A Qualitative Study of Symptom Experiences of Women With Acute Coronary Syndrome.
A Qualitative Study of Symptom Experiences of Women With Acute Coronary Syndrome.
复制标题
DOI：
10.1097/jcn.0000000000000381
复制
发表时间：
2017
期刊：
影响因子：
--
通讯作者：
Davis LL
中科院分区：
文献类型：
--
作者：
Davis LL
大多数研究表明，有急性冠状动脉综合征（ACS）症状的女性比男性延迟就医的时间更长。促成因素包括，女性更有可能经历不同的症状，经历与预先存在的症状预期不匹配的症状，将症状解释为非心脏病，并尽量减少症状，直到它们变得失能。该研究的目的是确定影响女性识别和准确解释疑似ACS症状的能力的因素。这项定性研究对18名诊断为ACS的女性进行了深入访谈，以确定她们如何识别，解释和应对症状。从作者的初步研究开发的采访指南被用来提供结构的过程。所有的妇女都经历了一个认识和解释她们的症状的过程。8名妇女的症状突然出现。这些妇女中的大多数立即意识到了变化，“知道”去接受治疗，并且很快就去了。三名妇女有模糊的症状，开始缓慢，意外地转化为强烈的症状，促使他们紧急寻求护理。其余7名女性的症状不断演变，更有可能将症状解释为与心脏无关，并避免向他人透露症状。尽管认识到情况可能很严重，但症状不断变化的妇女采取了观望态度。症状不严重、间歇性或进展性的女性ACS延迟就诊、诊断和治疗的风险增加。这些妇女应成为教育和行为干预的目标。
Most studies show that women with symptoms of acute coronary syndrome (ACS) delay seeking care longer than men. Contributing factors include that women are more likely to experience diverse symptoms, to experience symptoms that do not match pre-existing symptom expectations, to interpret symptoms as non-cardiac, and to minimize symptoms until they become incapacitating. The aim of the study was to identify factors influencing women’s ability to recognize and accurately interpret symptoms of suspected ACS. This qualitative study used in-depth interviews with 18 women diagnosed with ACS to determine how they recognized, interpreted, and acted on symptoms. An interview guide developed from the author’s initial research was used to provide structure for the process. All of the women went through a process of recognizing and interpreting their symptoms. Eight women had symptoms arise abruptly. Most of these women recognized a change immediately, “knew” to go for treatment, and did so quickly. Three women had vague symptoms which started slowly, converting unexpectedly to intense symptoms prompting them to seek care urgently. The remaining seven women had evolving symptoms, were more likely to interpret symptoms as unrelated to their heart, and avoided disclosing symptoms to others. Despite recognizing the situation may be serious, women with evolving symptoms adopted a wait-and-see approach. Women with less severe, intermittent, or evolving symptoms are at an increased risk of delayed presentation, diagnosis, and treatment for ACS. These women should be targeted for educational and behavioral interventions.