Dracup K, Moser D K
School of Nursing, University of California, Los Angeles 90024-6918.
Heart Lung. 1991 Sep;20(5 Pt 2):570-5.
Significant delays in seeking definitive treatment for the signs and symptoms of acute myocardial infarction increase morbidity and mortality. In most studies, delay times average more than 4 hours. The following variables are associated with increased delay: a medical history of angina, diabetes mellitus, or hypertension; older age; black race; seeking advice from a family member or a physician; symptom onset on a weekday; and attempts at self-treatment. Variables associated with reduced delay times are the following: pain recognized as cardiac in origin, hemodynamic instability, severe chest pain, younger age, and consultation with a coworker. Surprisingly, patients who have already experienced a myocardial infarction are just as likely to delay as patients who have not had this experience. These findings provide direction for developing and testing patient and family interventions, establishing community education programs, and reducing patient delay in response to the signs and symptoms of acute myocardial infarction.
对急性心肌梗死的体征和症状寻求确定性治疗的显著延迟会增加发病率和死亡率。在大多数研究中，延迟时间平均超过4小时。以下变量与延迟增加有关：心绞痛、糖尿病或高血压病史；年龄较大；黑人种族；向家庭成员或医生咨询；在工作日出现症状；以及尝试自我治疗。与延迟时间缩短相关的变量如下：认识到疼痛源于心脏、血流动力学不稳定、严重胸痛、年龄较小以及与同事咨询。令人惊讶的是，已经经历过心肌梗死的患者与未经历过这种情况的患者延迟的可能性一样大。这些发现为制定和测试患者及家庭干预措施、建立社区教育项目以及减少患者对急性心肌梗死体征和症状反应的延迟提供了方向。
