Abstract
BackgroundPatients with acute stroke often do not seek immediate medical help, which is assumed to be driven by lack of knowledge of stroke symptoms. We explored the process of help seeking behavior in patients with acute stroke, evaluating knowledge about stroke symptoms, socio-demographic and clinical characteristics, and onset-to-alarm time (OAT).MethodsIn a sub-study of the Preventive Antibiotics in Stroke Study (PASS), 161 acute stroke patients were prospectively included in 3 Dutch hospitals. A semi-structured questionnaire was used to assess knowledge, recognition and interpretation of stroke symptoms. With in-depth interviews, response actions and reasons were explored. OAT was recorded and associations with socio-demographic, clinical parameters were assessed.ResultsKnowledge about stroke symptoms does not always result in correct recognition of own stroke symptoms, neither into correct interpretation of the situation and subsequent action. In our study population of 161 patients with acute stroke, median OAT was 30 min (interquartile range [IQR] 10–150 min). Recognition of one-sided weakness and/or sensory loss (p = 0.046) and adequate interpretation of the stroke situation (p = 0.003), stroke at daytime (p = 0.002), severe stroke (p = 0.003), calling the emergency telephone number (p = 0.004), and transport by ambulance (p = 0.040) were associated with shorter OAT.ConclusionHelp seeking behavior after acute stroke is a complex process. A shorter OAT after stroke is associated with correct recognition of one-sided weakness and/or sensory loss, adequate interpretation of the stroke situation by the patient and stroke characteristics and logistics of stroke care, but not by knowledge of stroke symptoms.Electronic supplementary materialThe online version of this article (doi:10.1186/s12883-016-0749-2) contains supplementary material, which is available to authorized users.
Highlights
Patients with acute stroke often do not seek immediate medical help, which is assumed to be driven by lack of knowledge of stroke symptoms
We explored the process of help seeking behavior in patients with acute stroke, evaluating knowledge about
The majority of patients had a cerebral infarction (90%) and stroke severity was relatively mild with a median National Institutes of Health Stroke Scale (NIHSS) score of 4 (IQR 3–6)
Summary
Patients with acute stroke often do not seek immediate medical help, which is assumed to be driven by lack of knowledge of stroke symptoms. We explored the process of help seeking behavior in patients with acute stroke, evaluating knowledge about stroke symptoms, socio-demographic and clinical characteristics, and onset-to-alarm time (OAT). Many patients with acute stroke do not seek immediate medical help [3, 4]. This knowledge has prompted several public campaigns to increase public. Other factors of importance in the process of help seeking are age, stroke severity and ethnicity [10,11,12]. We explored the process of help seeking behavior in patients with acute stroke, evaluating knowledge about
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