Buscar en
Enfermería Intensiva
Toda la web
Inicio Enfermería Intensiva ¿Pueden ser útiles los descriptores verbales específicos para diferenciar a l...
Journal Information
Vol. 12. Issue 4.
Pages 164-174 (January 2001)
Share
Share
Download PDF
More article options
Vol. 12. Issue 4.
Pages 164-174 (January 2001)
Full text access
¿Pueden ser útiles los descriptores verbales específicos para diferenciar a los pacientes con o sin infarto agudo de miocardio? Resultados de un estudio de dos años
Can specific verbal descriptors be useful in differentiating those with and without MI? Findings from a two-year study
Visits
3771
J.W. Albarrán1,
Corresponding author
john.albarran@uwe.ac.uk

Correspondencia: Principal Lecturer in Critical Care Faculty of Health and Social Care University of the West of England Bristol BS16 1DD Tel.: 0117 3448611
, G. Chappel1, B. Durham1, J. Gowers2, J. Dwight1
1 Unidad de Cuidados Coronarios, North Bristol NHS Trust, Southmead Hospital, Bristol BS10 5NB, Gran Bretaña
2 Facultad de Estudios Informáticos y Matemáticos. University of the West of England, Bristol, Gran Bretaña
This item has received
Article information
Resumen

Este artículo presenta los resultados de un estudio de 2 años, realizado en una unidad coronaria de 11 camas situada en un hospital del suroeste de Inglaterra. El objetivo del estudio era explorar las diferencias entre los descriptores verbales utilizados por pacientes con y sin infarto agudo de miocardio (IAM), para determinar su contribución en la valoración de pacientes con sospecha de IAM. Además, el estudio analizaba si existían diferencias entre las palabras utilizadas por los varones y las mujeres con IAM para describir los síntomas de dolor torácico.

Todos los pacientes ingresados con un episodio de dolor torácico se seleccionaban para participar en el estudio, siempre que: hubieran estado sin dolor 24 h después del ingreso, fueran mayores de 18 años y hablaran inglés. La muestra incluyó 266 pacientes con IAM y 275 sin IAM. A todos los pacientes se les ofreció una lista de 12 palabras sensoriales y 10 afectivas, validadas en investigaciones anteriores.

Los resultados sugieren que hay poca diferencia entre las palabras utilizadas por los pacientes con o sin IAM para describir su dolor torácico, lo que puede confirmar la complejidad para obtener un diagnóstico diferencial exacto. Sin embargo, hay algunas diferencias claras entre el vocabulario utilizado por los varones y las mujeres con IAM, las mujeres se expresaban con un lenguaje más emotivo que los varones, refiriendo su dolor torácico en términos de estar “asustadas” (p < 0,05) y “aterradas” (21,1% frente a 12,1 %). La discusión presenta los aspectos metodológicos y posibles implicaciones para la práctica en el futuro.

Palabras clave:
Descriptores verbales
Descriptores sensoriales
Descriptores emotivos
Dolor torácico
Infarto agudo de miocardio
Enfermedad coronaria
Abstract

This paper discusses the findings of a two-year study, which was based in an eleven-bedded coronary care unit in the South-West of England. The study aimed to explore the difference between the verbal descriptors used by those with and without MI in order to determine their contribution in assessing patients with a suspected MI. The study also examined whether any differences existed between the words men and women with MI used to describe their chest pain symptoms.

All patients admitted with an episode of chest pain were eligible to participate providing that they were pain-free at 24 hours after admission, were over 18 years of age and could speak English. The sample comprised of 266 patients with MI and 275 without MI. All patients were offered a menu of 12 sensory and 10 afective words, which had been validated in previous research.

The results suggest that there is little difference in the words patients with and without MI use to describe their chest pain and this may reinforce the complexity in obtaining an accurate differential diagnosis. However, there are some clear differences in the vocabulary of men and women with MI. Women with MI appeared to report more emotive language than men and expressed their chest pain in terms of being “frightened” (p < 0.05) and “terrified” (21.1 % vs 12.1 %). The discussion will examine the methodological issues and possible practice implications for the future.

