Arslanian-Engoren Cynthia
Division of Acute, Chronic, and Long-Term Care, University of Michigan School of Nursing, Ann Arbor 48109, USA.
Appl Nurs Res. 2005 May;18(2):82-9. doi: 10.1016/j.apnr.2004.06.013.
The purpose of this study was to determine the patient cues that emergency department (ED) nurses use to triage male and female patients with complaints suggestive of acute coronary syndromes (ACSs) and to determine if cues used by ED nurses to make clinical inferences varied by patient sex or nurses' demographic characteristics. Using clinical vignette questionnaires with different patient characteristics, ED nurses' triage decisions were evaluated to determine the patient cues used to predict ACS. Men and women were equally likely to be given an ACS triage decision and this was not affected by nurses' demographic characteristics. However, nurses used different cues to triage men and women with complaints suggestive of ACS, although by receiver operating characteristic curves, the differences between sexes were small. In addition, female vignette patients were more likely than male vignette patients to be assigned a suspected cause of cholecystitis for their presentation in a small subset of 13 (11:2; odds ratio, 1.653; 95% confidence interval, 1.115-24.47; p=.036). This study provides insight into the complex phenomenon of triage decision making and warrants further exploration.
本研究的目的是确定急诊科护士用于对疑似急性冠脉综合征(ACS)的男性和女性患者进行分诊的患者线索,并确定急诊科护士用于做出临床推断的线索是否因患者性别或护士的人口统计学特征而异。使用具有不同患者特征的临床病例问卷,对急诊科护士的分诊决策进行评估,以确定用于预测ACS的患者线索。男性和女性被给予ACS分诊决策的可能性相同,且这不受护士人口统计学特征的影响。然而,尽管通过受试者工作特征曲线显示,性别之间的差异很小,但护士在对疑似ACS的男性和女性进行分诊时使用了不同的线索。此外,在一小部分13例(11:2)中,女性病例患者因其表现被分配胆囊炎疑似病因的可能性高于男性病例患者(比值比,1.653;95%置信区间,1.115 - 24.47;p = 0.036)。本研究为分诊决策这一复杂现象提供了见解,值得进一步探索。