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Prehospital Delay for Acute Coronary Syndrome in China

Cao, Yingjuan BMedSc, RN; Davidson, Patricia M. MEd, PhD, RN; DiGiacomo, Michelle PhD; Yang, Min MSN, RN

doi: 10.1097/JCN.0b013e3181dae42d
ARTICLES: Acute Coronary Syndrome

Background: Despite the effectiveness of timely reperfusion therapy for acute coronary syndrome, prehospital delay remains a global concern.

Objective: This article assesses the state-of-the-science regarding prehospital delay for acute coronary syndrome in China.

Method: Electronic databases and hand searching were undertaken using key words such as prehospital delay, care-seeking delay, coronary heart disease, heart disease, acute coronary syndrome, unstable angina pain, acute myocardial infarction, cardiovascular disease, chest pain, and Chin (China/Chinese). The Chinese search was supervised by a Chinese health librarian.

Results: Based on the search criteria, 28 studies were identified and reviewed using a standardized data extraction tool. Older age, attribution of symptoms to noncardiac causes, lack of health insurance coverage, poor access to transportation, and female sex were identified as contributing to prehospital delay.

Conclusion: Health system reforms in China are necessary, particularly with regard to addressing the needs of older people, women, and other vulnerable populations in the context of the rising number of people with coronary heart disease. Developing targeted strategies, learned from both national and international experience, are required to develop targeted interventions.

Yingjuan Cao, BMedSc, RN Fellow of Chinese Nursing Association, Qilu Hospital of Shandong University, P. R. China; Doctoral Candidate, Centre for Cardiovascular and Chronic Care, Curtin University of Technology, Chippendale, New South Wales, Australia.

Patricia M. Davidson, MEd, PhD, RN Professor of Cardiovascular and Chronic Care, Centre for Cardiovascular and Chronic Care, Curtin Health Innovation Research Institute, Curtin University of Technology, Chippendale, New South Wales, Australia.

Michelle DiGiacomo, PhD Postdoctoral Research Fellow, Centre for Cardiovascular and Chronic Care, Curtin Health Innovation Research Institute, Curtin University of Technology, Chippendale, New South Wales, Australia.

Min Yang, MSN, RN Fellow of Chinese Nursing Association, Professor in nursing, Masters' supervisor of Nursing School, Shandong University, and Director of Nursing, Qilu Hospital of Shandong University, P. R. China.

Corresponding author Patricia M. Davidson, MEd, PhD, RN, Centre for Cardiovascular and Chronic Care, Curtin University of Technology, Curtin House, 39 Regent St, Chippendale, New South Wales, Australia (p.davidson@curtin.edu.au).

© 2010 Lippincott Williams & Wilkins, Inc.