Appraisal and illness delay with symptoms of ACS: a questionnaire study of illness representations

Barbara Farquharson, Marie Johnston, Carol Bugge

Research output: Contribution to journalArticlepeer-review


Background: Reducing patient delay is key to reducing mortality in acute coronary syndrome (ACS). Interventions to date have had little success.

Aim: To explore whether illness representations (Leventhal's Commonsense Model of Self-Regulation (CS-SRM)) are associated with patient delay (appraisal or illness delay) in those with symptoms of ACS.

Design: A CS-SRM questionnaire study

Methods: A random sample of 182 patients who contacted NHS 24 with symptoms of ACS completed the Revised Illness Perception Questionnaire and gave access to data from their NHS 24 records.

Results: Median appraisal delay was 2 hours. Median illness delay was 75 minutes. Women were more likely than men to have long appraisal delays (>2 hours) (57% vs 43%, c2(df=1)=3.93, P=0.047) but did not differ regarding illness delay. Gender and illness representations (identity, emotion and consequences) predicted appraisal delay category (c2=19.907, df=4, P=0.001).

Conclusions: Appraisal and illness delays may be associated with different factors. Interventions addressing illness representations might reduce appraisal delay, especially in women.
Original languageEnglish
Pages (from-to)493-499
Number of pages7
JournalBritish Journal of Cardiac Nursing
Issue number10
Publication statusPublished - 5 Oct 2012


  • acute coronary syndrome
  • illness representations
  • pre-hospital delay
  • symptoms
  • NHS 24
  • seeking help


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