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Decision‐Making in Seeking Emergency Care for Stroke Symptoms
Department of Molecular and Clinical Medicine Sahlgrenska Academy University of Gothenburg Gothenburg Sweden;Region Västra Götaland Department of Medicine Geriatrics and Emergency Medicine/Östra Sahlgrenska University Hospital Gothenburg (SWE).
Institute of Health and Care Sciences Sahlgrenska Academy University of Gothenburg Gothenburg (SWE).
University West, Department of Health Sciences, Section for nursing - graduate level. Skaraborgs Hospital Skövde (SWE). (LOV)ORCID iD: 0000-0002-6454-9575
Department of Molecular and Clinical Medicine Sahlgrenska Academy University of Gothenburg Gothenburg Sweden;Region Västra Götaland Department of Medicine Geriatrics and Emergency Medicine/Östra Sahlgrenska University Hospital Gothenburg (SWE).
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2022 (English)In: Stroke: Vascular and Interventional Neurology, E-ISSN 2694-5746, Vol. 2, no 6Article in journal (Refereed) Published
Abstract [en]

Background

Previous studies have shown that rapid treatment for stroke, especially ischemic stroke, reduces mortality and disability. The focus has mainly been on reducing time from arrival at hospital to start of treatment. However, the main reason for delay is often time from symptom onset to arrival at hospital. This study therefore aimed to explore decision‐making processes after the onset of stroke symptoms in patients experiencing a first‐time stroke.

Methods

We included 36 patients aged 18 and older, all of whom were hospitalized with a first‐time stroke between October 2018 and April 2020. All patients were interviewed once within 4 weeks of symptom onset and before hospital discharge. Eligible patients were identified retrospectively through a targeted review of medical records. The data were collected and analyzed according to the grounded theory methodology.

Results

In total, 43 potential patients were identified and asked to participate. Overall, 36 patients were included in the study: 17 women (median age 77.0 years, interquartile range 17.5) and 19 men (median age 65.7 years, interquartile range 17.2). All interviewees felt fear, and this affected their decision to seek emergency care. The decision‐making processes were described by the core category of “Acting on fear.” The reason for feeling frightened determined the actions taken. The reasons were sorted into 3 main categories: (1) “seeking care”–recognized stroke symptoms and acted immediately; (2) “pending and reluctance”–suspected stroke but awaited to seek care; and (3) “seeking an explanation”–confused by symptoms.

Conclusion

We found that decision‐making when experiencing stroke symptoms was complex. All patients felt fear, which determined their actions. Some patients knew about stroke symptoms and acted immediately. Others suspected stroke but still chose to wait, whereas others were confused and tried to find answers. These results could contribute to form future awareness campaigns.

Place, publisher, year, edition, pages
2022. Vol. 2, no 6
Keywords [en]
decision‐making, grounded theory, prehospital delay, qualitative methodology, stroke symptoms
National Category
Nursing
Research subject
NURSING AND PUBLIC HEALTH SCIENCE, Nursing science
Identifiers
URN: urn:nbn:se:hv:diva-19711DOI: 10.1161/svin.122.000376ISI: 001156574700016OAI: oai:DiVA.org:hv-19711DiVA, id: diva2:1740511
Available from: 2023-03-01 Created: 2023-03-01 Last updated: 2024-04-26

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Rejnö, Åsa

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