Arslanian-Engoren C
College of Nursing and Health, Madonna University, Livonia, Michigan, USA.
Nurs Res. 2001 Jan-Feb;50(1):61-6. doi: 10.1097/00006199-200101000-00009.
Although evidence indicates that women who suffer a myocardial infarction (MI) are less likely than men to be diagnosed based on their presenting symptoms, to receive aggressive treatment, and to survive an acute cardiac event, most studies conducted to date are retrospective chart reviews that examine the triage decision-making practices of physicians.
This study examined whether emergency department (ED) nurses' triage decisions were different when the nurse was presented with similar cues for MI, but different patient gender.
A nonexperimental, descriptive study was conducted. Five hundred ED nurses were randomly selected to receive a mailed clinical vignette questionnaire. Data analysis included descriptive, bivariate, and multivariate analyses.
ED nurses perceived the middle-aged male vignette patient to be in need of more urgent triage (t = 2.58; df = 207; p = 0.01) and an admission to an intensive care unit bed (chi2 = 10.43; df = 1; p = 0.001) and were more likely to consider a cardiac diagnosis in the male than the age-matched female (chi2= 37.49; df = 1; p < 0.0001) with identical presentation. However, no such differences were noted in the elderly vignette patients.
The findings of this study suggest that gender bias and ageism may account for the disparities in triage decisions for middle-aged women with complaints suggestive of coronary artery disease. Although middle-aged women may have a lower incidence of MIs than middle-aged men, their increased morbidity and mortality warrants its consideration.
尽管有证据表明，患心肌梗死（MI）的女性基于其症状表现被诊断、接受积极治疗以及在急性心脏事件中存活的可能性低于男性，但迄今为止进行的大多数研究都是回顾性病历审查，旨在检查医生的分诊决策实践。
本研究调查了在面对类似的心肌梗死线索但患者性别不同时，急诊科（ED）护士的分诊决策是否存在差异。
进行了一项非实验性描述性研究。随机选择500名急诊科护士，让她们收到一份邮寄的临床病例问卷。数据分析包括描述性分析、双变量分析和多变量分析。
急诊科护士认为中年男性病例患者需要更紧急的分诊（t = 2.58；自由度 = 207；p = 0.01）并入住重症监护病房（卡方 = 10.43；自由度 = 1；p = 0.001），并且在症状相同的情况下，与年龄匹配的女性相比，更倾向于考虑男性患者为心脏疾病诊断（卡方 = 37.49；自由度 = 1；p < 0.0001）。然而，在老年病例患者中未发现此类差异。
本研究结果表明，性别偏见和年龄歧视可能是导致对有冠状动脉疾病症状的中年女性分诊决策存在差异的原因。尽管中年女性心肌梗死的发病率可能低于中年男性，但其较高的发病率和死亡率值得关注。
