Parrott Roxanne, Hong Soo Jung, Greenberg Marisa
a Department of Communication Arts & Sciences , The Pennsylvania State University , University Park , Pennsylvania , USA.
J Health Commun. 2015;20(1):35-42. doi: 10.1080/10810730.2014.901443. Epub 2014 May 2.
The difficulty of diagnosing blood clots makes salient the question, "What role does family history awareness have for guiding lay and expert actions?" The authors examine the in-depth life reflection interviews of 20 women who experienced a first venous blood clot between the ages of 18 and 50 years, identifying causal attributions the women made for thrombosis after the event. Twelve participants described an understanding of the cascade of events linked to thrombosis, revealing that there is seldom a single cause. The other eight identified belief in a single determining cause for their thrombosis. The authors reflect on the symptoms the women experienced during the course of the clotting event, patterns of care that they executed to self-manage their blood clot, and their misdiagnoses associated with symptoms and care. The women recalled the patterns of care received through formal health care systems and the reported misdiagnoses linked to these interactions. The recollections reveal that the subtle nature of venous blood clot symptoms contributes to lay and expert misdiagnoses. Use of antibiotics and pain killers in the wake of misdiagnosis masks symptoms, contributing to costly delays in accurate diagnoses. Four women were aware of a family history of clotting when the event occurred, 13 had such a history but lacked awareness until the clotting event, and three had no known history. Among women with awareness of their family history, blood clot diagnosis occurred sooner, promoting survival and efficiencies in health care. Implications for communicating about family history of thrombosis are considered.
“了解家族病史对指导非专业人士和专家的行动有何作用？”作者研究了20名年龄在18至50岁之间首次发生静脉血栓的女性的深度生活反思访谈，确定了这些女性在血栓形成后对其病因的归因。12名参与者描述了对与血栓形成相关的一系列事件的理解，这表明血栓形成很少是由单一原因导致的。另外8名参与者则认为自己的血栓形成有一个决定性原因。作者思考了这些女性在凝血过程中所经历的症状、她们为自我管理血栓而采取的护理模式，以及与症状和护理相关的误诊情况。这些女性回忆了通过正规医疗系统接受的护理模式以及与这些互动相关的误诊报告。这些回忆表明，静脉血栓症状的微妙性质导致了非专业人士和专家的误诊。误诊后使用抗生素和止痛药掩盖了症状，导致准确诊断出现代价高昂的延误。4名女性在事件发生时知道有凝血家族史，13名有这种家族史但直到发生凝血事件才意识到，3名则没有已知的家族史。在了解家族病史的女性中，血栓诊断出现得更早，提高了生存率并提升了医疗效率。文中还考虑了关于血栓形成家族病史沟通的意义。
