Research Output
Appraisal and illness delay with symptoms of ACS: A questionnaire study of illness representations
  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.

  • Type:


  • Date:

    31 October 2012

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  • Publisher

    Mark Allen Group

  • DOI:


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  • Library of Congress:

    RA Public aspects of medicine

  • Dewey Decimal Classification:

    610 Medicine & health


Farquharson, B., Johnston, M., & Bugge, C. (2012). Appraisal and illness delay with symptoms of ACS: A questionnaire study of illness representations. British Journal of Cardiac Nursing, 7(10), 493-499.



Acute coronary syndrome, Illness representations, pre-hospital delay, symptoms, NHS 24, seeking help,

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