Emergency department patients’ self-perceived medical severity and urgency of care: The role of health literacy, stress and coping

IF 1.8 4区医学 Q2 NURSING

International Emergency Nursing Pub Date : 2025-03-11 DOI:10.1016/j.ienj.2025.101599

Amanda McIntyre , Richard Booth , Lisa Shepherd , Mickey Kerr

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引用次数: 0

Abstract

Objectives

This study aimed to (1) compare the agreement between triage acuity and emergency department (ED) patients’ self-perceived medical severity and urgency, and (2) examine how health literacy, stress, and coping relate to patients’ perceptions of medical need and urgency.

Methods

In this cross-sectional, observational study, 171 patients from a large acute care teaching hospital in Southwestern Ontario were recruited in autumn 2020. English-speaking adults (18 + years) with Canadian Triage Acuity Scale (CTAS) scores from 2 (emergent) to 5 (non-urgent) were included. Patients completed surveys on stress (Perceived Stress Scale), coping (Brief Coping with Problems Experienced), and health literacy (Health Literacy Questionnaire). Electronic medical records linked ED utilization data with patient-reported data. Agreement between CTAS and patients’ self-assessed severity and urgency was analyzed using crosstabs and Cohen’s kappa.

Results

A total of 171 patients were recruited. There were no significant differences between ED patients with varying triage acuities and stress, coping, or health literacy levels. Cohen’s kappa statistics showed poor agreement between triage nurse-assigned scores and patients’ self-perceived medical severity and urgency of care. Those who overestimated were younger, single, had low medical acuity (CTAS 4/5), and lower understanding of how to navigate the health care system. Conversely, those who underestimated were older, married, and had high medical acuity (CTAS 2).

Conclusions

Future studies should focus on exploring the underlying factors (e.g., sociodemographic variables, clinical health information, and other personal attributes) contributing to discrepancies between patient-perceived severity and triage assessments in a larger, more representative sample.

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急诊科患者自我感知的医疗严重程度和护理紧迫性：健康素养、压力和应对的作用

目的本研究旨在(1)比较分诊敏锐度与急诊科（ED）患者自我感知的医疗严重程度和紧迫性之间的一致性；(2)研究健康素养、压力和应对与患者对医疗需求和紧迫性的感知之间的关系。方法在这项横断面观察性研究中，于2020年秋季从安大略省西南部一家大型急症护理教学医院招募了171名患者。英语成年人（18岁以上），加拿大分诊敏锐度量表（CTAS）评分从2（紧急）到5（非紧急）。患者完成压力感知量表（Perceived stress Scale）、应对问卷（Brief coping with Problems experience）和健康素养问卷（health literacy Questionnaire）的调查。电子医疗记录将急诊科的使用数据与患者报告的数据联系起来。使用交叉表和Cohen ' s kappa分析CTAS与患者自我评估的严重程度和紧迫性之间的一致性。结果共纳入患者171例。不同分诊敏锐度、压力、应对或健康素养水平的ED患者之间没有显著差异。科恩的kappa统计数据显示，分诊护士分配的分数与患者自我感知的医疗严重程度和护理紧迫性之间的一致性很差。那些被高估的人年轻，单身，医疗敏锐度低（CTAS 4/5），对如何驾驭医疗保健系统的理解较低。相反，那些被低估的人年龄较大，已婚，并且具有较高的医疗敏锐度（CTAS 2）。结论未来的研究应侧重于探索潜在因素（例如，社会人口学变量，临床健康信息和其他个人属性），在更大，更具代表性的样本中，导致患者感知的严重程度和分诊评估之间的差异。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Emergency Nursing NURSING-

CiteScore

3.20

自引率

11.10%

发文量

期刊介绍： International Emergency Nursing is a peer-reviewed journal devoted to nurses and other professionals involved in emergency care. It aims to promote excellence through dissemination of high quality research findings, specialist knowledge and discussion of professional issues that reflect the diversity of this field. With an international readership and authorship, it provides a platform for practitioners worldwide to communicate and enhance the evidence-base of emergency care. The journal publishes a broad range of papers, from personal reflection to primary research findings, created by first-time through to reputable authors from a number of disciplines. It brings together research from practice, education, theory, and operational management, relevant to all levels of staff working in emergency care settings worldwide.