PURPOSE This study was designed to identify meaningful themes related to the recognition of lifestyle risk factors and barriers in seeking treatment following an acute event of first-time acute myocardial infarction. METHODS A methodological mixed method of thematic content analysis and a quantitative analysis was used. The sample consisted of 120 male patients < 65 years of age who agreed to be in the study were interviewed using a semi-structured during 2008-2009. Data were analyzed according to the procedure of thematic content analysis and the meaningful themes were coded into SPSS data for quantitative analysis. RESULTS Pre-hospital delay greater than three hours reported by 58.3% (n=70) of the sample and similarly 63.3% had no recognition about their symptoms as cardiac in origin. The mean number of risk factors was 3.9+/-1.8 out of 11 when lifestyle and psychosocial factors were included. From the interview data among the 70 patients delayed greater than three hours, thirty-five themes categorized into 12 main themes influenced the delayed decision which was identified according to personal-cognitive, socio-cultural, and contextual factors. CONCLUSION Health care providers should consider these themes in designing individual interventions to make lifestyle changes and to facilitate more prompt decisions to seek care.
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