Response to symptoms of stroke in the UK: a systematic review
Response to symptoms of stroke in the UK: a systematic review
复制标题
DOI：
10.1186/1472-6963-10-157
复制
发表时间：
2010-06-08
影响因子：
2.8
通讯作者：
Rodgers, Helen
中科院分区：
文献类型：
--
作者：
Lecouturier, Jan;Murtagh, Madeleine J.;Rodgers, Helen
背景资料：英国国家卒中战略建议，有必要改善患者和目击者对急性卒中症状的反应，以增加快速获得专科护理的机会。我们希望回顾有关中风患者、目击者和公众对中风症状的知识、态度和行为的证据基础，以及在症状发作时紧急反应的必要性。方法：我们对英国报告实证研究的文章进行了系统回顾，这些研究涉及a）对急性卒中或TIA症状的认识和反应，以及B）对诊断的信念和态度，急性中风或TIA的早期治疗和后果。使用稳健的检索策略检索了9个电子数据库。引文和摘要由两名评审员独立筛选。结果：7144篇引文中有11篇符合纳入标准。收集资料的方法包括：邮寄调查（n = 2），访谈调查（n = 6），审查医院文件（n = 2）和定性访谈（n = 1）。有限的数据显示，对两种最常见的中风症状（单侧无力和言语障碍）以及普通公众和高危患者的紧急反应需求的了解程度很高。尽管如此，只有不到一半的患者承认他们患有中风。症状识别并没有减少出现的时间。对于大多数人来说，医疗援助的第一个接触点是一个全科医生。结论：有一个假设，在英国，公众知识的中风症状和需要紧急应对是缺乏的，但很少有发表的研究来支持这一点。因此，提高公众意识以改善对中风症状的反应的运动可能不会增加期望的行为。需要进一步的研究来了解为什么经历或目睹中风症状的人经常不打电话给急救服务。
Background: The English National Stroke Strategy suggests that there is a need to improve the response of patients and witnesses to the symptoms of acute stroke to increase rapid access to specialist care. We wished to review the evidence base regarding the knowledge, attitudes and behaviours of stroke patients, witnesses and the public to the symptoms of stroke and the need for an urgent response at the onset of symptoms.Methods: We conducted a systematic review of UK articles reporting empirical research on a) awareness of and response to the symptoms of acute stroke or TIA, and b) beliefs and attitudes about diagnosis, early treatment and consequences of acute stroke or TIA. Nine electronic databases were searched using a robust search strategy. Citations and abstracts were screened independently by two reviewers. Data were extracted by two researchers independently using agreed criteria.Results: 11 studies out of 7144 citations met the inclusion criteria. Methods of data collection included: postal survey (n = 2); interview survey (n = 6); review of hospital documentation (n = 2) and qualitative interviews (n = 1). Limited data reveal a good level of knowledge of the two commonest stroke symptoms (unilateral weakness and speech disturbance), and of the need for an emergency response among the general public and at risk patients. Despite this, less than half of patients recognised they had suffered a stroke. Symptom recognition did not reduce time to presentation. For the majority, the first point of contact for medical assistance was a general practitioner.Conclusions: There is an assumption that, in the UK, public knowledge of the symptoms of stroke and of the need for an emergency response is lacking, but there is little published research to support this. Public awareness raising campaigns to improve response to the symptoms of stroke therefore may not produce an increase in desired behaviours. Further research is needed to understand why people who experience or witness stroke symptoms frequently do not call emergency services.