Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford.
Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham; Department of Geriatric Medicine, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham.
Br J Gen Pract. 2020 Apr 30;70(694):e312-e321. doi: 10.3399/bjgp20X709397. Print 2020 May.
Infection is common in older adults. Serious infection has a high mortality rate and is associated with unplanned hospital admissions. Little is known about the factors that prompt older patients to seek medical advice when they may have an infection.
To explore the symptoms of infection from the perspective of older adults, and when and why older patients seek healthcare advice for a possible infection.
A qualitative interview study among adults aged ≥70 years with a clinical diagnosis of infection recruited from ambulatory care units in Oxford, UK.
Interviews were semi-structured and based on a flexible topic guide. Participants were given the option to be interviewed with their carer. Thematic analysis was facilitated using NVivo (version 11).
A total of 28 participants (22 patients and six carers) took part. Patients (aged 70-92 years) had experienced a range of different infections. Several early non-specific symptoms were described (fever, feeling unwell, lethargy, vomiting, pain, and confusion/delirium). Internally minimising symptoms was common and participants with historical experience of infection tended to be better able to interpret their symptoms. Factors influencing seeking healthcare advice included prompts from family, specific or intolerable symptoms, symptom duration, and being unable to manage with self-care. For some, not wanting to be a burden affected their desire to seek help.
Tailored advice to older adults highlighting early symptoms of infection may be beneficial. Knowing whether patients have had previous experience of infection may help healthcare professionals in assessing older patients with possible infection.
感染在老年人中很常见。严重感染的死亡率很高，并与非计划性住院有关。对于促使老年患者在可能感染时寻求医疗建议的因素知之甚少。
从老年人的角度探讨感染的症状，以及老年患者何时以及为何因疑似感染寻求医疗建议。
这是一项在英国牛津的门诊护理单位招募的有临床感染诊断的≥70 岁成年人中进行的定性访谈研究。
访谈采用半结构化的方式，并基于灵活的主题指南。参与者可以选择与他们的照顾者一起接受采访。使用 NVivo（第 11 版）促进主题分析。
共有 28 名参与者（22 名患者和 6 名照顾者）参与。患者（年龄 70-92 岁）经历了各种不同的感染。描述了一些早期的非特异性症状（发热、不适、乏力、呕吐、疼痛和意识混乱/谵妄）。内部对症状的最小化很常见，有感染病史的参与者往往更能解释他们的症状。影响寻求医疗建议的因素包括来自家人的提示、特定或难以忍受的症状、症状持续时间以及无法通过自我护理来管理。对于一些人来说，不想成为负担会影响他们寻求帮助的愿望。
向老年人提供有关感染早期症状的个性化建议可能会有所帮助。了解患者是否有过感染史可能有助于医疗保健专业人员评估疑似感染的老年患者。
