急性心肌梗塞病人前驅症狀之相關因素

吳柏勲; 詹世鴻; 邱艷芬; 陳幸眉

doi:10.6224/JN.202104_68(2).06

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P32 - 42

医药卫生 > 预防保健与卫生学
医药卫生 > 社会医学

DOI： 10.6224/JN

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急性心肌梗塞病人前驱症状之相关因素

吴柏勲(Bo-Hsun WU) ；詹世鸿(Shih-Hung CHAN) ；邱艳芬(Yann-Fen CHAO) ；陈幸眉(Hsing-Mei CHEN)

护理杂志； 68 卷 2 期 (2021 / 04 / 01) ， P32 - 42

繁体中文 DOI： 10.6224/JN.202104_68(2).06

心肌梗塞；前驱症状；急性症状；院前延迟时间； acute myocardial infarction ； prodromal symptoms ； acute symptom ； pre-hospital delay time

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摘要 │ 参考文献 (32) │ 国际计量

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Background: Prior to acute myocardial infarction (AMI), patients may experience different prodromal symptoms (PSs) that may delay their seeking medical treatment prior to hospitalization. Purpose: This study was designed to identify the relationship between PSs and demographics, including gender and age, acute symptoms, and pre-hospital delay time, in patients with AMI. Methods: A cross-sectional study design was applied, and a convenience sampling approach was used to recruit 121 patients in the emergency room of a medical center located in southern Taiwan. Instruments, including a demographic and disease variables datasheet, acute symptoms of AMI, McSweeney Acute and Prodromal Myocardial Infarction Symptom Survey (MAPMISS), and pre-hospital delay time, were used. Chi-square, Fisher exact, and Spearman correlation coefficients tests were used to examine the respective relationships between the targeted variables and PSs. Binary logistic regression analysis was used to determine the important determinants of PSs. Results: Most (83.5%) of the participants had experienced PSs. The MAPMISS score was significantly associated with age (ρ= -.20, p ＜ .05) and marital status (Z = 2.23, p ＜ .05). Three prodromal symptoms, including pain or discomfort in left breast, pain or discomfort in the legs, and change in headache intensity, were significantly different between male and female participants. Only one symptom, pain or discomfort in the central high chest area, differed significantly among age groups. Binary logistic regression analysis found that participants in the 40-60 years old age group were 3.19 times more likely to develop PSs than their peers in the 65 years old and older group. Conclusions / Implications for Practice: The results of this study suggest that PSs should be incorporated into medical education to increase the cognition and awareness of healthcare professionals toward PSs and to improve patient education overall in order to strengthen public awareness regarding the relationship between PSs and AMI and subsequently increase the timeliness of their seeking appropriate medical help.

参考文献 ( 32 ) 〈TOP〉

Ängerud, K. H.,Sederholm Lawesson, S.,Isaksson, R.-M.,Thylén, I.,Swahn, E.(2019).Differences in symptoms, first medical contact and pre-hospital delay times between patients with ST-and non-ST-elevation myocardial infarction.European Heart Journal: Acute Cardiovascular Care,8(3),201-207.
Bahr, R.,Christenson, R.,Farin, H.,Hand, M.,Long, J. M.(2001).Prodromal symptoms of acute myocardial infarction: Overview of evidence.Maryland Medicine,Suppl.,49-59.
Barrett-O’Keefe, Z.,Lee, J. F.,Ives, S. J.,Trinity, J. D.,Witman, M. A.,Rossman, M. J.,Groot, H. J.,Sorensen, J. R.,Morgan, D. E.,Nelson, A. D.,Stehlik, J.,Richardson, R. S.,Wray, D. W.(2019).α-adrenergic receptor regulation of skeletal muscle blood flow during exercise in heart failure patients with reduced ejection fraction.American Journal of Physiology-Regulatory,316(5),R512-R524.
Beaton, D. E.,Bombardier, C.,Guillemin, F.,Ferraz, M. B.(2000).Guidelines for the process of cross-cultural adaptation of self-report measures.Spine,25(24),3186-3191.
DeVon, H. A.,Pettey, C. M.,Vuckovic, K. M.,Koenig, M. D.,McSweeney, J. C.(2016).A review of the literature on cardiac symptoms in older and younger women.Journal of Obstetric, Gynecologic, & Neonatal Nursing,45(3),426-437.

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