Volume 21, Issue 1 (April 2023)
Nursing and Midwifery Journal 2023, 21(1): 12-24 |
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Emamimehr L, Ghahramanian A, Nabighadim A, Rahmani A, Hajieskandar A. PRE-HOSPITAL AND IN-HOSPITAL DELAY IN TREATMENT OF PATIENTS WITH ACUTE MYOCARDIAL INFARCTION ADMITTED TO IMAM KHOMEINI HOSPITAL OF BENAB CITY, IRAN. Nursing and Midwifery Journal 2023; 21 (1) :12-24
URL: http://unmf.umsu.ac.ir/article-1-4839-en.html
URL: http://unmf.umsu.ac.ir/article-1-4839-en.html
Lida Emamimehr1 
, Akram Ghahramanian * 2, Amirreza Nabighadim3 , Azad Rahmani4 , Alireza Hajieskandar5
, Akram Ghahramanian * 2, Amirreza Nabighadim3 , Azad Rahmani4 , Alireza Hajieskandar5
1- Department of Medical Surgical Nursing, Faculty of Nursing and Midwifery, Islamic Azad University of Bonab, Iran
2- Department of Medical Surgical Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran (Corresponding Author) ,ghahramaniana@gmail.com
3- Pediatric Urology and Regenerative Medicine Research Center, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
4- Medical-surgical Department, Nursing & Midwifery Faculty, Medical Education Research Center, Tabriz University of Medical Sciences, South Shariati Street, Tabriz, East Azerbaijan Province, Iran
5- Department of Computer, Bonab Branch, Islamic Azad University, Bonab, Iran
2- Department of Medical Surgical Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran (Corresponding Author) ,
3- Pediatric Urology and Regenerative Medicine Research Center, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
4- Medical-surgical Department, Nursing & Midwifery Faculty, Medical Education Research Center, Tabriz University of Medical Sciences, South Shariati Street, Tabriz, East Azerbaijan Province, Iran
5- Department of Computer, Bonab Branch, Islamic Azad University, Bonab, Iran
Abstract: (1651 Views)
Background & Aims: The delay from the onset of acute myocardial infarction (AMI) symptoms to seeking medical help can have life-threatening consequences. This study was performed to determine the pre-hospital and in-hospital delay in treating the patients with AMI hospitalized in the hospital of Bonab city, Iran.
Materials & Methods: The present study was a descriptive, cross-sectional study performed from February 2020 to August 2020. Among 265 patients diagnosed with AMI referred to Imam Khomeini Hospital in Bonab city, 247 patients were eligible to include in the study. The data was collected by a three-part questionnaire including demographic information, the patient's medical history, and reasons for the delay in pre-hospital and in-hospital treatment. The validity and reliability of the questionnaire were checked by content validity and intra-class correlation coefficient, respectively. The data were analyzed in SPSS version 16 at a significance level of less than 0.05.
Results: Most of the patients (%74.5) attributed symptoms of AMI to gastrointestinal and respiratory problems. The mean time for decision-making was 2.31±2.99 hours. Moreover, just a few numbers of them (%6.5) informed the emergency medical services after the onset of symptoms. The mean time of transmission of patients to the Cardiac Care Unit (CCU) was 3.81 hours. From them, %62.34 had not received thrombolytic therapy. Also, the mean time of taking the first dose of aspirin since the onset of symptoms was 3.75±2.99 hours. There was a significant relationship between decision-making time and sex (p= 0.03), rural residence (p= 0.04), and the job of the patients (p=0.001).
Conclusion: Prolonged delay was related to delay in patients’ decision-making for informing emergency medical services as well as referral of primary care services to the CCU ward. Interventions should be taken to recognize cognitive and behavioral factors involved in decision-making. New public health strategies should be developed to facilitate rapid access to acute care for AMI and to increase knowledge of people about the signs and symptoms of AMI.
Materials & Methods: The present study was a descriptive, cross-sectional study performed from February 2020 to August 2020. Among 265 patients diagnosed with AMI referred to Imam Khomeini Hospital in Bonab city, 247 patients were eligible to include in the study. The data was collected by a three-part questionnaire including demographic information, the patient's medical history, and reasons for the delay in pre-hospital and in-hospital treatment. The validity and reliability of the questionnaire were checked by content validity and intra-class correlation coefficient, respectively. The data were analyzed in SPSS version 16 at a significance level of less than 0.05.
Results: Most of the patients (%74.5) attributed symptoms of AMI to gastrointestinal and respiratory problems. The mean time for decision-making was 2.31±2.99 hours. Moreover, just a few numbers of them (%6.5) informed the emergency medical services after the onset of symptoms. The mean time of transmission of patients to the Cardiac Care Unit (CCU) was 3.81 hours. From them, %62.34 had not received thrombolytic therapy. Also, the mean time of taking the first dose of aspirin since the onset of symptoms was 3.75±2.99 hours. There was a significant relationship between decision-making time and sex (p= 0.03), rural residence (p= 0.04), and the job of the patients (p=0.001).
Conclusion: Prolonged delay was related to delay in patients’ decision-making for informing emergency medical services as well as referral of primary care services to the CCU ward. Interventions should be taken to recognize cognitive and behavioral factors involved in decision-making. New public health strategies should be developed to facilitate rapid access to acute care for AMI and to increase knowledge of people about the signs and symptoms of AMI.
Keywords: Acute Myocardial Infarction, Decision Making, Emergency Care, In-Hospital, Pre-Hospital, Treatment Delay
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