King Kathleen B, McGuire Mary Ann
University of Rochester School of Nursing, Rochester, NY 14642, USA.
Heart Lung. 2007 Jul-Aug;36(4):235-43. doi: 10.1016/j.hrtlng.2006.08.008.
Leventhal's common sense model of illness representation was used to examine symptom presentation, time to seek care, and expectations about the experience of having an acute myocardial infarction (AMI).
(1) Women with AMI will report a different symptom set than men, (2) women's expectations about AMI, for level of risk and symptoms, will be different than men's, (3) women will take longer to seek care than men, and (4) as suggested by the common sense model, a match between expected and actual symptoms will be related to shorter time to seek care.
A descriptive, correlational design was used. Thirty woman and 30 men diagnosed with AMI or an evolving MI treated with thrombolytic therapy or primary percutaneous coronary intervention were interviewed using the Symptom Representation Questionnaire.
Gender differences in symptom presentation were limited. The majority of women and men reported that their symptoms were different from what they expected an AMI would be like. Most stated that their pain was less than expected, whereas some reported either the location of discomfort or associated symptoms as different then expected. There was no gender difference in time to seek care. Logistic regression and survival analysis demonstrated that participants who reported a match between symptoms expected and actual symptoms experienced arrived in the emergency department sooner than those whose symptoms did not match their expectations.
The findings provide support for the use of the common sense model to explain care-seeking behavior in AMI.
运用莱文索尔的疾病表征常识模型来研究急性心肌梗死（AMI）的症状表现、就医时间以及对患病体验的期望。
（1）患AMI的女性报告的症状组合与男性不同；（2）女性对AMI在风险程度和症状方面的期望与男性不同；（3）女性寻求治疗的时间比男性长；（4）正如常识模型所表明的，预期症状与实际症状的匹配将与更短的就医时间相关。
采用描述性、相关性设计。使用症状表征问卷对30名被诊断为AMI或正在发展的心肌梗死且接受了溶栓治疗或直接经皮冠状动脉介入治疗的女性和30名男性进行访谈。
症状表现方面的性别差异有限。大多数女性和男性报告称，他们的症状与他们预期的AMI症状不同。大多数人表示他们的疼痛比预期轻，而有些人报告不适的部位或相关症状与预期不同。就医时间上没有性别差异。逻辑回归和生存分析表明，报告预期症状与实际症状相匹配的参与者比症状与预期不匹配的参与者更早到达急诊科。
这些发现为使用常识模型来解释AMI中的就医行为提供了支持。
