“Hesitating and Puzzling”: The Experiences and Decision Process of Acute Ischemic Stroke Patients with Prehospital Delay after the Onset of Symptoms
Despite campaigns to increase public awareness of stroke symptoms by advocating FAST (Face-Arms-Speech-Time), some stroke patients still show delays in the recognition of and response to stroke symptoms and miss the golden first 4.5 h to receive rt-PA (recombinant tissue plasminogen activator) treat...
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doaj-6eef10e6fdef48609c923b79de3a6bba2021-08-26T13:47:59ZengMDPI AGHealthcare2227-90322021-08-0191061106110.3390/healthcare9081061“Hesitating and Puzzling”: The Experiences and Decision Process of Acute Ischemic Stroke Patients with Prehospital Delay after the Onset of SymptomsPao-Yu Wang0Lee-Ing Tsao1Yu-Wei Chen2Ying-Tao Lo3Hui-Lin Sun4Department of Nursing, MacKay Junior College of Medicine, Nursing and Management, New Taipei City 25245, TaiwanDepartment of Nursing, National Taipei University of Nursing and Health Sciences, Taipei 112303, TaiwanDepartment of Neurology, Neuroscience Center, Landseed International Hospital, Taoyuan 324609, TaiwanDepartment of Division of Marketing Planning, Landseed International Hospital, Taoyuan 324609, TaiwanDepartment of Nursing, MacKay Junior College of Medicine, Nursing and Management, New Taipei City 25245, TaiwanDespite campaigns to increase public awareness of stroke symptoms by advocating FAST (Face-Arms-Speech-Time), some stroke patients still show delays in the recognition of and response to stroke symptoms and miss the golden first 4.5 h to receive rt-PA (recombinant tissue plasminogen activator) treatment. The aim of this study was to explore how acute ischemic stroke patients with prehospital delay seek help and undergo the decision process before arriving at the hospital. A qualitative approach using a grounded theory was applied. There were 24 ischemic stroke patients recruited by purposive sampling. Our main findings were: “Hesitating and puzzling” was the core category to describe and guide the process of acute ischemic stroke patients with prehospital delay. During the process, “Awareness the sudden change of physical sensation and/or function” was the antecedent category. In the prehospital delay experience, the following five interaction categories were identified: (1) “Self-judgment and interpretation according to previous experience,” (2) “Puzzling and doubting—it may only be a minor problem,” (3) “Self-treatment or seeking medical attention nearby,” (4) “Unexpected symptoms getting worse” needing immediate advanced medical help and (5) “Rushing to ER with different transportation—self-alerting that serious disease is coming.” Eventually, the patients “Regret to delay seeking treatment and become a disable person.” The process of prehospital delay provides some hidden cues for patients to increase their knowledge about strokes. The study emphasizes the importance of educating community residents about identifying stroke symptoms, breaking the myth of folk therapy, and seeking medical attention immediately. These results will assist healthcare providers by offering references for designing patient-centric educational strategies for preventing stroke prehospital delay to improve the quality of stroke medical care.https://www.mdpi.com/2227-9032/9/8/1061grounded theoryprehospital delayacute ischemic strokert-PA |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Pao-Yu Wang Lee-Ing Tsao Yu-Wei Chen Ying-Tao Lo Hui-Lin Sun |
spellingShingle |
Pao-Yu Wang Lee-Ing Tsao Yu-Wei Chen Ying-Tao Lo Hui-Lin Sun “Hesitating and Puzzling”: The Experiences and Decision Process of Acute Ischemic Stroke Patients with Prehospital Delay after the Onset of Symptoms Healthcare grounded theory prehospital delay acute ischemic stroke rt-PA |
author_facet |
Pao-Yu Wang Lee-Ing Tsao Yu-Wei Chen Ying-Tao Lo Hui-Lin Sun |
author_sort |
Pao-Yu Wang |
title |
“Hesitating and Puzzling”: The Experiences and Decision Process of Acute Ischemic Stroke Patients with Prehospital Delay after the Onset of Symptoms |
title_short |
“Hesitating and Puzzling”: The Experiences and Decision Process of Acute Ischemic Stroke Patients with Prehospital Delay after the Onset of Symptoms |
title_full |
“Hesitating and Puzzling”: The Experiences and Decision Process of Acute Ischemic Stroke Patients with Prehospital Delay after the Onset of Symptoms |
title_fullStr |
“Hesitating and Puzzling”: The Experiences and Decision Process of Acute Ischemic Stroke Patients with Prehospital Delay after the Onset of Symptoms |
title_full_unstemmed |
“Hesitating and Puzzling”: The Experiences and Decision Process of Acute Ischemic Stroke Patients with Prehospital Delay after the Onset of Symptoms |
title_sort |
“hesitating and puzzling”: the experiences and decision process of acute ischemic stroke patients with prehospital delay after the onset of symptoms |
publisher |
MDPI AG |
series |
Healthcare |
issn |
2227-9032 |
publishDate |
2021-08-01 |
description |
Despite campaigns to increase public awareness of stroke symptoms by advocating FAST (Face-Arms-Speech-Time), some stroke patients still show delays in the recognition of and response to stroke symptoms and miss the golden first 4.5 h to receive rt-PA (recombinant tissue plasminogen activator) treatment. The aim of this study was to explore how acute ischemic stroke patients with prehospital delay seek help and undergo the decision process before arriving at the hospital. A qualitative approach using a grounded theory was applied. There were 24 ischemic stroke patients recruited by purposive sampling. Our main findings were: “Hesitating and puzzling” was the core category to describe and guide the process of acute ischemic stroke patients with prehospital delay. During the process, “Awareness the sudden change of physical sensation and/or function” was the antecedent category. In the prehospital delay experience, the following five interaction categories were identified: (1) “Self-judgment and interpretation according to previous experience,” (2) “Puzzling and doubting—it may only be a minor problem,” (3) “Self-treatment or seeking medical attention nearby,” (4) “Unexpected symptoms getting worse” needing immediate advanced medical help and (5) “Rushing to ER with different transportation—self-alerting that serious disease is coming.” Eventually, the patients “Regret to delay seeking treatment and become a disable person.” The process of prehospital delay provides some hidden cues for patients to increase their knowledge about strokes. The study emphasizes the importance of educating community residents about identifying stroke symptoms, breaking the myth of folk therapy, and seeking medical attention immediately. These results will assist healthcare providers by offering references for designing patient-centric educational strategies for preventing stroke prehospital delay to improve the quality of stroke medical care. |
topic |
grounded theory prehospital delay acute ischemic stroke rt-PA |
url |
https://www.mdpi.com/2227-9032/9/8/1061 |
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