Acute coronary syndrome - What do patients know?
Acute coronary syndrome - What do patients know?
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DOI：
10.1001/archinte.168.10.1049
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发表时间：
2008-05-26
影响因子：
--
通讯作者：
Paul, Steven M.
中科院分区：
文献类型：
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作者：
Dracup, Kathleen;McKinley, Sharon;Paul, Steven M.
背景：急性冠状动脉综合征（ACS）治疗的有效性取决于患者寻求治疗的快速决定。我们调查了患者的心脏病知识水平和自我感知的风险，为未来的急性心肌梗死（AMI）的患者记录缺血性heartdisease.Methods：患者（N = 3522）的平均年龄为67岁，68%是男性，所有的历史AMI或侵入性心脏手术缺血性心脏病。数据收集使用一个26项的工具，侧重于ACS症状和适当的步骤，以寻求治疗。患者被要求确定他们对未来AMI的感知风险水平。结果：46%的患者知识水平低（即，< 70%的答案是正确的）。平均得分为71%。较高的知识得分与女性性别（P =.001）、年轻（P =.001）、高等教育（P =.001）、参与心脏康复（P =.001）以及接受心脏病专家而不是内科医生或全科医生的护理（P =.005）显著相关。临床病史（如AMI [P =.24]和心脏手术[P =.38]）不是知识的显著预测因素。大多数人（57%）认为自己未来发生AMI的风险高于年龄匹配的无心脏病个体，只有1例例外。也就是说，谁经历了冠状动脉搭桥手术的患者感到未来的AMI比其他人的同龄.Conclusions：即使在ACS的诊断和众多的互动与医生和其他医疗保健专业人士，知识ACS症状和治疗的心脏病患者的一部分仍然很差。患者需要继续加强对心脏症状的性质，早期治疗的好处，他们的风险状态。
Background: The effectiveness of therapy for an acute coronary syndrome (ACS) is dependent on patients' quick decision to seek treatment. We surveyed patients' level of knowledge about heart disease and self-perceived risk for a future acute myocardial infarction (AMI) in patients with documented ischemic heart disease.Methods: Patients (N = 3522) had a mean age of 67 years, 68% were male, and all had a history of AMI or invasive cardiac procedure for ischemic heart disease. Data were gathered using a 26-item instrument focusing on ACS symptoms and appropriate steps to seeking treatment. Patients were asked to identify their level of perceived risk for a future AMI.Results: Forty-six percent of patients had low knowledge levels (ie, < 70% of answers were correct). The mean score was 71%. Higher knowledge scores were significantly related to female sex (P =.001), younger age (P =.001), higher education (P =.001), participation in cardiac rehabilitation (P =.001), and receiving care by a cardiologist rather than an internist or general practitioner (P =.005). Clinical history (eg, AMI [P =.24] and cardiac surgery [P =.38]) were not significant predictors of knowledge. Most (57%) identified themselves as being at higher risk for a future AMI compared with an age-matched individual without heart disease with 1 exception. Namely, patients who had undergone coronary artery bypass surgery felt significantly less vulnerable for a future AMI than other individuals of the same age.Conclusions: Even following diagnosis of ACS and numerous interactions with physicians and other health care professionals, knowledge about ACS symptoms and treatment on the part of patients with cardiac disease remains poor. Patients require continued reinforcement about the nature of cardiac symptoms, the benefits of early treatment, and their risk status.