Løvlien M, Schei B, Hole T
Norwegian University of Science and Technology, Faculty of Medicine, NO-7489 Trondheim, Norway; Molde University College, NO-6402 Molde, Norway.
Eur J Cardiovasc Nurs. 2007 Dec;6(4):308-13. doi: 10.1016/j.ejcnurse.2007.03.002. Epub 2007 Apr 23.
In patients with acute myocardial infarction (AMI), the delay between the onset of symptoms and hospital admission is a critical factor in reducing morbidity and mortality.
To assess gender differences in prehospital delay among women and men with first time AMI, generate more knowledge about aspects influencing this delay and investigate responses to acute symptoms.
Of 738 eligible patients, 149 women and 384 men responded to a questionnaire (72%). Over half of both women and men waited over one hour before they called for medical assistance and more than half the patients had a total prehospital delay exceeding two hours. Rapid development of symptoms and symptoms matching expectations reduced, self medication and consulting the spouse increased patient delay in both genders. Calling the Emergency Medical Service (EMS) reduced and calling a general practitioner increased total prehospital delay in both genders. ST-ELEVATION: (STEMI), symptoms experienced as unbearable and attributed as cardiac reduced patient delay, and symptoms from the back, shoulders or between scapulae increased prehospital delay, only in men.
How patients responded to symptoms had vital impact on prehospital delay among both genders, but the experience and interpretation of symptoms had more influence in men than in women.
在急性心肌梗死(AMI)患者中,症状发作与入院之间的延迟是降低发病率和死亡率的关键因素。
评估首次发生AMI的女性和男性在院前延迟方面的性别差异,获取更多影响该延迟的因素的知识,并调查对急性症状的反应。
在738名符合条件的患者中,149名女性和384名男性回复了问卷(回复率72%)。超过半数的女性和男性在呼叫医疗救助前等待了超过一小时,超过半数的患者院前总延迟超过两小时。症状快速出现以及症状符合预期会减少延迟,自我用药和咨询配偶会增加两性患者的延迟。呼叫紧急医疗服务(EMS)会减少延迟,而呼叫全科医生会增加两性患者的院前总延迟。ST段抬高型心肌梗死(STEMI)、难以忍受且归因于心脏的症状会减少患者延迟,而背部、肩部或肩胛骨之间的症状会增加院前延迟,这仅在男性中出现。
患者对症状的反应对两性的院前延迟都有至关重要的影响,但症状的体验和解读对男性的影响比对女性的影响更大。