Zerwic Julie Johnson, Ryan Catherine J, DeVon Holli A, Drell Mary Jo
University of Illinois at Chicago, School of Nursing, 60612-7350, USA.
Nurs Res. 2003 May-Jun;52(3):159-67. doi: 10.1097/00006199-200305000-00005.
Patients experiencing an acute myocardial infarction are known to delay seeking treatment between 2 and 4 hours. This delay is problematic because individuals who receive treatment 2 or more hours after the onset of symptoms are less likely to benefit from emergent reperfusion techniques. Persons most likely to delay seeking treatment for an acute myocardial infarction and their reasons have not been clearly identified.
The purpose of this study was to identify the effect of selected demographic, clinical, cognitive, and environmental variables on the length of the time of delay. In addition, the study was designed to identify whether women delayed longer than men, and whether African Americans delayed longer than non-Hispanic Whites during an acute myocardial infarction.
A structured interview was conducted in a convenience sample (N eq> 212) of African American and non-Hispanic White patients hospitalized after acute myocardial infarction. Patients were asked detailed information about the sequence of events prior to the acute myocardial infarction, and the symptoms experienced. Medical records were examined for clinical information.
Women did not delay significantly longer than men (2.0 vs. 2.5 median hours). African Americans delayed significantly longer than non-Hispanic Whites (3.25 hours vs. 2.0 median hours). Race did not contribute unique variance to delay time in a simultaneous multiple regression analysis; however, race was a significant predictor variable in whether or not participants sought treatment within the first hour after the onset of symptoms. The variance in delay time for African American and Non-Hispanic White men and women that could be explained by the predictor variables ranged from 23-47%.
The reasons for delay differed in part by sex and race.
已知急性心肌梗死患者在症状出现后2至4小时会延迟就医。这种延迟存在问题，因为症状出现2小时或更长时间后接受治疗的患者从紧急再灌注技术中获益的可能性较小。最有可能延迟急性心肌梗死就医的人群及其原因尚未明确。
本研究的目的是确定选定的人口统计学、临床、认知和环境变量对延迟时间长度的影响。此外，该研究旨在确定在急性心肌梗死期间女性的延迟时间是否比男性长，以及非裔美国人的延迟时间是否比非西班牙裔白人长。
对因急性心肌梗死后住院的非裔美国人和非西班牙裔白人患者的便利样本（N>212）进行结构化访谈。询问患者有关急性心肌梗死前事件顺序及所经历症状的详细信息。检查病历以获取临床信息。
女性的延迟时间并未显著长于男性（中位数分别为2.0小时和2.5小时）。非裔美国人的延迟时间显著长于非西班牙裔白人（中位数分别为3.25小时和2.0小时）。在同时进行的多元回归分析中，种族对延迟时间没有独特的影响；然而，种族是参与者在症状出现后第一小时内是否寻求治疗的重要预测变量。预测变量可解释的非裔美国人和非西班牙裔白人男性及女性延迟时间的差异范围为23%至47%。
延迟的原因在一定程度上因性别和种族而异。
