How patients interpret early signs of foot problems and reasons for delays in care: Findings from interviews with patients who have undergone toe amputations.
How patients interpret early signs of foot problems and reasons for delays in care: Findings from interviews with patients who have undergone toe amputations.
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患者如何解释足部问题的早期迹象和延误护理的原因：对接受脚趾截肢的患者进行采访的结果。
DOI：
10.1371/journal.pone.0248310
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发表时间：
2021
期刊：
影响因子：
3.7
通讯作者：
Dillon MP
中科院分区：
文献类型：
--
作者：
Littman AJ;Young J;Moldestad M;Tseng CL;Czerniecki JR;Landry GJ;Robbins J;Boyko EJ;Dillon MP
描述患者如何对足部问题的早期迹象做出反应，以及导致护理延误的因素。对美国各地患有糖尿病并接受脚趾截肢手术的退伍军人进行了半结构化访谈。数据采用归纳内容分析方法进行分析。我们采访了61名男性患者。平均年龄为66岁，41%已婚，37%高中及以下学历。与延迟护理相关的患者层面的因素包括：1)不知道有什么不对劲，2)误解症状，3)“突然”和“意想不到”的疾病进展，4)相互竞争的优先事项阻碍了寻求治疗的方式。系统层面的因素包括：5)要求患者观看，6)在需要时难以获得正确的护理类型，7)距离护理的距离和其他交通障碍。患者因素(例如，没有定期或彻底检查他们的脚和/或在他们发现问题时没有迅速采取行动)和系统因素(例如，缺乏支持患者评估症状的机制，无法获得及时和方便的预约)共同延误了护理。找出可以缩短或消除护理延误的患者和系统级别的干预措施，有助于降低肢体损失率。
To describe how patients respond to early signs of foot problems and the factors that result in delays in care. Semi-structured interviews were conducted with a large sample of Veterans from across the United States with diabetes mellitus who had undergone a toe amputation. Data were analyzed using inductive content analysis. We interviewed 61 male patients. Mean age was 66 years, 41% were married, and 37% had a high school education or less. The patient-level factors related to delayed care included: 1) not knowing something was wrong, 2) misinterpreting symptoms, 3) “sudden” and “unexpected” illness progression, and 4) competing priorities getting in the way of care-seeking. The system-level factors included: 5) asking patients to watch it, 6) difficulty getting the right type of care when needed, and 7) distance to care and other transportation barriers. A confluence of patient factors (e.g., not examining their feet regularly or thoroughly and/or not acting quickly when they noticed something was wrong) and system factors (e.g., absence of a mechanism to support patient’s appraisal of symptoms, lack of access to timely and convenient-located appointments) delayed care. Identifying patient- and system-level interventions that can shorten or eliminate care delays could help reduce rates of limb loss.
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影响因子：
3.9
作者：
Claessen H;Narres M;Haastert B;Arend W;Hoffmann F;Morbach S;Rümenapf G;Kvitkina T;Friedel H;Günster C;Schubert I;Ullrich W;Westerhoff B;Wilk A;Icks A
通讯作者：
Icks A
影响因子：
2.9
作者：
Barg, Frances K.;Cronholm, Peter F.;Margolis, David J.
通讯作者：
Margolis, David J.
影响因子：
2.9
作者：
Greenwell K;Sivyer K;Vedhara K;Yardley L;Game F;Chalder T;Richards G;Drake N;Gray K;Weinman J;Bradbury K
通讯作者：
Bradbury K
影响因子：
5.4
作者：
ANDERSEN, BL;CACIOPPO, JT;ROBERTS, DC
通讯作者：
ROBERTS, DC
影响因子：
16.2
作者：
Littman, Alyson J.;Tseng, Chin-Lin;Boyko, Edward J.
通讯作者：
Boyko, Edward J.