Iacoe Emma, Ratner Pamela A, Wong Sabrina T, Mackay Martha H
1 St. Paul's Hospital, Providence Health Care, Canada.
2 University of British Columbia, Canada.
Eur J Cardiovasc Nurs. 2018 Apr;17(4):297-304. doi: 10.1177/1474515117741893. Epub 2017 Nov 15.
Patient-related delays in acquiring medical care for symptoms of acute coronary syndrome remain unacceptably long. Many clinical and sociodemographic characteristics associated with treatment-seeking delay are known; however, ethnicity has not been extensively evaluated.
The purpose of this study was to examine ethnicity-based differences in the time-to-treatment-seeking intervals of patients experiencing symptoms of acute coronary syndrome.
Data for this descriptive study were collected for the larger Acute Coronary Syndrome Care in Emergency Departments (ASCEND) study. The larger study is a prospective, observational study in which patients presenting to hospital emergency departments and triaged as having symptoms suggestive of acute coronary syndrome are identified. The primary outcome of this study, the time-to-treatment-seeking interval, was defined as the time between symptom onset and treatment seeking. The predictor variable, ethnicity, was measured with self-reported data and categorised as Chinese, South Asian, or 'Other' ethnic group. Participants in the 'Other' ethnic group were predominantly of European ancestry. Univariate and multivariate analyses were undertaken, along with nonparametric testing.
The study sample consisted of 419 participants: 36 Chinese, 126 South Asian, and 257 'Other' participants. The median time-to-treatment-seeking interval, for the total sample, was 180 minutes. A Kruskal-Wallis test demonstrated no statistically significant differences in the time-to-treatment-seeking intervals by ethnicity.
No ethnicity-based differences in the time-to-treatment-seeking intervals for symptoms of acute coronary syndrome were found. It is possible that Chinese and South Asian patients living in western countries are more aware of the potential signs and symptoms of acute coronary syndrome or feel more confident to access healthcare services than they have been previously.
急性冠状动脉综合征患者因自身原因导致获得医疗救治的延迟时间仍然长得令人无法接受。许多与寻求治疗延迟相关的临床和社会人口学特征已为人所知；然而，种族因素尚未得到广泛评估。
本研究旨在探讨急性冠状动脉综合征患者在寻求治疗时间间隔上基于种族的差异。
本描述性研究的数据收集自规模更大的急诊科急性冠状动脉综合征护理（ASCEND）研究。规模更大的研究是一项前瞻性观察性研究，在该研究中识别出到医院急诊科就诊并经分诊有急性冠状动脉综合征症状提示的患者。本研究的主要结局指标，即寻求治疗时间间隔，定义为症状发作到寻求治疗之间的时间。预测变量种族，通过自我报告数据进行测量，并分为华裔、南亚裔或“其他”种族群体。“其他”种族群体的参与者主要是欧洲血统。进行了单变量和多变量分析以及非参数检验。
研究样本包括419名参与者：36名华裔、126名南亚裔和257名“其他”参与者。整个样本的寻求治疗时间间隔中位数为180分钟。克鲁斯卡尔 - 沃利斯检验表明，按种族划分的寻求治疗时间间隔没有统计学上的显著差异。
未发现急性冠状动脉综合征症状的寻求治疗时间间隔存在基于种族的差异。生活在西方国家的华裔和南亚裔患者可能比以前更了解急性冠状动脉综合征的潜在体征和症状，或者在获得医疗服务方面更有信心。
