McCabe Pamela J, Barton Debra L, DeVon Holli A
Mayo Clinic Department of Nursing, Mayo Clinic College of Medicine, Rochester, MN, USA.
University of Michigan School of Nursing, Ann Arbor, MI, USA.
SAGE Open Nurs. 2017 Jan-Dec;3. doi: 10.1177/2377960817720324. Epub 2017 Aug 29.
Early detection of atrial fibrillation (AF) is crucial for averting AF-related stroke and heart failure, but treatment is delayed when AF is not recognized. The critical need for early detection and treatment requires education to promote AF awareness. Knowledge deficits, attitudes, and beliefs about AF that should be addressed to improve awareness and reduce treatment-seeking delay in older adults at risk for developing AF have not been well documented. The purpose of this study was to describe knowledge, treatment-seeking attitudes, and beliefs about AF in adults ⩾ 65 years old and identify demographic characteristics associated with knowledge, attitudes, and beliefs. Patients with no history of AF recruited from an academic medical center were interviewed using the Knowledge, Attitudes, and Beliefs about Atrial Fibrillation Survey. Data were analyzed using descriptive statistics and independent tests. Participants ( = 180) were 63% male with a mean age of ±3.± 6.0 years, and 52% held ⩾ 4-year college degree. About one third could not identify common symptoms of AF including palpitations (31%), chest pain (36%), dyspnea (30%), and fatigue (35%). A majority (84%) lacked confidence to recognize AF, and 58% were not sure when they should seek care for AF symptoms. Nearly a third (32%) believed palpitations are always present with AF, and 74% believed that low energy would not be their only symptom of AF. Higher scores for AF Symptom Knowledge ( = .02) were observed in females, and General Knowledge about AF was greater for younger participants ( < .001). Participants lacked knowledge and confidence to aid decision-making for treatment-seeking for symptoms of AF and held inaccurate beliefs about AF that could hinder early treatment-seeking. Programs to promote AF awareness should explain the spectrum of symptoms that may be manifested by AF and include action plans for responding to symptoms.
早期发现房颤(AF)对于预防与房颤相关的中风和心力衰竭至关重要,但当房颤未被识别时,治疗就会延迟。早期发现和治疗的迫切需求需要开展教育以提高对房颤的认识。关于房颤的知识缺陷、态度和信念,若要加以解决以提高认识并减少有患房颤风险的老年人寻求治疗的延迟,目前尚未得到充分记录。本研究的目的是描述65岁及以上成年人对房颤的知识、寻求治疗的态度和信念,并确定与知识、态度和信念相关的人口统计学特征。从一家学术医疗中心招募的无房颤病史患者使用房颤知识、态度和信念调查问卷进行访谈。数据采用描述性统计和独立检验进行分析。参与者(n = 180)中63%为男性,平均年龄为63.4±3.6岁,52%拥有至少4年制大学学位。约三分之一的人无法识别房颤的常见症状,包括心悸(31%)、胸痛(36%)、呼吸困难(30%)和疲劳(35%)。大多数人(84%)缺乏识别房颤的信心,58%不确定出现房颤症状时应何时就医。近三分之一(32%)的人认为房颤总是伴有心悸,74%的人认为精力不足并非房颤的唯一症状。女性的房颤症状知识得分较高(P = 0.02),年轻参与者对房颤的一般知识了解更多(P < 0.001)。参与者缺乏帮助他们就房颤症状寻求治疗做出决策的知识和信心,并且对房颤持有可能阻碍早期寻求治疗的错误信念。提高对房颤认识的项目应解释房颤可能表现出的症状范围,并包括应对症状的行动计划。