ABSTRACT
PURPOSE: This cross-sectional survey research was undertaken to identify the factors influencing time from onset to hospital arrival of stroke patients and to provide basic information for the development of intervention programs for stroke patients. METHODS: The data were collected using a convenient sampling method from three hospitals in Inchon. The subjects were 78 patients who were diagnosed as stroke by doctor and they voluntarily participated in the study. RESULTS: On the average, subjects arrived at the hospitals by 16.72 hours after the onset of stroke events with the range from 0.17 hours to 72 hours. Thirty-four(43.6%) subjects arrived within 3 hours which can maximize treatment effects. There was significant difference in hospital presentation time according to the level of knowledge(chi-square=18.629, p=.0003). A negative correlation was found between the hospital presentation time and self-efficacy (r= -.320, p=.004). Stepwise multiple regression analysis revealed that the most powerful predictor was self-efficacy. Self-efficacy, the level of knowledge and physical symptoms were significant factors and accounted for 21.7% of the variance of hospital presentation time in stroke patients. CONCLUSION: According to the results, self-efficacy is a useful concept for reducing the hospital presentation time from onset of attack in stroke patients. Therefore, nurses should consider educational programs which include not only a knowledge of stroke and recurrence prevention but also the concept of self-efficacy.
Subject(s)
Humans , Cross-Sectional Studies , Recurrence , StrokeABSTRACT
BACKGROUND: Recent advances in stroke therapies require patients to be treated very early after the onset of symptoms. To reduce the delay in time upon stroke and arriving at the hospital, we assessed the time delay, stroke recognition, and awareness before and after a public education program designed to increase recognition and awareness. METHODS: Prospective standardized and structured interviews were performed in 155 patients with ischemic stroke who were admitted to the Severance hospital before and after the public education program. The educational program included local newspaper articles, distribution of pamphlets, and lectures to 119 emergency care teams. Time delay, variable factors, stroke recognition, and stroke awareness of patients were then assessed (75 pre-education and 80 post-education groups). RESULTS: 52% of the pre-education group and 52.5% of the post-education group arrived at the hospital within 24 hours. Those who arrived within 3 hours were only 21.3% and 15% respectively. A direct visit to the hospital and a cardioembolic infarction appeared to be associated with a shorter time delay. About half of the patients recognized their symptoms as a stroke before a diagnosis was made by a doctor. Most of them had known that a stroke should be treated urgently. However, the stroke recognition and awareness was not associated with an early arrival, which suggests that their knowledge was not solid. The efforts to inform the public using local newspaper articles and pamphlets geared towards the local residents for the limited time period was not effective in shortening arrival times. CONCLUSIONS: Many of the stroke patients did not arrive within the therapeutic time window. Our findings suggest that extensive and multi-directional campaigns should be performed to reduce the time delay. Our findings also suggest that educational aims should include the need for the rapid treatment of stroke and a therapeutic time window as well as stroke recognition.