Pastorius Benziger Catherine, Bernabe-Ortiz Antonio, Miranda J Jaime, Bukhman Gene
University of Minnesota Medical School, Minneapolis, USA.
Crit Pathw Cardiol. 2011 Jun;10(2):99-103. doi: 10.1097/HPC.0b013e318223e375.
: Recognizing reasons for prehospital delay after symptoms of acute coronary syndrome (ACS) is established in developed countries yet evidence from Latin America is limited. We aimed to assess ACS symptom recognition, health care-seeking behavior, and confidence in local health care facilities to take care of ACS by gender in a sample of Peruvians.
: A community-based interview survey in a peri-urban area in Lima, Peru. The 24-item study instrument included vignettes and questions assessing identification of urgent and emergent ACS symptoms, anticipated help-seeking behaviors, and confidence in local health care facilities.
: In the study population (90 people; 45.6% men; mean age, 43.5 years), women were 4 times less likely to correctly attribute symptoms of chest pain to the heart (OR = 0.23; 95% CI: 0.063-0.87; P = 0.03). Women were much more likely to respond that a man would "Seek help" (OR = 4.54; 95% CI: 1.21-16.90; P = 0.024) and that "Yes," a woman would be less likely to seek help for chest pain symptoms (OR = 3.26; 95% CI: 1.13-9.41 P = 0.029) after adjusting for age, education level, age at migration, and history of chest pain. Women were less likely than men to think that their local Health Care Post would help them if they had a heart attack (2.1% vs. 14.6%; P = 0.04), and only 18.7% of women believed that their local emergency room would help them.
: Our findings suggest women are less likely to seek help for chest pain and women and men in a peri-urban area in Peru are not confident in their local health care facility to treat urgent or emergent ACS symptoms.
在发达国家，急性冠状动脉综合征（ACS）症状出现后，院前延误的原因已明确，但拉丁美洲的相关证据有限。我们旨在评估秘鲁人群样本中，按性别划分的ACS症状识别、寻求医疗行为以及对当地医疗机构处理ACS的信心。
在秘鲁利马的一个城郊地区进行基于社区的访谈调查。这份包含24个项目的研究工具包括一些案例以及用于评估紧急和突发ACS症状识别、预期的求助行为，以及对当地医疗机构信心的问题。
在研究人群（90人；男性占45.6%；平均年龄43.5岁）中，女性将胸痛症状正确归因于心脏的可能性比男性低4倍（比值比[OR]=0.23；95%置信区间[CI]：0.063 - 0.87；P = 0.03）。在调整年龄、教育水平、移民年龄和胸痛病史后，女性更有可能回答男性会“寻求帮助”（OR = 4.54；95% CI：1.21 - 16.90；P = 0.024），并且回答“是”，女性因胸痛症状寻求帮助的可能性较小（OR = 3.26；95% CI：1.13 - 9.41；P = 0.029）。如果心脏病发作，女性认为当地医疗站会帮助她们的可能性低于男性（2.1%对14.6%；P = 0.04），只有18.7%的女性相信当地急诊室会帮助她们。
我们的研究结果表明，女性因胸痛寻求帮助的可能性较小，并且秘鲁城郊地区的女性和男性对当地医疗机构处理紧急或突发ACS症状的能力缺乏信心。
