PDF(Pubmed)
Abstract：
UNASSIGNED: Early diagnosis and continuity of care is vital for atrial fibrillation (AF), to reduce stroke ; There is a lack of understanding of when and how AF is being diagnosed and managed the care pathway) in in low- and middle-income countries (LMICs). We aimed to identify the AF care pathway in Northern Province, Sri Lanka and determine how the COVID-19 pandemic impacted the care pathway.
UNASSIGNED: This descriptive longitudinal study utilised two quantitative questionnaires to evaluate the AF pathway: The first questionnaire (baseline) was used to identify where AF was being diagnosed and the second questionnaire (3 months following baseline) was used to identify where and how often AF follow-up care was being received. How the COVID-19 pandemic impacted the care pathway was asked in the second questionnaire. We aimed to recruit 236 adults (≥18 years) with AF from Jaffna Teaching Hospital. Data were collected between October 2020 and June 2021 and analysed using descriptive statistics.
UNASSIGNED: 151 participants were recruited (median age 57 years; 70% female). Most participants were diagnosed in the accident & emergency (38%) or inpatient department (26%), followed by an outpatient department (19%) or private facility (16%). Nearly all (97%) participants received follow-up care during the study period, with an average of 1.3 AF-related healthcare visits per person for a month; most visited an outpatient department (88%). The COVID-19 pandemic negatively impacted 39% of participants\' care: healthcare visits were reduced or, delayed or medications were unattainable, and longer intervals between blood tests were experienced; however, 24% of participants were able to receive their medication by ambulance, public health staff or post during lockdowns.
UNASSIGNED: Primary care was not involved in the diagnosis of AF, indicating that most diagnoses occurr after a medical emergency. The frequency of blood tests was lower than the guideline recommendations of one per month which could in-part be due to the adverse impacts of the pandemic. Strengthening primary and community-based care may enable early diagnosis and improve continuity of care during and beyond future healthcare crises.
UNASSIGNED: This descriptive longitudinal study utilised two quantitative questionnaires to evaluate the AF pathway: The first questionnaire (baseline) was used to identify where AF was being diagnosed and the second questionnaire (3 months following baseline) was used to identify where and how often AF follow-up care was being received. How the COVID-19 pandemic impacted the care pathway was asked in the second questionnaire. We aimed to recruit 236 adults (≥18 years) with AF from Jaffna Teaching Hospital. Data were collected between October 2020 and June 2021 and analysed using descriptive statistics.
UNASSIGNED: 151 participants were recruited (median age 57 years; 70% female). Most participants were diagnosed in the accident & emergency (38%) or inpatient department (26%), followed by an outpatient department (19%) or private facility (16%). Nearly all (97%) participants received follow-up care during the study period, with an average of 1.3 AF-related healthcare visits per person for a month; most visited an outpatient department (88%). The COVID-19 pandemic negatively impacted 39% of participants\' care: healthcare visits were reduced or, delayed or medications were unattainable, and longer intervals between blood tests were experienced; however, 24% of participants were able to receive their medication by ambulance, public health staff or post during lockdowns.
UNASSIGNED: Primary care was not involved in the diagnosis of AF, indicating that most diagnoses occurr after a medical emergency. The frequency of blood tests was lower than the guideline recommendations of one per month which could in-part be due to the adverse impacts of the pandemic. Strengthening primary and community-based care may enable early diagnosis and improve continuity of care during and beyond future healthcare crises.
摘要：
■早期诊断和护理的连续性对于心房颤动（AF）至关重要，减少中风；在低收入和中等收入国家（LMICs），人们对何时以及如何诊断和管理房颤的护理途径缺乏了解。我们旨在确定北部省份的房颤护理途径，斯里兰卡并确定COVID-19大流行如何影响护理途径。
■本描述性纵向研究使用两份定量问卷来评估房颤途径：第一份问卷（基线）用于确定房颤的诊断位置，第二份问卷（基线后3个月）用于确定房颤后续护理的位置和频率。第二份问卷中询问了COVID-19大流行如何影响护理途径。我们的目标是从Jaffna教学医院招募236名患有房颤的成年人(≥18岁)。数据收集于2020年10月至2021年6月之间，并使用描述性统计分析。
■招募了151名参与者（平均年龄57岁；70%为女性）。大多数参与者在事故和急诊（38％）或住院部门（26％）被诊断出，其次是门诊部(19%)或私人机构(16%)。在研究期间，几乎所有（97％）的参与者都接受了后续护理，每月平均每人1.3次与AF相关的医疗保健访问;大多数访问门诊部(88%)。COVID-19大流行对39%的参与者的护理产生了负面影响：医疗保健访问减少或，延迟或药物无法实现，血液测试之间的间隔时间较长；然而，24%的参与者能够通过救护车接受药物治疗，公共卫生人员或封锁期间的岗位。
■初级护理未参与房颤的诊断，表明大多数诊断发生在医疗紧急情况之后。血液检查的频率低于每月一次的指南建议，这可能部分是由于大流行的不利影响。加强初级和社区护理可以在未来的医疗保健危机期间和之后进行早期诊断并改善护理的连续性。
■本描述性纵向研究使用两份定量问卷来评估房颤途径：第一份问卷（基线）用于确定房颤的诊断位置，第二份问卷（基线后3个月）用于确定房颤后续护理的位置和频率。第二份问卷中询问了COVID-19大流行如何影响护理途径。我们的目标是从Jaffna教学医院招募236名患有房颤的成年人(≥18岁)。数据收集于2020年10月至2021年6月之间，并使用描述性统计分析。
■招募了151名参与者（平均年龄57岁；70%为女性）。大多数参与者在事故和急诊（38％）或住院部门（26％）被诊断出，其次是门诊部(19%)或私人机构(16%)。在研究期间，几乎所有（97％）的参与者都接受了后续护理，每月平均每人1.3次与AF相关的医疗保健访问;大多数访问门诊部(88%)。COVID-19大流行对39%的参与者的护理产生了负面影响：医疗保健访问减少或，延迟或药物无法实现，血液测试之间的间隔时间较长；然而，24%的参与者能够通过救护车接受药物治疗，公共卫生人员或封锁期间的岗位。
■初级护理未参与房颤的诊断，表明大多数诊断发生在医疗紧急情况之后。血液检查的频率低于每月一次的指南建议，这可能部分是由于大流行的不利影响。加强初级和社区护理可以在未来的医疗保健危机期间和之后进行早期诊断并改善护理的连续性。
