Why people do, or do not, immediately contact emergency medical services following the onset of acute stroke: qualitative interview study.
Why people do, or do not, immediately contact emergency medical services following the onset of acute stroke: qualitative interview study.
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DOI：
10.1371/journal.pone.0046124
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发表时间：
2012
期刊：
影响因子：
3.7
通讯作者：
White M
中科院分区：
文献类型：
--
作者：
Mackintosh JE;Murtagh MJ;Rodgers H;Thomson RG;Ford GA;White M
确定个人因中风症状而联系或延迟联系紧急医疗服务的原因。对中风患者和目击者进行有目的的定性访谈研究，根据获得医疗护理的方法和所需时间进行选择。使用框架方法分析数据。英格兰东北部三个急性中风病房所覆盖的区域。 19 名中风患者和 26 名目击者在中风症状出现后寻求帮助。影响谁拨打紧急医疗服务以及何时拨打电话的因素包括中风严重程度、人们如何理解症状以及寻求帮助的动机程度。由于担心中风的后果，包括未来的依赖性或对家庭生活的破坏、以前在医院的负面经历，或让朋友或亲戚参与决定是否接受医疗服务，所有这些都导致了延迟入院。缺乏对中风症状的了解也是一个重要的决定因素。对医疗服务范围的看法是延迟入院的主要原因，许多人认为最合适的行动是给全科医生打电话。初级保健团队对急性中风症状的反应也存在明显差异。影响寻求帮助决策的因素很复杂。仍然需要通过呼叫紧急医疗服务来提高患者、目击者和医护人员对将中风作为医疗紧急情况进行治疗的必要性的认识，以及增加患者和潜在目击者对中风症状的了解。恐惧、否认和不愿强加于人会阻碍寻求帮助的过程，需要通过适当的干预措施来具体解决。初级保健服务应对中风的方式存在差异，需要进一步调查，为干预措施提供信息，以促进最佳实践。英国临床研究网络 UKCRN 6590
To identify the reasons why individuals contact, or delay contacting, emergency medical services in response to stroke symptoms. Qualitative interview study with a purposive sample of stroke patients and witnesses, selected according to method of accessing medical care and the time taken to do so. Data were analysed using the Framework approach. Area covered by three acute stroke units in the north east of England. Nineteen stroke patients and 26 witnesses who had called for help following the onset of stroke symptoms. Factors influencing who called emergency medical services and when they called included stroke severity, how people made sense of symptoms and their level of motivation to seek help. Fear of the consequences of stroke, including future dependence or disruption to family life, previous negative experience of hospitals, or involving a friend or relations in the decision to access medical services, all resulted in delayed admission. Lack of knowledge of stroke symptoms was also an important determinant. Perceptions of the remit of medical services were a major cause of delays in admission, with many people believing the most appropriate action was to telephone their GP. Variations in the response of primary care teams to acute stroke symptoms were also evident. The factors influencing help-seeking decisions are complex. There remains a need to improve recognition by patients, witnesses and health care staff of the need to treat stroke as a medical emergency by calling emergency medical services, as well as increasing knowledge of symptoms of stroke among patients and potential witnesses. Fear, denial and reticence to impose on others hinders the process of seeking help and will need addressing specifically with appropriate interventions. Variability in how primary care services respond to stroke needs further investigation to inform interventions to promote best practice. UK Clinical Research Network UKCRN 6590
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