Andreia Santos Mendes

Pre-hospital delay in acute myocardial infarction: judgement of symptoms and resistance to pain

OBJECTIVE To estimate the time of decision (TD) to look for medical care and the time of arrival (TA) at the health service for men (M) and women (W) suffering from acute myocardial infarction and to analyze the influence of the interpretation of pain and pain resistance behaviors during these times. METHODS This is an exploratory research, performed at the university hospital in Salvador/Bahia. 43 W and 54 M were interviewed. To study the dependence among sociodemographic and gender variables, the Fisher Exact Test was used. To analyze times, a geometric mean (GM) was used. In order to verify the association between the GM of TD and TA and the judgment of pain, and between the GM of TD and TA and the behavior of resistance to pain, as well as to test the time of interaction between the gender variable and other variables of interest, the robust regression model was used. The statistical significance adopted was 5%. RESULTS The GM of the TD for M was 1.13 h; for W, 0.74 h. The GM of the TA was 1.74 h for M and 1.47 h for W. Those who did not recognize the symptoms of AMI and presented behavior of resistance to pain had higher TD and TA, being the associations significant. Gender did not change the associations of interest. CONCLUSION The findings demonstrate the importance of health education aiming at the benefits of early treatment.

Sociodemographic and clinical factors associated with the decision time for seeking care in acute myocardial infarction

OBJECTIVE: this study aimed to analyze the interaction of gender in the association between decision time for seeking healthcare services and the sociodemographic and clinical variables. METHOD: this exploratory, cross-sectional study was performed with 100 individuals interviewed in hospitals in Salvador, Bahia. The chi-square test or Fishers exact test and the robust linear regression model were used in the analysis. A statistical significance of 5% was adopted. RESULTS: men and women presented long decision times. The decision time was less for smokers and those with constant and/or severe pain. There was an interaction between gender and smoking and between gender and pain radiating to the neck or jaw for the decision time outcome. CONCLUSION: decision times were long and were influenced by clinical and gender variables. The study provides support for nursing care practices focused on the specificity of these factors and of the genders aiming to reduce the decision time.OBJECTIVE this study aimed to analyze the interaction of gender in the association between decision time for seeking healthcare services and the sociodemographic and clinical variables. METHOD this exploratory, cross-sectional study was performed with 100 individuals interviewed in hospitals in Salvador, Bahia. The chi-square test or Fishers exact test and the robust linear regression model were used in the analysis. A statistical significance of 5% was adopted. RESULTS men and women presented long decision times. The decision time was less for smokers and those with constant and/or severe pain. There was an interaction between gender and smoking and between gender and pain radiating to the neck or jaw for the decision time outcome. CONCLUSION decision times were long and were influenced by clinical and gender variables. The study provides support for nursing care practices focused on the specificity of these factors and of the genders aiming to reduce the decision time.

Des)controle de parâmetros clínicos e antropométricos em indivíduos com doença arterial coronária

This cross-sectional study evaluated the clinical and anthropometrical parameters of 100 individuals with coronary artery disease, who were assisted at preventive cardiology outpatient clinic at a public hospital in Salvador/BA. Data collection was performed through interviews and both clinical and laboratory evaluations. The results were analyzed as averages and percentages. Most participants were black men, aged <60 years, married, low education level and small income, unemployed and diagnosed with myocardial infarction. Most reported having arterial hypertension, dyslipidemia, a sedentary lifestyle, and had quit smoking and drinking. All women and 82% of the men had an increased abdominal circumference, 19% had causal blood glucose>200 mg/dl, 36% was overweight, 28% were obese, 65% were in soma stage of hypertension, 65% had low HDL-C and 43% had high total cholesterol. It was observed that individuals with high cardiovascular risk and deficient socioeconomic conditions show a lack of control of several cardiovascular risk factors, thus demanding effective health care practices to control the illness.This cross-sectional study evaluated the clinical and anthropometrical parameters of 100 individuals with coronary artery disease, who were assisted at preventive cardiology outpatient clinic at a public hospital in Salvador/BA. Data collection was performed through interviews and both clinical and laboratory evaluations. The results were analyzed as averages and percentages. Most participants were black men, aged 200 mg/dl, 36% was overweight, 28% were obese, 65% were in soma stage of hypertension, 65% had low HDL-C and 43% had high total cholesterol. It was observed that individuals with high cardiovascular risk and deficient socioeconomic conditions show a lack of control of several cardiovascular risk factors, thus demanding effective health care practices to control the illness.

