Lefler Leanne
University of Central Arkansas, Conway, Arkansas, USA.
J Am Acad Nurse Pract. 2002 Oct;14(10):449-56. doi: 10.1111/j.1745-7599.2002.tb00075.x.
To synthesize nursing literature on reasons women delay in seeking treatment for signs and symptoms of an acute myocardial infarction (AMI), to hypothesize upon the primary reason(s) for this delay, and to propose advanced practice nurse (APN) interventions to reduce this delay.
Utilizing Stetler's Model of Research Utilization, all reports published in nursing journals within the last 10 years specifically examining prehospital delay related to gender factors were analyzed.
Women, especially those in advanced age, delay longer before seeking treatment for signs and symptoms of AMI. Effective treatment is time dependent; mortality and morbidity rise with increased prehospital delay. The reasons identified in the literature for this delay included severity, specificity, atypical presentation of symptoms, differences in event perception according to gender roles, and the interpretation and attribution of symptoms.
Identifying and teaching women at highest risk for delay, dispelling internal and external gender bias, increasing one's perception of patient vulnerability to AMI, and developing one's awareness of atypical presentations are the major factors that are likely to impact APN practice and consequently reduce prehospital delays for women at risk.
综合有关女性延迟寻求急性心肌梗死（AMI）症状治疗原因的护理文献，推测导致这种延迟的主要原因，并提出高级实践护士（APN）干预措施以减少这种延迟。
利用斯特特勒研究应用模型，分析了过去10年护理期刊上发表的所有专门研究与性别因素相关的院前延迟的报告。
女性，尤其是老年女性，在出现AMI症状后延迟寻求治疗的时间更长。有效治疗取决于时间；院前延迟增加会导致死亡率和发病率上升。文献中确定的导致这种延迟的原因包括症状的严重程度、特异性、非典型表现、根据性别角色对事件的认知差异以及症状的解释和归因。
识别并教导延迟风险最高的女性，消除内部和外部的性别偏见，增强对患者易患AMI的认知，以及提高对非典型表现的认识，这些是可能影响APN实践并因此减少有风险女性院前延迟的主要因素。
