Perceptions and emergency medical service use for acute myocardial infarction among community-dwelling older adults: an embedded mixed method study

Acute myocardial infarction is a medical emergency where timely treatment is critical to improving survival. Older adults, however, delay seeking treatment and experience increased mortality because of misunderstandings and negative attitudes toward emergency medical services, especially when experiencing atypical symptoms. This embedded mixed-methods study explored perceptions of acute myocardial infarction, emergency medical service utilization, and their related factors among older adults and caregivers in urban and peri-urban communities. The study was conducted from October 2020 to January 2021, with 133 participants for quantitative and 25 for qualitative analysis. Findings indicated that while the perceived benefits of timely medical treatment were high, understanding and attitudes toward emergency medical service use were moderate. Age, occupation, settings, chronic disease status and groups, hospitalization history, and seeing patients with acute myocardial infarction were associated with perception. Past experiences and seeing patients with acute myocardial infarction were associated with emergency medical service utilization. The decision to seek immediate treatment (first-of-action) correlated with perceived benefits of timely treatment, the possibility of calling 1669, and attitudes toward emergency medical service. A correlation was found between perceived benefits and attitudes toward emergency medical services. Attitude and overall perception correlated with the perceived benefit of calling 1669. Finally, three possible emergency medical service utilization groups emerged: those who would use, those who would not, and those who would decide based on circumstances. Future studies should focus on targeted interventions to improve recognition of acute myocardial infarction and positive perceptions and attitudes toward emergency medical service utilization, ensuring timely care within the critical early treatment window. Clinical Trial Registration Number: https://osf.io/qxd6j and TCTR20240706001.