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新发关节痛患者寻求医疗帮助的原因。

Reasons for medical help-seeking behaviour of patients with recent-onset arthralgia.

机构信息

Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands.

出版信息

Ann Rheum Dis. 2013 Aug;72(8):1302-7. doi: 10.1136/annrheumdis-2012-201995. Epub 2012 Sep 6.

Abstract

OBJECTIVE

Patient delay in seeking medical help may cause suboptimal use of the therapeutic window in rheumatoid arthritis. We aimed to assess the motivations and the urgency with which patients with arthralgia seek medical help.

METHODS

612 patients with arthralgia-visiting two Dutch Early Arthritis Recognition Clinics-were studied. Patients filled out a questionnaire with questions on their symptoms and their reasons for seeking medical help. Comparisons were made for patients with short or prolonged patient delay, patients with and without arthritis, age and gender.

RESULTS

The median symptom duration was 4 weeks. A prolonged delay in seeking help was associated with a gradual onset of symptoms (78%) and the perception that symptoms would not be serious or would go away (16% and 48%, respectively). Arthralgia patients who promptly sought medical help more often had an acute onset of symptoms and more frequently reported impairments at work or in daily functioning than patients who postponed seeking help (all p<0.005). Patients with and without arthritis generally had similar reasons for seeking help. The proportion of patients who had a prolonged patient delay was comparable between male and female subjects and between age categories. Particularly younger patients postponed seeking help because they thought their symptoms would disappear spontaneously.

CONCLUSIONS

This large-scale study observed several reasons and symptom characteristics influencing the help-seeking behaviour of persons with arthralgia. These data can be helpful to define strategies aiming at early identification of arthritis.

摘要

目的

患者寻求医疗帮助的延迟可能导致类风湿关节炎治疗窗的利用不理想。我们旨在评估关节痛患者寻求医疗帮助的动机和紧迫性。

方法

对 612 例关节痛就诊于荷兰两家早期关节炎识别诊所的患者进行了研究。患者填写了一份问卷,内容包括他们的症状和寻求医疗帮助的原因。对短或长的患者延迟、有和无关节炎、年龄和性别患者进行了比较。

结果

中位症状持续时间为 4 周。较长的就诊延迟与症状逐渐出现(78%)和认为症状不会严重或会消失(分别为 16%和 48%)有关。迅速寻求医疗帮助的关节痛患者更常出现急性症状发作,并且比延迟就诊的患者更频繁地报告工作或日常功能受损(均 p<0.005)。有和无关节炎的患者通常有类似的寻求帮助的原因。男性和女性患者以及不同年龄组之间就诊延迟的患者比例相当。特别是年轻患者推迟就诊,因为他们认为自己的症状会自行消失。

结论

这项大规模研究观察到了影响关节痛患者寻求帮助行为的几个原因和症状特征。这些数据有助于制定旨在早期识别关节炎的策略。

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