Department of Nursing, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
ESC Heart Fail. 2024 Aug;11(4):2086-2099. doi: 10.1002/ehf2.14757. Epub 2024 Apr 3.
This study aims to explore the duration and influencing factors of care-seeking delay among patients with heart failure (HF) in China.
A convergent mixed method containing a cross-sectional study and two parts of qualitative studies was designed, following the STROBE and COREQ guidelines. Convenience sampling was applied to recruit patients with HF from two general hospitals from December 2021 to December 2022. Purposive sampling was used to enrol healthcare professionals from two general hospitals and two community hospitals from June to November 2022. Among the 258 patients with HF in the cross-sectional study, the median duration of care-seeking delay was 7.5 days. The result integration indicated that the delay duration was influenced by the dyspnoea symptom burden, the oedema symptom burden, and the depression status. The lower dyspnoea symptom burden, the higher oedema symptom burden, and the higher depression score were related to the prolonged care-seeking delay duration. The duration was also affected by the COVID-19 pandemic, level of support from medical system, and the symptom management abilities of the caregivers. The COVID-19 pandemic, low level of support from medical system, and limited symptom management abilities of caregivers were related to the prolonged care-seeking delay duration.
Care-seeking delay among patients with HF needs attention in China. The duration of care-seeking delay of patients with HF was influenced by the dyspnoea symptom burden, the oedema symptom burden, and depression status, as well as the COVID-19 pandemic, level of support from medical system, and the symptom management abilities of the caregivers.
本研究旨在探讨中国心力衰竭(HF)患者的就医延迟时间及其影响因素。
采用包含横断面研究和两部分定性研究的收敛混合方法,遵循 STROBE 和 COREQ 指南。便利抽样用于 2021 年 12 月至 2022 年 12 月从两家综合医院招募 HF 患者。2022 年 6 月至 11 月,采用目的抽样从两家综合医院和两家社区医院招募医疗保健专业人员。在横断面研究的 258 例 HF 患者中,就医延迟的中位数为 7.5 天。结果整合表明,延迟时间受呼吸困难症状负担、水肿症状负担和抑郁状况的影响。较低的呼吸困难症状负担、较高的水肿症状负担和较高的抑郁评分与就医延迟时间延长有关。延迟时间还受到 COVID-19 大流行、医疗系统支持水平以及照顾者的症状管理能力的影响。COVID-19 大流行、医疗系统支持水平低以及照顾者的症状管理能力有限与就医延迟时间延长有关。
中国需要关注 HF 患者的就医延迟问题。HF 患者的就医延迟时间受呼吸困难症状负担、水肿症状负担和抑郁状况的影响,以及 COVID-19 大流行、医疗系统支持水平和照顾者的症状管理能力的影响。