Barriers to Seeking and Substaining Cardiovascular Care

寻求和维持心血管护理的障碍

• 批准号: 6985721
• 负责人: TINA L HARRALSON
• 金额: $ 7.65万
• 依托单位: ALBERT EINSTEIN HEALTHCARE NETWORK
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-08-01 至 2007-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6985721
• 关键词: African American; acute disease /disorder; angina pectoris; behavioral /social science research tag; cardiovascular disorder education; caregivers; clinical research; comorbidity; depression; emergency care; female; health behavior; health care service utilization; health disparity; health services research tag; human morbidity; human old age (65+); human subject; interview; longitudinal human study; myocardial infarction; outcomes research; quality of life; statistics /biometry; therapy compliance; women' s health

DESCRIPTION (provided by applicant): Delaying the decision to seek emergency medical treatment for the symptoms of an acute ischemic event (i.e., acute myocardial infarction, unstable angina) can mean the difference between life and death. Research has shown that women, African Americans, and older persons tend to delay seeking treatment for the symptoms of an acute myocardial infarction (AMI) longer than middle-aged white men. Delays can lead to the destruction of heart muscle and may lead to poorer recovery, greater disability, and premature death. The purpose of this pilot study is to examine barriers to seeking prompt emergency care for acute ischemic symptoms and to see how these barriers impede sustained cardiovascular care over 6 month period after an acute event. This study will focus on an urban, predominantly older African American population who are admitted for the symptoms for AMI or unstable angina. Participants will be referred by hospital staff and will be interviewed within 5 days of hospitalization for the acute event. Follow-up interviews will take place 3- months and 6-months post-event. Baseline interviews will include questions pertaining to psychosocial factors, perceived and practical barriers to medical care, acute cardiac symptoms, medical comorbidity, knowledge of the warning signs of a heart attack and of personal cardiovascular risk factors, depressive symptomatology, and health cognitions and somatic complaints associated with cardiovascular disease. Follow-up interviews will focus on barriers that impede sustained cardiac care (i.e., treatment and medication compliance, lifestyle changes, and improved well-being). Many patients who experience symptoms of acute ischemia die before they reach the hospital or expire in the emergency room. In an effort to understand the barriers to delay in all acute ischemia patients, a retrospective proxy interview will be conducted among next of kin based on the in-hospital patient interview. The results of this study could play a key role in disentangling cardiovascular disparities among women and African Americans, and lead to the development of an intervention that would focus on lowering practical and perceived barriers to emergency cardiac care and recovery.

描述（由申请人提供）：延迟针对急性缺血事件（即急性心肌梗死、不稳定心绞痛）的症状寻求紧急医疗治疗的决定可能意味着生与死的区别。研究表明，女性、非裔美国人和老年人往往比中年白人推迟因急性心肌梗塞 (AMI) 症状寻求治疗的时间更长。延误可能会导致心肌受损，并可能导致恢复较差、残疾程度加大和过早死亡。这项试点研究的目的是检查针对急性缺血症状寻求及时紧急护理的障碍，并了解这些障碍如何阻碍急性事件发生后 6 个月内持续的心血管护理。这项研究将重点关注因 AMI 或不稳定心绞痛症状入院的城市人口，主要是老年非裔美国人。参与者将由医院工作人员转介，并在因急性事件住院后 5 天内接受采访。后续采访将在活动后 3 个月和 6 个月进行。基线访谈将包括与心理社会因素、医疗保健的感知和实际障碍、急性心脏症状、医疗合并症、心脏病发作警告信号和个人心血管危险因素的知识、抑郁症状、健康认知和躯体疾病有关的问题与心血管疾病有关。后续访谈将重点关注阻碍持续心脏护理的障碍（即治疗和药物依从性、生活方式的改变和改善福祉）。许多出现急性缺血症状的患者在到达医院或在急诊室之前死亡。为了了解所有急性缺血患者延误治疗的障碍，将在住院患者访谈的基础上对近亲进行回顾性代理访谈。这项研究的结果可能在消除女性和非裔美国人之间的心血管差异方面发挥关键作用，并导致开发出一种干预措施，重点是降低紧急心脏护理和康复的实际和感知障碍。