Abstract:
Background and Purpose: Campaigns within Australia
and internationally have sought to increase awareness
of the emergent nature of stroke. For these initiatives to
be effective it is important to gather information about
delay in seeking treatment and the reasons given for the
delay by people with stroke. The purpose of this study
was to examine delay in seeking treatment in people
with an evolving stroke or TIA and identify clinical, behavioral
and demographic factors that contributed to the
delay. Subjects and Methods: During a l-year period 150
participants were given the Response to Stroke Symptoms
Questionnaire. The six domains included in the
questionnaire were: (1) context in which the stroke occurred;
(2) antecedents to symptoms; (3) affective response
to symptoms; (4) behavioral response to symptoms;
(5) cognitive response to symptoms; (6) the
response of others to patient symptoms. Results: The
median delay time from symptom onset to admission to
hospital was 4.5 h. While 41% of participants delayed
less than 3 h, more than 45% delayed greater than 6 h.
Independent predictors of delay time included mode of
arrival at hospital with those taking an ambulance having a median delay time of 2.7 h vs. 15.4 h for those arriving
by private car (p = 0.04). Gender also predicted
delay with women delaying longer (p = 0.001). The first
response of others was also an independent predictor of
delay time (p = 0.003) with those who called the emergency
services number or took the patient to hospital
resulting in the shortest patient delays. Finally, if the patient
appraised their symptoms as serious they had a
shorter delay time (p = 0.02). Conclusions: The message
about the emergent nature of stroke may be helping to
improve delay times. However, there are still many people
who delay greater than 3 h after symptom onset. It
is important to direct education programs to those with
known risk factors for stroke and their families, who often
make the decision to call an ambulance.
