Prehospital Delay, Procrastination and Personality in Patients with Acute Coronary Syndrome

Coronary heart disease alone caused one out of every six deaths in the United States in 2009. Individuals who experience signs and symptoms of acute coronary syndrome (ACS) often delay seeking treatment. Compared to patients who arrive within two hours of symptom onset, those with prolonged prehospital delay are less likely to receive thrombolytic therapy and percutaneous coronary intervention (PCI) within 90 minutes of hospital arrival. Personality and procrastination has been linked to health behavior in many studies. The objective of this study was to investigate whether specific personality factors and procrastination behavior influence prehospital delay in patients with ACS. The central hypothesis was that specific personality factors (neuroticism and conscientiousness) and procrastination behavior could predict prehospital delay in patients diagnosed with ACS. An exploratory descriptive design was used on a convenience sample of patients admitted with ACS for the first time to a large metropolitan hospital. Data was collected by questionnaires and review of the medical record. Data analysis included correlations between specific personality factors (neuroticism and conscientiousness), procrastination and prehospital delay. Data analysis also included subgroup analysis across demographic variables utilizing analyses of variance and covariance and multiple regression techniques. Study results indicated that low conscientiousness and high procrastination are associated with prehospital delay. High procrastination and arrival by private vehicle instead of emergency medical system (EMS) transportation predicted longer prehospital delays. Investigating the association of personality factors and procrastination with prehospital delay was an initial step in identifying the psychological factors associated with prehospital delay. The information on the association between conscientiousness, procrastination and prehospital delay can be utilized to redesign educational strategies for the public. Based on the study findings, individualized education approaches addressing personality and procrastination behavior should be investigated.