Lack of) control of clinical and anthropometrical parameters in individuals with coronary artery disease

This cross-sectional study evaluated the clinical and anthropometrical parameters of 100 individuals with coronary artery disease, who were assisted at preventive cardiology outpatient clinic at a public hospital in Salvador/BA. Data collection was performed through interviews and both clinical and laboratory evaluations. The results were analyzed as averages and percentages. Most participants were black men, aged <60 years, married, low education level and small income, unemployed and diagnosed with myocardial infarction. Most reported having arterial hypertension, dyslipidemia, a sedentary lifestyle, and had quit smoking and drinking. All women and 82% of the men had an increased abdominal circumference, 19% had causal blood glucose>200 mg/dl, 36% was overweight, 28% were obese, 65% were in soma stage of hypertension, 65% had low HDL-C and 43% had high total cholesterol. It was observed that individuals with high cardiovascular risk and deficient socioeconomic conditions show a lack of control of several cardiovascular risk factors, thus demanding effective health care practices to control the illness.This cross-sectional study evaluated the clinical and anthropometrical parameters of 100 individuals with coronary artery disease, who were assisted at preventive cardiology outpatient clinic at a public hospital in Salvador/BA. Data collection was performed through interviews and both clinical and laboratory evaluations. The results were analyzed as averages and percentages. Most participants were black men, aged 200 mg/dl, 36% was overweight, 28% were obese, 65% were in soma stage of hypertension, 65% had low HDL-C and 43% had high total cholesterol. It was observed that individuals with high cardiovascular risk and deficient socioeconomic conditions show a lack of control of several cardiovascular risk factors, thus demanding effective health care practices to control the illness.

Acesso de usuários com infarto do miocárdio a hospitais referência em cardiologia

Objectives Characterize the access of patients with myocardial infarction to cardiology reference hospitals. Methods Cross-sectional study conducted in two cardiology reference hospitals. A sample of 100 patients, with a diagnosis of myocardial infarction, was interviewed employing a specific instrument. Mean, standard deviation and percentage values were used in the analysis. Results Male subjects; black skin; married; low socioeconomic status and mean age of 56.4 years predominated. The onset of symptoms at home, use of inadequate means of transportation, emergency service as the first place sought for assistance; and admission to cardiology reference hospitals up to the third medical assistance prevailed. Of the 67 patients with myocardial infarction with ST segment elevation, 12% received reperfusion therapies. The lack of resources was the main reason for the pilgrimage within the healthcare system. Conclusion Use of inappropriate means of transportation, low proportion of myocardial reperfusion, and lack of structure of the healthcare network to deliver care related to the infarct was observed.

Tempos de acesso a serviços de saúde face ao infarto do miocárdio

Objective To analyze the access times of men and women who are having a myocardial infarction to referral hospitals in cardiology and the correlation between them. Methods Cross-sectional research, involving 100 victims of a myocardial infarction who were interviewed at referral hospitals in cardiology. To analyze the data, descriptive and inferential statistics were used with statistical significance. Results The access times were long (decision to seek care, arrival to first health service, time in care network and admission to referral hospitals in cardiology), except for the transportation time, mainly for women. The decision time contributed more to the time it took to arrive at the first health service and the time in the care network contributed more to the time to arrive at the referral hospitals in cardiology. Conclusion The long time waiting for specialized care reflects the lack of structure of the health services and the long decision time reflects the participants’ lack of recognition of the myocardial infarction.