Key words:
Verbal descriptors
Sensory descriptors
Affective descriptors
Chest pain
Acute miocardial infarction
Coronary heart disease
Full text is only aviable in PDF
Bibliografía
[1.]
European Society of Cardiology. Acute myocardial infarction: Pre-hospital and in-hospital management.
Eur Heart J, 17 (1996), pp. 43-63
[2.]
The Stationary Office, (2000),
[3.]
E. Boersma, M.L. Simoons.
Reperfusion strategies in acute myocardial infarction.
Eur Heart J, 18 (1997), pp. 1703-1711
[4.]
C. Baignet, R. Collins, P. Appleby, S. Parish, P. Sleigh, R. Peto.
ISIS-2: 10 year survival among patients with suspected myocardial infarction in randomized comparison of intravenous streptokinase, oral aspirin, both or neither.
Br Med J, 316 (1998), pp. 1337-1343
[5.]
J. Adams, R. Trent, J. Rowles.
Earliest electrocardiographic evidence of myocardial infarction: Implications for thrombolysis treatment.
Br Med J, 307 (1993), pp. 409-413
[6.]
D.G. Julian.
Thrombolysis, the general practitioner and the electrocardiogram.
Br Heart J, 72 (1994), pp. 220-221
[7.]
Albarrán JW. Acute chest pain- Listening to your patient! Nurs Times 2001 (en prensa).
[8.]
A. Kanojia, M. Salih.
Recent advances in the evaluation of chest pain.
Br J Cardiology, 7 (2000), pp. 123-130
[9.]
R. Melzack.
The McGill pain questionnaire: Major properties and scoring methods.
Pain, 1 (1975), pp. 277-299
[10.]
R. Melzack, P.D. Wall.
Penguin, (1982),
[11.]
R. Melzack, P.D. Wall, T. Ty.
Acute pain in an emergency clinic: Latency of onset and descriptor patterns related to different injuries.
Pain, 14 (1982), pp. 33-43
[12.]
F. Gaston-Johansson.
Pain assessment: Differences in quality and intensity of the words pain, ache and hurt.
Pain, 20 (1984), pp. 69-76
[13.]
J. Latham.
Assessment, observation and measurement of pain.
Prof Nurse, January (1986), pp. 107-110
[14.]
M. Berker, B. Hughes.
Using a tool for pain assessment.
Nurs Times, 86 (1990), pp. 50-52
[15.]
B.W. Karlson, J. Herlitz, J.A. Liljekvist, P. Pettersson, P. Hallgren, U. Strombom, et al.
Prognosis in suspected acute myocardial infarction in relation to delay time between on set of symptoms and arrival to hospital.
Cardiology, 78 (1991), pp. 131-137
[16.]
J. Bleeker, M.L. Simmons, R. Erdman, C. Leenders, H. Kruyssen, L Lamers, et al.
Patient and doctor delay in acute myocardial infarction: A study in Rotterdam. The Netherlands.
Br J Gen Pract, 45 (1995), pp. 181-184
[17.]
J.G. Canto, M.G. Shlipak, W.J. Rogers, J.A. Malmgren, P.D. Frederick, C.T. Lambrew, et al.
Prevalence, clinical characteristics and mortality amongst patients with myocardial infarction presenting with chest pain.
JAMA, 238 (2000), pp. 3223-3229
[18.]
H. Meischke, Y. Yasui, A. Kuniyuki, D.J. Bowen, R. Andersen, N. Urban.
How women label and respond to symptoms of acute myocardial infarction: Responses to hypothetical scenarios.
Heart Lung, 28 (1999), pp. 261-269
[19.]
S. Penque, M. Halm, M. Smith, J. Deutsch, M. Roekel, L. McLaughlin, et al.
Women and coronary heart disease: Relationship between descriptor of signs and symptoms and diagnostic and treatment course.
Am J Crit Care, 7 (1998), pp. 175-182
[20.]
F. Gaston-Johansson, C. Hofgren, P. Watson, J. Herlitz.
Myocardial infarction pain: Systematic description and analysis.
Intens Care Nurs, 7 (1991), pp. 3-10
[21.]
C. Hofgren, B.W. Karlson, F. Gaston-Johansson, J. Herlitz.
Word descriptors in suspected myocardial infarction: A comparison of patients with and without MI.
Heart Lung, 23 (1994), pp. 397-403
[22.]
J.W. Albarrán, B. Durham, G. Chappel, J Dwight, J. Gowers.
Are manual gestures, verbal descriptors and pain radiation as reported by patients reliable indicators of myocardial infarction?- Preliminary findings and implications.
Intens Crit Care Nurs, 16 (2000), pp. 98-110
[23.]
T. Treasure.
Pain is not the only feature of the heart attack (carta.
Br Med J, 317 (1998), pp. 602-603
[24.]
A. Ruston, J. Clayton, M. Calnan.
Patients’ action during their cardiac event: Qualitative study exploring differences and modifiable factors.
Br Med J, 316 (1998), pp. 1060-1064
[25.]
J.S. Hochman, J.E. Tamis, T.D. Thompson, W.D. Weaver, H.D. White, F. Van de Werf, et al.
Sex, clinical presentation and outcome in patients with acute coronary syndromes.
N Engl J Med, 341 (1999), pp. 226-232
[26.]
W. Edmonstone.
Cardiac chest pain: Does body language help in the diagnosis?.
Br Med J, 311 (1995), pp. 1660-1661
[27.]
J.H. Pope, T. Aufderheide, R. Ruthazer, R. Woolard, J. Feldman, J. Beshanky, et al.
Missed diagnosis of acute cardiac ischaemia in the emergency department.
N Engl J Med, 342 (2000), pp. 1163-1170
[28.]
A.G. Rosenfeld, J. Gilkeson.
Meaning of illness for women with coronary heart disease.
Heart Lung, 29 (2000), pp. 105-112
[29.]
C. Mackintosh.
Non-reporting of cardiac pain.
Nurs Times, 90 (1994), pp. 36-39
[30.]
A. Alconero, S. Pérez, R. Fernández, J.M. Sola.
Registros de enfermería en la valoración del dolor en el infarto agudo de miocardio.
Enfermería en Cardiología, 17 (1999), pp. 20-24
[31.]
K.A. Kim, D.K. Moser, BJ. Garvin, B.J. Riegel, L.V. Doering, R. Jaddack, et al.
Differences between men and women in anxiety early after acute myocardial infarction.
Am J Crit Care, 9 (2000), pp. 245-253
[32.]
M. Halm, S. Penque.
Heart disease in women.
Am J Nurs, 99 (1999), pp. 26-31
[33.]
J.C. McSweeney, M. Cody, P.B. Crane.
Do you know them when you see them? Women’s prodromal and acute symptoms of myocardial infarction.
J Cardiovasc Nurs, 15 (2001), pp. 26-38
[34.]
M. Rajendra, K.L. Eagle.
Missed diagnoses of acute coronary syndromes in the emergency room-continuing challenges.
N Engl J Med, 342 (2000), pp. 1207-1210
[35.]
R.A. Cooke, N. Smeeton, J.B. Chambers.
Comparative study of chest pain characteristics in patients with normal and abnormal angiograms.
Heart, 78 (1997), pp. 142-146
Copyright © 2001. Elsevier España, S.L. y Sociedad Española de Enfermería Intensiva
Article options
Tools
es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos