摘要
目的基于急性缺血性脑卒中患者发病就医轨迹视角分析并阐明急性缺血性脑卒中患者就医延迟的概念内涵,为相关研究提供理论依据。方法运用Rodgers演化概念分析法分析Cochrane Library、CINAHL、PubMed、Embase、Web of Science、Psyc INFO、中国知网、万方数据知识服务平台、维普中文科技期刊数据库等建库至2023年5月6日关于急性缺血性脑卒中患者就医延迟的相关文献。结果急性缺血性脑卒中患者发病就医过程经历了院前和院内两个阶段,就医延迟的相关因素包括院前延迟、院内延迟两部分,院前延迟分为患者延迟和转运延迟,患者延迟的相关因素有知识缺乏、社会支持不足、经济条件制约、身心感知差异;转运延迟的相关因素有交通堵塞、就医方式不当、首诊医院、紧急医疗服务反应不良;院内延迟的相关因素有医疗机构诊疗水平、医疗机构管理制度、医患关系等。就医延迟的4个概念属性即院前延迟严重、治疗时间不足、不良预后、病耻感强烈。结论界定急性缺血性脑卒中患者就医延迟的概念,有助于医护人员开展相关理论研究,编制相关适用的测评量表,实施针对性干预措施,降低急性缺血性脑卒中患者就医延迟的发生率,改善患者预后。
Objective Based on the perspective of acute ischemic stroke patients'onset medical treatment trajectory,to analyze and clarify the concept connotation of acute ischemic stroke patients'medical treatment delay,and provide a theoretical basis for related research.Methods The Rodgers evolution concept analysis method was used to analyze the relevant literature on the medical treatment delay in patients with acute ischemic stroke from the establishment of the Cochrane Library,CINAHL,PubMed,Embase,Web of Science,Psyc INFO,China National Knowledge Infrastructure,Wanfang Data Knowledge Service Platform,and VIP Chinese Science and Technology Journal Database to May 6,2023.Results The process of acute ischemic stroke patients'onset of medical care had gone through both pre-hospital and in-hospital stages.The related factors of medical treatment delay were sorted out,including pre-hospital delay and in-hospital delay.The pre-hospital delay included patient delay and transfer delay.The related factors of patient delay were lack of knowledge,lack of social support,restriction of economic conditions,and difference of physical and mental perception.The related factors of transfer delay were traffic congestion,inappropriate ways of accessing medical care,first treatment hospital,and poor response to emergency medical services.The related factors of in-hospital delay were the level of diagnosis and treatment of medical institutions,the management system of medical institutions,and the relationship between doctors and patients.The 4 conceptual attributes of medical treatment delay were severe pre-hospital delay,insufficient treatment time,poor prognosis,and strong sense of stigma.Conclusion The definition of the concept of medical treatment delay in patients with acute ischemic stroke is helpful to carry out relevant theoretical research,develop relevant and applicable evaluation scales,implement targeted intervention measures,reduce the incidence of medical delay in patients with acute ischemic stroke,and improve the prognosis of patients.
作者
董建惠
杨子琰
李佳璐
张通
秦江霞
郭佳丽
马玉霞
韩琳
DONG Jianhui;YANG Ziyan;LI Jialu;ZHANG Tong;QIN Jiangxia;GUO Jiali;MA Yuxia;HAN Lin(School of Nursing,Lanzhou University,Lanzhou 730000,China;Nursing Department,People's Hospital of Gansu Province,Lanzhou 730030,China)
出处
《护理管理杂志》
CSCD
2024年第7期569-574,共6页
Journal of Nursing Administration
基金
国家自然科学基金(72274087)
甘肃省重点研发计划项目(23YFFA0006)
兰州大学护理学院科研项目(LZUSON202002)
甘肃省联合科研基金重大项目(23JRRA1538)。
关键词
急性缺血性脑卒中
就医延迟
演化概念分析
护理
就医轨迹
acute ischemic stroke
medical treatment delay
evolution concept analysis
nursing
medical treatment trajectory