Environmental factors associated with the decision time for seeking care in myocardial infarction

The purpose was to estimate the decision time (DT) for searching for attendance for men and women suffering from acute myocardial infarction (AMI); and to analyze the influence of surrounding variables in the DT. Transversal study, involving one hundred patients interviewed in hospitals of Salvador-BA, Brazil. For data analysis, it was used the chi-squared or Fishers exact test, and the Robust Linear Regression Model. AMI at the home predominated, with family members and patients receiving mistaken actions. A high DT was observed both, for women (0.9h) and men (1.4h). Those at home during the initial symptoms had higher DT, compared to those at work; and lower in relation to those in public spaces (p=0.047). Statistically significant interaction occurred among gender and the fact of living with company; and among gender and having a companion and children, for the outcome of the DT. Nursing care focused on the specificity of surrounding factors and gender can optimize early attendance.Se objetivo estimar el tiempo de decision para buscar atendimiento (TD) para hombres y mujeres con infarto agudo de miocardio (IAM); analizar la influencia de variables ambientales en TD y la interaccion entre genero y variables ambientales para el desfecho del TD. Estudio transversal, envolviendo cien pacientes entrevistados en hospitales de Salvador-BA, Brasil. En el analisis se utilizo el chi-cuadrado o el Teste Exacto de Fisher y el Modelo de Regresion Linear Robusto. Predomino el IAM en el domicilio, familiares en el entorno y con pacientes siendo objeto de acciones equivocadas. Se observo TD elevados para mujeres (0,9h) y hombres (1,4h). Aquellos en sus casas en el inicio de los sintomas tuvieron mayor TD, comparados a los en el trabajo, y menor en relacion aquellos en via publica (p=0,047). Hubo interaccion estadisticamente significante entre genero y vivir acompanado y entre genero y tener companero e hijos en el entorno, para el desfecho del TD. El cuidar en enfermeria focalizado en especificidades de factores ambientales y de generos puede optimizar el atendimiento precoce.

Fatores ambientais associados ao tempo de decisão para procura de atendimento no infarto do miocárdio

The purpose was to estimate the decision time (DT) for searching for attendance for men and women suffering from acute myocardial infarction (AMI); and to analyze the influence of surrounding variables in the DT. Transversal study, involving one hundred patients interviewed in hospitals of Salvador-BA, Brazil. For data analysis, it was used the chi-squared or Fishers exact test, and the Robust Linear Regression Model. AMI at the home predominated, with family members and patients receiving mistaken actions. A high DT was observed both, for women (0.9h) and men (1.4h). Those at home during the initial symptoms had higher DT, compared to those at work; and lower in relation to those in public spaces (p=0.047). Statistically significant interaction occurred among gender and the fact of living with company; and among gender and having a companion and children, for the outcome of the DT. Nursing care focused on the specificity of surrounding factors and gender can optimize early attendance.Se objetivo estimar el tiempo de decision para buscar atendimiento (TD) para hombres y mujeres con infarto agudo de miocardio (IAM); analizar la influencia de variables ambientales en TD y la interaccion entre genero y variables ambientales para el desfecho del TD. Estudio transversal, envolviendo cien pacientes entrevistados en hospitales de Salvador-BA, Brasil. En el analisis se utilizo el chi-cuadrado o el Teste Exacto de Fisher y el Modelo de Regresion Linear Robusto. Predomino el IAM en el domicilio, familiares en el entorno y con pacientes siendo objeto de acciones equivocadas. Se observo TD elevados para mujeres (0,9h) y hombres (1,4h). Aquellos en sus casas en el inicio de los sintomas tuvieron mayor TD, comparados a los en el trabajo, y menor en relacion aquellos en via publica (p=0,047). Hubo interaccion estadisticamente significante entre genero y vivir acompanado y entre genero y tener companero e hijos en el entorno, para el desfecho del TD. El cuidar en enfermeria focalizado en especificidades de factores ambientales y de generos puede optimizar el atendimiento precoce.

