McCabe Pamela J, Rhudy Lori M, Chamberlain Alanna M, DeVon Holli A
Department of Nursing, Mayo Clinic, Rochester MN, USA
Department of Nursing, Mayo Clinic, Rochester MN, USA School of Nursing, University of Minnesota, USA.
Eur J Cardiovasc Nurs. 2016 Oct;15(6):459-68. doi: 10.1177/1474515115603901. Epub 2015 Aug 28.
Delay in seeking treatment for symptoms of atrial fibrillation (AF) at onset results in a missed opportunity for vital early treatment of AF which is important for reducing stroke, tachycardia induced heart failure, and treatment-resistant AF. Little is known about factors that contribute to treatment-seeking delay for symptoms of AF.
The purpose of this study was to identify factors associated with treatment-seeking delay for symptoms of AF before diagnosis.
For this descriptive study, 150 participants with recently detected AF completed structured interviews to collect data about symptoms, symptom characteristics, symptom representation regarding cause, seriousness, controllability of symptoms, responses to symptoms before diagnosis, and time from symptom onset to treatment-seeking. Chi-square analysis was used to identify factors associated with delay (>1 week) versus no delay (⩽1 week) in treatment-seeking after symptom onset.
Participants were 51% female (n=76) with a mean age of 66.5 (standard deviation (SD)±11.1) years. A majority (70%, n=105) delayed treatment-seeking. Factors associated with delay included experiencing fatigue, dyspnea, intermittent symptoms, attributing symptoms to deconditioning, overwork, inadequate sleep, and perceiving symptoms as not very serious and amenable to self-management. Responses such as a wait and see approach, working through symptoms, reporting no fear of symptoms, or attempting to ignore symptoms were associated with delay.
Experiencing fatigue, dyspnea and intermittent symptoms produced symptom representations and emotional and behavioral responses associated with treatment-seeking delay. There is a critical need to develop and test educational interventions to increase awareness of the spectrum and characteristics of AF symptoms and appropriate treatment-seeking behaviors.
房颤（AF）发作时症状的治疗延迟导致错失了对房颤进行重要早期治疗的机会，这对于降低中风、心动过速诱发的心力衰竭以及难治性房颤至关重要。关于导致房颤症状治疗延迟的因素知之甚少。
本研究的目的是确定在诊断前与房颤症状治疗延迟相关的因素。
在这项描述性研究中，150名最近被诊断为房颤的参与者完成了结构化访谈，以收集有关症状、症状特征、症状对病因的表述、严重性、症状的可控性、诊断前对症状的反应以及从症状发作到寻求治疗的时间等数据。采用卡方分析来确定症状发作后寻求治疗延迟（>1周）与无延迟（≤1周）相关的因素。
参与者中51%为女性（n = 7），平均年龄为66.5（标准差（SD）±11.1）岁。大多数（70%，n = 105）延迟寻求治疗。与延迟相关的因素包括感到疲劳、呼吸困难、间歇性症状、将症状归因于身体状况不佳、工作过度、睡眠不足以及认为症状不太严重且适合自我管理。诸如观望态度、忍受症状、报告不害怕症状或试图忽视症状等反应与延迟相关。
经历疲劳、呼吸困难和间歇性症状会产生与寻求治疗延迟相关的症状表现、情绪和行为反应。迫切需要开发和测试教育干预措施，以提高对房颤症状范围和特征以及适当寻求治疗行为的认识。
