, 60-67.

[30]   Eshah, N., Bond, A. and Froelicher, E. (2010) The Effects of a Cardiovascular Disease Prevention Program on Knowledge and Adoption of a Heart Healthy Lifestyle in Jordanian Working Adults. European Journal of Cardiovascular Nursing, 9, 244-253.

[31]   Li, P., Lee, D. and Doris, S. (2014) Psychometric Evaluation of the Symptoms of Acute Coronary Syndromes Inventory in Chinese Patients with Acute Coronary Syndromes. European Journal of Cardiovascular Nursing, 13, 295-303.

[32]   Eshah, N. (2013) Seeking Medical Attention among Jordanian Patients with Acute Myocardium Infarction. The Meeting of the 1st Annual International Interdisciplinary Conference, Azores, 24-26 April 2013, 753-761.

[33]   Allana, S., Ali, T., Khowaja, K., Khan, A. and Moser, D. (2013) Validity and Reliability Testing: Urdu Translated Modified Response to Symptoms Questionnaire. Journal of the College of Physicians and Surgeons Pakistan, 23, 383-387.

[34]   Cytryn, K., Yoskowitz, N., Cimino, J. and Patel, V. (2009) Lay Public’s Knowledge and Decisions in Response to Symptoms of Acute Myocardial Infarction. Advances in Health Sciences Education, 14, 43-59.

[35]   Mosleh, S. and Darawad, M. (2015) Patients’ Adherence to Healthy Behavior in Coronary Heart Disease: Risk Factor Management among Jordanian Patients. Journal of Cardiovascular Nursing, 30, 471-478.

[36]   Darawad, M., Alfasfos, N., Saleh, Z., Saleh, A. and Hamdan-Mansour, A. (2016) Predictors of Delay in Seeking Treatment by Jordanian Patients with Acute Coronary Syndrome. International Emergency Nursing, 26, 20-25.

[37]   Hammad, S., Darawad, M., Haourani, E. and Demeh, W. (2015) Predictors of Glycated Hemoglobin among Jordanian Diabetic Patients. Iranian Journal of Public Health, 44, 1482-1491.

[38]   Darawad, M. and Khalil, A. (2012) Jordanian Dialysis Patients’ Perceived Exercise Benefits and Barriers: A Correlation Study. Rehabilitation Nursing, 38, 315-322.

[39]   Khalil, A., Darawad, M., Eljamal, E., Mansour, A. and Abed, M. (2012) Predictors of Dietary and Fluid Non-Adherence in Jordanian Patients with End-Stage Renal Disease Receiving Hemodialysis: A Cross-Sectional Study. Journal of Clinical Nursing, 22, 127-136.

[40]   Al-Hassan, M. and Omran, S. (2005) The Effects of Health Beliefs on Health Care Seeking Decisions of Jordanian Patients with Myocardial Infarction Symptoms. International Journal of Nursing Practice, 11, 13-20.

[41]   Antonovsky, A. (1987) Unraveling the Mystery of Health: How People Manage Stress and Stay Well. Jossey-Bass, San Francisco.