Factores ambientales asociados con el tiempo de decisión para la búsqueda de atención en el infarto de miocardio

The purpose was to estimate the decision time (DT) for searching for attendance for men and women suffering from acute myocardial infarction (AMI); and to analyze the influence of surrounding variables in the DT. Transversal study, involving one hundred patients interviewed in hospitals of Salvador-BA, Brazil. For data analysis, it was used the chi-squared or Fishers exact test, and the Robust Linear Regression Model. AMI at the home predominated, with family members and patients receiving mistaken actions. A high DT was observed both, for women (0.9h) and men (1.4h). Those at home during the initial symptoms had higher DT, compared to those at work; and lower in relation to those in public spaces (p=0.047). Statistically significant interaction occurred among gender and the fact of living with company; and among gender and having a companion and children, for the outcome of the DT. Nursing care focused on the specificity of surrounding factors and gender can optimize early attendance.Se objetivo estimar el tiempo de decision para buscar atendimiento (TD) para hombres y mujeres con infarto agudo de miocardio (IAM); analizar la influencia de variables ambientales en TD y la interaccion entre genero y variables ambientales para el desfecho del TD. Estudio transversal, envolviendo cien pacientes entrevistados en hospitales de Salvador-BA, Brasil. En el analisis se utilizo el chi-cuadrado o el Teste Exacto de Fisher y el Modelo de Regresion Linear Robusto. Predomino el IAM en el domicilio, familiares en el entorno y con pacientes siendo objeto de acciones equivocadas. Se observo TD elevados para mujeres (0,9h) y hombres (1,4h). Aquellos en sus casas en el inicio de los sintomas tuvieron mayor TD, comparados a los en el trabajo, y menor en relacion aquellos en via publica (p=0,047). Hubo interaccion estadisticamente significante entre genero y vivir acompanado y entre genero y tener companero e hijos en el entorno, para el desfecho del TD. El cuidar en enfermeria focalizado en especificidades de factores ambientales y de generos puede optimizar el atendimiento precoce.

Factores sociodemográficos y clínicos asociados al tiempo de decisión para la búsqueda de atención en el infarto agudo del miocardio

OBJECTIVE: this study aimed to analyze the interaction of gender in the association between decision time for seeking healthcare services and the sociodemographic and clinical variables. METHOD: this exploratory, cross-sectional study was performed with 100 individuals interviewed in hospitals in Salvador, Bahia. The chi-square test or Fishers exact test and the robust linear regression model were used in the analysis. A statistical significance of 5% was adopted. RESULTS: men and women presented long decision times. The decision time was less for smokers and those with constant and/or severe pain. There was an interaction between gender and smoking and between gender and pain radiating to the neck or jaw for the decision time outcome. CONCLUSION: decision times were long and were influenced by clinical and gender variables. The study provides support for nursing care practices focused on the specificity of these factors and of the genders aiming to reduce the decision time.OBJECTIVE this study aimed to analyze the interaction of gender in the association between decision time for seeking healthcare services and the sociodemographic and clinical variables. METHOD this exploratory, cross-sectional study was performed with 100 individuals interviewed in hospitals in Salvador, Bahia. The chi-square test or Fishers exact test and the robust linear regression model were used in the analysis. A statistical significance of 5% was adopted. RESULTS men and women presented long decision times. The decision time was less for smokers and those with constant and/or severe pain. There was an interaction between gender and smoking and between gender and pain radiating to the neck or jaw for the decision time outcome. CONCLUSION decision times were long and were influenced by clinical and gender variables. The study provides support for nursing care practices focused on the specificity of these factors and of the genders aiming to reduce the decision time.