Limbu Yuba R, Malla Rabi, Regmi Shyam R, Dahal Ramesh, Nakarmi Hari L, Yonzan Ganesh, Gartaula Ritu P
SG National Heart Centre, Kathmandu, Nepal.
Heart Lung. 2006 May-Jun;35(3):164-9. doi: 10.1016/j.hrtlng.2005.12.003.
Limited knowledge of heart attack symptoms may prevent patients from seeking time-dependent thrombolytic therapy, an intervention that offers impressive survival benefit. Previous studies carried out in developed countries demonstrated a deficit of knowledge about a wide range of heart attack symptoms. The aim of this study was to describe knowledge of heart attack, knowledge of heart attack symptoms, and anticipated first response to symptoms among the lay public in Nepal.
A total of 1192 participants (657 men and 535 women age 16 to 88 years old) were interviewed in a cross-sectional manner. Those <16 years of age, all health professionals, and individuals with a history of heart attack were excluded.
A total of 862 (72.3%) participants had heard of heart attack. Significantly more male than female participants had heard of heart attack (P <.001). Of the respondents, 91.7% with >or=10 years of education (ED-2) had heard of heart of attack, whereas only 54% respondents with <10 years of education or who were illiterate (unable to read and write) (ED-1) had heard of heart attack, and in both the male and female populations, a higher percentage of the ED-2 group had heard of heart attack than the ED-1 group (92.6% vs. 60% and 85.6% vs. 49.6%, respectively). A significantly higher number of respondents from 31 to 50 years of age (AGE-2) had heard of heart attack than those 16 to 30 years of age (AGE-1) and those >50 years of age (AGE-3) (P <.001). Among 862 respondents who had heard of heart attack, 21.3% could not name any heart attack symptoms. A total of 16 different heart attack symptoms were named. Fainting or collapsing (48%), chest pain (22.4%), shortness of breath (9%), dizziness (8.4%), palpitations (7.4%), and sweating (7.4%) were the leading symptoms named by respondents. Fainting or collapsing and chest pain and shortness of breath were named more frequently among the ED-2 group respondents and the AGE-3 group men. Only 3.7% could name >or=2 typical heart attack symptoms. A significantly larger number of the ED-2 group named >or=2 typical symptoms than their counterparts (P <0.001). A large number (77.6%) of respondents preferred immediate hospital referral and/or doctor consultation after a heart attack.
In Nepal, better-educated men are more aware of heart attack. Fainting or collapsing and chest pain and shortness of breath were leading heart attack symptoms named by the general population. Public heart attack awareness is not adequate and knowledge of wide range of heart attack symptoms is deficient in the Nepalese general population.
对心脏病发作症状的了解有限可能会阻碍患者寻求具有时间依赖性的溶栓治疗，而这种干预措施能带来显著的生存益处。此前在发达国家开展的研究表明，人们对多种心脏病发作症状缺乏了解。本研究的目的是描述尼泊尔普通民众对心脏病发作的认知、对心脏病发作症状的了解以及对症状的预期第一反应。
采用横断面研究方法，共对1192名参与者（657名男性和535名女性，年龄在16至88岁之间）进行了访谈。将16岁以下者、所有卫生专业人员以及有心脏病发作史的个体排除在外。
共有862名（72.3%）参与者听说过心脏病发作。听说过心脏病发作的男性参与者显著多于女性参与者（P<.001）。在受访者中，接受过≥10年教育（ED - 2）的91.7%听说过心脏病发作，而接受过<10年教育或文盲（无法读写）（ED - 1）的受访者中只有54%听说过心脏病发作，在男性和女性人群中，ED - 2组听说过心脏病发作的比例均高于ED - 1组（分别为92.6%对60%以及85.6%对49.6%）。年龄在31至50岁（AGE - 2）的受访者中听说过心脏病发作的人数显著多于16至30岁（AGE - 1）以及>50岁（AGE - 3）的受访者（P<.001）。在862名听说过心脏病发作的受访者中，21.3%说不出任何心脏病发作症状。总共说出了16种不同的心脏病发作症状。晕厥或昏倒（48%）、胸痛（22.4%）、呼吸急促（9%）、头晕（8.4%）、心悸（7.4%）和出汗（7.4%）是受访者提到的主要症状。ED - 2组受访者以及AGE - 3组男性中，晕厥或昏倒、胸痛和呼吸急促被提及的频率更高。只有3.7%的人能说出≥2种典型的心脏病发作症状。ED - 2组中说出≥2种典型症状的人数显著多于其他组（P<0.001）。大量（77.6%）受访者倾向于在心脏病发作后立即转诊至医院和/或咨询医生。
在尼泊尔，受教育程度较高的男性对心脏病发作的认知更高。晕厥或昏倒、胸痛和呼吸急促是普通民众提到的主要心脏病发作症状。尼泊尔普通民众对心脏病发作的认知不足，对多种心脏病发作症状的了解也很欠缺。
