School of Nursing, Jinan University, Guangzhou, China.
J Clin Nurs. 2023 Nov;32(21-22):7891-7908. doi: 10.1111/jocn.16802. Epub 2023 Jun 23.
To describe the experiences and perceptions of acute myocardial infarction (AMI) patients with a prolonged decision-making phase of treatment-seeking.
Previous attempts to reduce the treatment-seeking time of AMI have been less than optimal. Due to the coronavirus disease 2019 (COVID-19) pandemic, the situation of prehospital delay is possibly worse. Decisions to seek treatment are influenced by multiple factors and need individualised interventions. Understanding patients' external and internal experiences and psychological perceptions is essential.
Meta-synthesis.
We searched PubMed, Embase, Cochrane Library, Web of Science, Scopus and four Chinese databases from inception to April 2022.
We screened the retrieved articles with predetermined inclusion and exclusion criteria, and reviewed articles using Thomas and Harden's (BMC Medical Research Methodology, 2008 8, 45) qualitative thematic synthesis approach. The Joanna Briggs Institute critical appraisal tool for qualitative research was used to assess the quality of studies.
Twenty-one studies were included, identifying four themes and nine sub-themes. The four primary themes were difficulty recognising and attributing symptoms, attempt to act, unwillingness to change and self-sacrifice.
Deciding to seek treatment is a complex social and psychological process, which needs comprehensive interventions considering personal and sociocultural factors and factors related to the COVID-19 pandemic.
IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Details of interventions for decisions to seek treatment in AMI patients need to be further designed and evaluated.
Results would help healthcare professionals to implement individualised management of decision-making of treatment-seeking among AMI patients, and improve medical records of patients' prehospital experiences.
The Preferred Reporting Items for Systematic Reviews 2020 checklist was used to report the findings.
Two AMI patients contributed to the data synthesis by giving simple feedback about the final themes.
描述急性心肌梗死（AMI）患者在寻求治疗的决策阶段耗时过长的经历和感受。
先前减少 AMI 患者寻求治疗时间的尝试并不理想。由于 2019 年冠状病毒病（COVID-19）大流行，院前延误的情况可能更糟。寻求治疗的决定受到多种因素的影响，需要个体化干预。了解患者的外部和内部经历以及心理感受至关重要。
元综合。
我们从成立之初到 2022 年 4 月在 PubMed、Embase、Cochrane 图书馆、Web of Science、Scopus 和四个中文数据库中进行了搜索。
我们使用预定的纳入和排除标准筛选检索到的文章，并使用托马斯和哈登（BMC 医学研究方法，2008 年，第 8 卷，第 45 页）定性主题综合方法对文章进行了回顾。我们使用乔安娜·布里格斯研究所（Joanna Briggs Institute）的定性研究批判性评估工具来评估研究的质量。
纳入了 21 项研究，确定了四个主题和九个子主题。四个主要主题是难以识别和归因于症状、试图采取行动、不愿意改变和自我牺牲。
决定寻求治疗是一个复杂的社会和心理过程，需要综合考虑个人和社会文化因素以及与 COVID-19 大流行相关的因素进行干预。
对专业人员和/或患者护理的影响：需要进一步设计和评估 AMI 患者治疗决策的干预措施细节。
研究结果将帮助医疗保健专业人员实施 AMI 患者决策的个体化管理，并改善患者院前经历的医疗记录。
我们使用 2020 年系统评价的首选报告项目清单报告研究结果。
两名 AMI 患者通过对最终主题提供简单反馈，为数据综合做出了贡献。
