York University Faculty of Health, Toronto, Ontario, Canada.
J Card Fail. 2011 Sep;17(9):779-87. doi: 10.1016/j.cardfail.2011.05.003. Epub 2011 Jun 16.
Delay in seeking timely medical care by patients with acute coronary syndrome and stroke has been well established in the literature, but less is known about delay in care-seeking behavior by patients with heart failure (HF). The purpose of this narrative review was to synthesize the literature regarding non-symptom-related factors that contribute to delay in seeking medical care for HF symptoms.
A literature search of Scopus, Medline, and Pubmed was conducted for published articles from database inception to July 2009. Available evidence has shown that non-symptom-related factors, such as HF severity, HF history, age, and ethnocultural background, were related to delay in certain studies; however, null results have also been reported. Other non-symptom-related factors, such as male gender, initial contact with a primary care physician, arriving in the emergency department by means other than ambulance, and patient responses such as self-care, low anxiety, and hopelessness, may play a role in longer delay.
Although this review identified several non-symptom-related factors that may be implicated in care-seeking delay, health care professionals should be vigilant in identifying all high-risk individuals and educating them about warning signs of HF. Moreover, access to outpatient chronic disease management programs that may have potential to reduce care-seeking delay behavior should be explored.
患有急性冠脉综合征和中风的患者寻求及时医疗的延迟已经在文献中得到充分证实，但对于心力衰竭（HF）患者的这种寻求医疗行为的延迟原因知之甚少。本叙述性综述的目的是综合有关非症状相关因素导致 HF 症状寻求医疗延误的文献。
对 Scopus、Medline 和 Pubmed 数据库从建库开始至 2009 年 7 月发表的文章进行了文献检索。现有证据表明，非症状相关因素，如 HF 严重程度、HF 病史、年龄和种族文化背景，与某些研究中的延迟有关；但是，也有报道称结果为阴性。其他非症状相关因素，如男性、最初与初级保健医生接触、通过救护车以外的方式到达急诊室以及患者的反应，如自我护理、低焦虑和绝望，可能在较长的延迟中发挥作用。
尽管本综述确定了一些可能与寻求医疗的延迟有关的非症状相关因素，但医疗保健专业人员应警惕识别所有高危人群，并对 HF 的警告信号进行教育。此外，应探索可能有潜力减少寻求医疗的延迟行为的门诊慢性病管理计划。
