ABSTRACT
BACKGROUND: In patients with acute myocardial infarction (AMI), the delay between the onset of symptoms and hospital admission is a critical factor in reducing morbidity and mortality. AIMS: To assess gender differences in prehospital delay among women and men with first time AMI, generate more knowledge about aspects influencing this delay and investigate responses to acute symptoms. METHODS AND RESULT: Of 738 eligible patients, 149 women and 384 men responded to a questionnaire (72%). Over half of both women and men waited over one hour before they called for medical assistance and more than half the patients had a total prehospital delay exceeding two hours. Rapid development of symptoms and symptoms matching expectations reduced, self medication and consulting the spouse increased patient delay in both genders. Calling the Emergency Medical Service (EMS) reduced and calling a general practitioner increased total prehospital delay in both genders. ST-ELEVATION: (STEMI), symptoms experienced as unbearable and attributed as cardiac reduced patient delay, and symptoms from the back, shoulders or between scapulae increased prehospital delay, only in men. CONCLUSION: How patients responded to symptoms had vital impact on prehospital delay among both genders, but the experience and interpretation of symptoms had more influence in men than in women.
Subject(s)
Decision Making , Men/psychology , Myocardial Infarction/psychology , Patient Acceptance of Health Care/psychology , Women/psychology , Analysis of Variance , Chest Pain/etiology , Dyspnea/etiology , Emergency Medical Services/statistics & numerical data , Family Practice/statistics & numerical data , Female , Health Services Needs and Demand , Humans , Logistic Models , Male , Men/education , Myocardial Infarction/complications , Nausea/etiology , Norway , Nurse's Role , Nursing Methodology Research , Patient Acceptance of Health Care/statistics & numerical data , Patient Education as Topic , Self Care/methods , Self Care/psychology , Sex Factors , Surveys and Questionnaires , Time Factors , Women/educationABSTRACT
We studied the effect of transcutaneous electrical nerve stimulation (TENS) on stump healing and postoperative and late phantom pain after major amputations of the lower limb. A total of 51 patients were randomised to one of three postoperative treatment regimens: sham TENS and chlorpromazine medication, sham TENS only, and active low frequency TENS. There were fewer re-amputations and more rapid stump healing among below-knee amputees who had received active TENS. Sham TENS had a considerable placebo effect on pain. There were, however, no significant differences in the analgesic requirements or reported prevalence of phantom pain between the groups during the first four weeks. The prevalence of phantom pain after active TENS was significantly lower after four months but not after more than one year.
