院前心肌梗死延迟的相关因素

Francisco de Sousa Holanda, W. B. D’Alessandro, I. A. M. Damasceno, P. Vellano, Leda Terezinha Freitas e Silva, Sávia Denise Silva Carlotto Herrera, Maykon Jhuly Martins De Paiva
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摘要

目的:本研究的目的是根据已发表的文献,回顾和分析导致院前心肌梗死延迟的相关因素。方法:进行系统的文献综述,以确定和分析院前心肌梗死(MI)延迟的相关因素。2003年至2022年间发表的相关研究使用电子数据库中预定义的搜索词进行了搜索。研究选择包括筛选标题和摘要,然后对潜在相关文章进行全文评估。从选定的研究中提取数据并进行定性分析,以确定常见的模式和关联。使用适当的工具评估纳入研究的质量,并对研究结果进行叙述性综合。结果:社会形态和临床因素,如年龄较大、女性、社会经济地位较低以及糖尿病和高血压等合并症,始终与延迟到医疗机构就诊有关。有精神病史的人,包括抑郁症和焦虑症患者,也更有可能因MI症状而延迟就医。心理社会和行为因素,如恐惧、否认、健康知识水平低以及对病情严重性的误解,进一步阻碍了及时识别和应对。此外,系统层面的因素,包括基础设施不足、资源有限和急诊室人满为患,也导致了诊断延误。结论:院前心肌梗死(MI)诊断的延迟是一个受多种因素影响的重要问题。社会形态、临床、心理社会和系统层面的因素导致了这种延迟。通过有针对性的干预、教育和改善获得医疗保健的机会来解决这些因素,可以帮助缓解延误,提高及时识别,并提高MI患者的预后。
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Associated Factors with Delay in Prehospital Myocardial Infarction
Aims: The aim of this study is to review and analyze the associated factors that contribute to delay in prehospital myocardial infarction, based on published literature. Methodology: A systematic literature review was conducted to identify and analyze the associated factors with delay in prehospital myocardial infarction (MI). Relevant studies published between 2003 and 2022 were searched using predefined search terms in electronic databases. Study selection involved screening titles and abstracts, followed by a full-text evaluation of potentially relevant articles. Data from selected studies were extracted and analyzed qualitatively to identify common patterns and associations. The quality of included studies was assessed using appropriate tools, and the findings were synthesized narratively. Results: Sociodemographic and clinical factors, such as older age, female gender, lower socioeconomic status, and comorbidities like diabetes and hypertension, were consistently associated with delayed presentation to healthcare facilities. Individuals with a history of psychiatric disorders, including depression and anxiety, were also more likely to experience delays in seeking medical attention for MI symptoms. Psychosocial and behavioral factors, such as fear, denial, low health literacy, and misconceptions about the seriousness of the condition, further impeded timely recognition and response. Additionally, system-level factors, including inadequate infrastructure, limited resources, and overcrowding in emergency departments, contributed to diagnostic delays. Conclusion: The delay in prehospital myocardial infarction (MI) diagnosis is a significant issue influenced by various factors. Sociodemographic, clinical, psychosocial, and system-level factors contribute to this delay. Addressing these factors through targeted interventions, education, and improved access to healthcare can help mitigate delays, improve timely recognition, and enhance outcomes for individuals experiencing MI.
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