Responses to chest pain : a qualitative study
Previous research has suggested the existence of socio-economic and gender variation in uptake of hospital cardiology services but it is not known at which stage of the care pathway these variations arise. This thesis aims to address this gap in the literature by exploring the perceptions of an behaviour in response to chest pain of men and women living in two socio-economically contrasting areas of Glasgow. It has 3 objectives: to describe respondents' perceptions of and actions in response to chest pain; to ascertain whether there are differences in perceptions and behaviour associated with socio-economic status or gender; and, to relate any observed differences to the known variations in uptake of cardiology services. Respondents' interpretations of chest pain were related to their perceived vulnerability to heart disease and their previous illness experience. Their decisions of whether to present to a general practitioner were influenced by the quality of previous encounters with doctors and by their lay care and self-care. Women generally felt less vulnerable to heart disease than men, and often believed that their health problems were secondary to those of family members. These factors led women to report a reluctance to present with chest pain. Compared with more affluent people, those from the deprived area generally felt more vulnerable to heart disease but the perception that they were to blame for their ill-health often led to reluctance to present with chest pain. Differences in perceptions and behaviour might partly explain gender inequities in access to hospital cardiology services but socio-economic inequities in uptake of services have proved more difficult to explain.