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1. 注意：健康素养变量 2. 混合性研究设计，是相互补充的作用。 3. 就医延迟的影响因素还有很多，可以继续探讨，与“期望”结合。 Ivynian S E, Ferguson C, Newton P J, et al. Factors influencing care-seeking delay or avoidance of heart failure management: A mixed-methods study[J]. International Journal of Nursing Studies, 2020,108:103603. 心力衰竭患者就医延迟的影响因素分析：混合性研究  Background Delayed care-seeking for heart failure symptoms increases the risk of unplanned and frequent hospitalization. Presenting to hospital at a later stage when symptoms are severe requires more complex treatment, contributing to longer lengths of stay and higher risk of mortality. Patient-related factors such as knowledge have been highlighted as key contributors to care-seeking delay, yet little is known about how previous experiences within the healthcare setting, including relationships with providers, influence decisions to engage with health services when required. 研究背景：心力衰竭症状的延迟就医会导致意外和住院风险的发生。如果就医较晚，就需要比较复杂的治疗，导致住院时间更长，死亡风险更高。以往的研究证实，与疾病相关的知识是导致患者就医延迟的关键因素，但是其他因素，如以往就医经历、医护人员的关系等如何影响就医尚不清楚。 Objective To assess patient-related factors thought to impact care-seeking, and examine the role of previous healthcare experiences in decisions to seek or avoid professional care. 研究目的：评估影响就医延迟的与患者有关的因素；同时探讨以往的就医经历对于就医的影响。 Design Sequential mixed-methods study with a phenomenological approach. 研究设计：混合性研究 Settings A cardiology in-patient ward in a quaternary referral hospital in Sydney, Australia. 研究地点：澳大利亚一家医院 Participants A total of 72 symptomatic in-patients diagnosed with heart failure. 研究对象：72名心力衰竭患者 Methods Self-efficacy, heart failure knowledge and health literacy were assessed quantitatively.Semi-structured, in-depth interviews were undertaken with a subset of participants to elicit previous healthcare experiences and their influence on seeking care when symptoms worsened.Qualitative data were analyzed using interpretative phenomenological analysis and interpreted in the context of quantitative findings. 研究方法：（1）对患者的自我效能感、心衰知识和健康素养进行定量评估（使用相应量表）。（2）对一部分研究对象进行了半结构化、深入的访谈，以了解以往的就医经历及其在症状恶化时对寻求治疗的影响。定性数据采用解释性现象学分析，并在定量结果的背景下进行解释。 Results Three major themes were identified that impacted decisions to seek or avoid professional care: (i) preference for continuity; (ii) previous hospital experience and; (iii) patient-provider relationships. 研究结果：确定了影响就医与否的三个主要主题：①对持续护理（治疗）连续性的偏好；②以往就医的经历；③医患关系。 Avoidance of care-seeking was described, despite quantitative data reflecting high levels of self-efficacy, heart failure knowledge (12.3±1.9 out of 15), and above-average health literacy levels (75% adequate -15% higher than average in heart failure). The qualitative and quantitative data together demonstrate that participants delayed seeking care for heart failure symptoms despite having sound knowledge and self-efficacy to seek professional care when necessary. 尽管定量数据显示心力衰竭患者具有较高水平的自我效能感、心衰知识和高于平均水平的健康素养，但数据中仍显示出部分对于就医的回避。定性和定量数据共同表明，尽管参与者有良好的知识和自我效能感，在必要时寻求专业护理，但他们推迟了对心力衰竭症状的寻求护理。（出现就医延迟） Conclusion Previous healthcare experience affects patient's subsequent action, despite having skills and heart failure knowledge. Interactions with the healthcare system and those within it may impact decisions to avoid seeking treatment more than patient-related factors such as condition-specific understanding. 研究结论：除去疾病知识等因素，以往的医疗保健经验也会影响患者的后续就医行为。医患关系可能会影响人们做出就医延迟（回避）的决定。 |
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来自： Nursing小班长 > 《待分类》
