University of Twente Student Theses


Onderzoek naar de determinanten die de keuze voor een keteningang bepalen bij patiënten met een acuut coronair syndroom

Bentum, S.B. and Hendriks, J.N. (2016) Onderzoek naar de determinanten die de keuze voor een keteningang bepalen bij patiënten met een acuut coronair syndroom.

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Abstract:Background: Patients with an acute coronary syndrome (ACS) must receive treatment as soon as possible to prevent or limit damage of the heart. Patients with an ACS can choose one of the six possible healthcare providers prior to hospital arrival. The shortest time between seeking medical help and treatment in the hospital is achieved when a patient chooses to directly call for an ambulance. The aim of this study was to find factors that influence the choice for one of the healthcare providers. Methods: This quantitative, exploratory study included patients with an ACS who chose a particular health care provider when decided they needed care. Data was retrieved by means of a questionnaire completed by these patients and by hospital registries. A statistical analysis was executed in order to describe the results and test for significance. Results: Sixty-eight patients arrived at the hospital through five different paths. The general practitioner was most used as first contacted health care provider (43%). The decision for a first contacted health care provider is influenced by several factors. Clinical factors, the onset of symptoms (p<0,05) and the occurrence of pain (p<0,05), were of influence. A fast onset ACS and acute pain made patients choose for an ambulance more often. A significant influence was found with the day of the week (p=0,01) and moment of the day (p=0,01). This influence is caused by the organization (opening hours) of the health care providers in the Netherlands. Furthermore, the degree of perceived severity had influence. Patients that indicated their symptoms as severe and estimated they would need hospital care were more likely to call an ambulance (p<0,05 and p=0,01). Also, the beliefs of the patient, namely the belief that the GP knows best what the patient needs, showed significant influence (p=0,01). Finally, a significant influence was found with the presence of bystanders (p<0,05). Patients were more likely to choose the emergency department or the use of an ambulance when in presence of bystanders. Conclusion: Factors that influence the choice of a health care provider are clinical factors, situational factors, perceived severity, beliefs and the presence of bystanders. For the prevention of prehospital delay it is important that the perceived severity and beliefs of the patient fit with the health care that the patient actually needs. Keywords: Acute coronary syndrome, Prehospital paths, Prehospital delay, Decision-making
Item Type:Essay (Bachelor)
Faculty:TNW: Science and Technology
Subject:44 medicine, 70 social sciences in general, 77 psychology
Programme:Health Sciences BSc (56553)
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