This was a single-center, prospective survey of 224 randomly selected women presenting to an urban academic emergency department. Approximately 46,000 patients are evaluated in the emergency department annually. It is estimated that there are equal percentages of men and women evaluated over the course of a year. The emergency department is located within a largely African-American and Hispanic neighborhood. The study period was from June 1, 2000 to December 31, 2000. This study protocol was reviewed and exempted by the Institutional Review Board.

Patient Selection Criteria

Research team members rotated through the emergency department at varying times and days of the week in three-hour intervals during the study period in order to obtain a representational sample. All women presenting to the emergency department during research collection times were eligible for participation regardless of presenting complaint. Women accompanying other patients were also eligible for participation. Women excluded from study participation included those women presenting with an unstable medical condition, active labor, women under police custody, and age less than 18 years.

Surveys were distributed by the primary investigators for the study. Surveys were performed both in the waiting room and in the main treatment area. All participants verbally consented for participation. Participants who declined to participate were thanked for their time. No record was kept of survey participation refusals. English and Spanish versions of the questionnaires were available. No identifiable data was collected from participants.

Survey Development

Selected survey questions were adapted from a previously validated survey instrument regarding awareness, perception, and knowledge of heart disease among women in the United States. A 16-item questionnaire was developed for use in this study. The first section contained questions about demographic characteristics and general medical care. The second section contained open-ended questions concerning the greatest health problems and leading cause of death in women today. Study participants were prompted for subjective ratings of their knowledge of heart disease and stroke using a four-point Likert-type scale, which included the following options for responses: “very well informed,” “moderately informed,” “well-informed,” and “not informed.” For all questions that included graded responses, the option “no answer/don’t know” was included. The final section evaluated knowledge of risk factors associated with heart disease and familiarity with signs and symptoms of heart attacks in women. kamagra soft tablets

Outcome Measures

The four primary aims of the survey were to examine knowledge of women in a predominately urban population concerning the disease that has the greatest morality in women, the disease posing the greatest health issue for women today, risk factors for heart disease, and symptoms of MI. Choices for the disease responsible for the greatest mortality in women and the greatest health issue for women included: asthma,  cerebrovascular vascular accident, diabetes, domestic violence, heart disease, lung cancer, pneumonia, and stress. Participants were provided with a list of risk factors and asked to select those specifically related to the development of heart disease. Participants were also asked to identify those symptoms associated with myocardial infarctions.