Signs, symptoms and diagnosis of necrotizing fasciitis experienced by survivors and family: a qualitative Nordic multi-center study.
Signs, symptoms and diagnosis of necrotizing fasciitis experienced by survivors and family: a qualitative Nordic multi-center study.
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DOI：
10.1186/s12879-018-3355-7
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发表时间：
2018-08-28
影响因子：
3.7
通讯作者：
Fagerdahl AM
中科院分区：
文献类型：
--
作者：
Erichsen Andersson A;Egerod I;Knudsen VE;Fagerdahl AM
坏死性软组织感染是所有软组织感染中最严重的。病人的生命取决于及时的诊断和积极的治疗。诊断延迟与发病率和死亡率增加有关，由于这种疾病的罕见性，诊断不足或漏诊的风险很高。对疾病的早期迹象缺乏了解。因此，这项研究的目的是探讨患者和家属的早期体征和症状的经历，并描述他们与医疗保健系统的最初接触。一个定性的探索性设计，以获得更多的知识，经验的早期体征和症状。来自三个研究中心的53名参与者接受了采访。数据分析采用框架法。大多数受试者在接受正确治疗之前经历了治疗延迟并多次联系医疗保健。参与者的疾病经历因先前体征和症状的持续时间而异。其他重要发现包括描述了早期疾病进展的三个阶段，症状强度增加。在坏死性软组织感染中经历的疼痛特别痛苦，并且对止痛药无反应。其他常见症状有呼吸困难、颤抖、肌肉无力、胃肠道问题、焦虑和恐惧。我们的研究增加了对NSTI的生活经验的理解，通过提供对NSTI诊断的前期体征和症状的深入描述。我们将诊断延迟描述为与患者相关、与初级保健相关或与医院相关，并建议在诊断NSTI时应考虑患者和家属的叙述，以减少诊断延迟。
Necrotizing soft tissue infection is the most serious of all soft tissue infections. The patient’s life is dependent on prompt diagnosis and aggressive treatment. Diagnostic delays are related to increased morbidity and mortality, and the risk of under- or missed diagnosis is high due to the rarity of the condition. There is a paucity of knowledge regarding early indications of disease. The aim of the study has thus been to explore patients’ and families’ experiences of early signs and symptoms and to describe their initial contact with the healthcare system. A qualitative explorative design was used to gain more knowledge about the experience of early signs and symptoms. Fifty-three participants from three study sites were interviewed. The framework method was used for data analysis. Most of the participants experienced treatment delay and contacted healthcare several times before receiving correct treatment. The experience of illness varied among the participants depending on the duration of antecedent signs and symptoms. Other important findings included the description of three stages of early disease progression with increase in symptom intensity. Pain experienced in necrotizing soft tissue infections is particularly excruciating and unresponsive to pain medication. Other common symptoms were dyspnea, shivering, muscle weakness, gastrointestinal problems, anxiety, and fear. Our study adds to the understanding of the lived experience of NSTI by providing in-depth description of antecedent signs and symptoms precipitating NSTI-diagnosis. We have described diagnostic delay as patient-related, primary care related, or hospital related and recommend that patient and family narratives should be considered when diagnosing NSTI to decrease diagnostic delay.
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影响因子：
4.2
作者：
Simonen, SME;Van Orman, ER;Lyon, JL
通讯作者：
Lyon, JL
影响因子：
2
作者：
May, Addison K.;Stafford, Renae E.;Eachempati, Soumitra R.
通讯作者：
Eachempati, Soumitra R.
影响因子：
2
作者：
SANDELOWSKI, M
通讯作者：
SANDELOWSKI, M
影响因子：
6
作者：
DiCicco-Bloom, B;Crabtree, BF
通讯作者：
Crabtree, BF
影响因子：
1.5
作者：
Edlich, Richard F.;Cross, Catherine L.;Long, William B., III
通讯作者：
Long, William B., III