Treatment decision‐making during the early stages of heart attack: a case for the role of body and self in influencing delays
Treatment decision‐making during the early stages of heart attack: a case for the role of body and self in influencing delays
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心脏病发作早期阶段的治疗决策：身体和自我在影响延误中的作用的案例
DOI：
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发表时间：
2001
期刊：
影响因子：
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通讯作者：
A. Clark
中科院分区：
文献类型：
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作者：
A. Clark
大多数有心脏病发作（或心肌梗塞）症状的人会拖延很长一段时间才寻求医疗救助。这些延误往往时间较长，并且会损害溶栓治疗的功效，从而对死亡率产生不利影响。这项定性研究回顾性地检查了苏格兰心肌梗死 (MI) 患者样本 (n #14) 的院前决策。从入院 48 小时后对参与者的采访来看，决策制定被解释为遵循五个阶段的模式。这些阶段是：将症状体验为熟悉的感觉、摆脱日常生活、应对崩溃、增加危机以及决策和对话。在这些阶段中，参与者利用身体、自我和社会的各个方面来理解发生在他们身上的事情并做出反应。从现象学角度来看，与慢性疾病相关的运动相呼应，参与者在决策的不同阶段对身体和自我的体验不同。他们的决策受到他们对自我的看法、对身体的解释和心肌梗死症状以及个人和一般风险的概念的影响。
A majority of individuals with the symptoms of heart attack (or myocardial infarction) delay for significant periods before seeking medical assistance. These delays are often lengthy and adversely affect mortality by compromising the efficacy of thrombolytic therapy. This qualitative study examined prehospital decision-making retrospectively in a sample of Scottish myocardial infarction (MI) patients (n #14). From interviews with participants 48 hours after admittance to hospital, decision making was interpreted as following a five-stage pattern. The phases were: Experiencing symptoms as familiar sensations, moving from the everyday, responding to breakdown, increasing crisis and decisions and dialogue. Throughout these phases, participants drew on aspects of the body, self and society in order to understand and react to what was happening to them. Phenomenologically, echoing movements associated with chronic illness, participants experienced the body and self differently during the different stages of decision making. Their decision making was influenced by their views of the self, interpretations of the body and the symptoms of MI and conceptions of personal and general risk.