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急性心肌梗死患者心脏症状归因的预测因素

Predictors of cardiac symptom attribution among AMI patients.

作者信息

Dunlop Tina, Fox-Wasylyshyn Susan

机构信息

Public Services Health and Safety Association, 1505-4950 Yonge St, Toronto, ON.

出版信息

Can J Cardiovasc Nurs. 2011;21(3):14-22.

Abstract

BACKGROUND

Care-seeking delay represents a major cause of death and disability for cardiac patients. With more than 70,000 new and recurrent acute myocardial infarctions (AMI) in Canada each year, recognizing symptoms as heart-related and seeking prompt medical care is essential for increasing the likelihood of successful treatment and survival. However, little is known about the factors associated with whether or not individuals attribute their symptoms to the heart (i.e., adopt a cardiac symptom attribution).

PURPOSE AND DESIGN

Secondary analyses were conducted on data from a sample of 135 patients from four North American hospitals to identify the predictors of correct symptom attribution (CSA) during AMI.

RESULTS AND CONCLUSIONS

Logistic regression investigations revealed that patients with a prior diagnosis of coronary heart disease and patients whose AMI experience paralleled their pre-existing symptom expectations were associated with greater odds of adopting a CSA. Results suggest that patient education and a clearer understanding of patients' beliefs about AMI can help nurses in acute care and community settings identify and manage misconceptions that may interfere with correctly attributing symptoms to a cardiac cause.

摘要

背景

寻求治疗的延迟是心脏病患者死亡和残疾的主要原因。加拿大每年有超过70000例新发和复发性急性心肌梗死(AMI),将症状识别为与心脏相关并及时寻求医疗护理对于提高成功治疗和生存的可能性至关重要。然而,对于个体是否将其症状归因于心脏(即采用心脏症状归因)的相关因素知之甚少。

目的与设计

对来自四家北美医院的135名患者样本的数据进行二次分析,以确定急性心肌梗死期间正确症状归因(CSA)的预测因素。

结果与结论

逻辑回归研究表明,先前诊断为冠心病的患者以及急性心肌梗死经历与其先前症状预期相符的患者采用心脏症状归因的几率更高。结果表明,患者教育以及对患者对急性心肌梗死信念的更清晰理解有助于急症护理和社区环境中的护士识别和管理可能干扰将症状正确归因于心脏原因的误解。

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