急性心肌梗死患者就医延迟状况及其影响因素分析  

Analysis on Treatment-seeking Delay Status and Related Factors for Patients with Acute Myocardial Infarction

作　　者：汪雪玲[1] 徐丽华[2] 尹涛[2] 张瑞岩[3] 

机构地区：[1]上海交通大学医学院附属新华医院耳鼻喉头颈外科,上海200092 [2]上海交通大学医学院护理学院,上海200092 [3]上海交通大学医学院瑞金医院心内科,上海200092

出　　处：《解放军护理杂志》2010年第11期801-804,808,共5页Nursing Journal of Chinese People's Liberation Army

摘　　要：目的探讨急性心肌梗死(acute myocardial infarction,AMI)患者就医延迟状况及其主要影响因素。方法选择2008年1-11月某地三所三级甲等医院就诊的250例AMI患者,使用《急性心肌梗死患者就医行为调查问卷》在患者入院后48h内进行调查。结果 250例患者中,主要症状为:胸痛,手臂、肩颈或下颌疼痛,胸闷,出冷汗,劳累与乏力以及呼吸困难。就医决策中位时间是130min,就医转运延迟中位时间为30min,就医院内等候延迟中位时间为20min,其中70.8%的患者就医决策时间超过1h。Logistic回归分析表明,非工作者(如退休人员)、女性和非自主决定入院是影响患者决策延迟的独立变量,而疼痛严重、自认为症状严重和是否转院是缩短患者决策延迟时间的独立变量。女性和老年患者就医决策延迟更甚,与其他患者比较差异有统计学意义(均P<0.05)。结论 AMI患者存在严重的就医延迟情况,女性和老年患者是就医决策延迟的高危人群。Objective To explore the treatment-seeking delay time and the main associated factors for patients with acute myocardial infarction（AMI）.Methods A total of 250 AMI patients in three Level-III Grade A hospitals were selected using purposive sampling from January to November,2008.The participates were investigated with the Chinese version of ＂Treatment-seeking behavior questionnaire for AMI＂ within 48 h after hospital admission.Results The mian symptoms of AMI patients were chest pain,pains in arm,neck,articulus or mandibularis,chest distress,cold sweat,tiredness,asthenia and dyspnea.The median time for AMI patients to make a treatment-seeking decision,to go to hospital and to wait for treatments were 130,30,20 min,respectively.Up to 70.8% of the patients had a delayed time for more than 1 h.Logistic analysis showed that non-worker（e.g.retiree）,female and non-autonomous decision admission appeared as the independent predictors to predicate the delay for making a treatment-seeking decision.In addition,severe pain,self-consideration of serious symptoms and non-transferring patients appeared to be the independent predictors to decrease the delay for making the treatment-seeking decision.The treatment delayed time was significantly longer in women and elders than that in others（P〈0.05 or P〈0.01）.Conclusion AMI patients were found with significant delay in making treatment-seeking decision and women and elders are at high risk of delayed treatment-seeking decision.

关 键 词：急性心肌梗死 就医延迟 性别 年龄 

分 类 号：R542.22[医药卫生—心血管疾病]