Abstract 11404: Delayed Hospital Arrival Among Women With Acute Ischemic Stroke: Cognitive and Behavioral Responses to Symptoms
Background: Delay seeking medical assistance for acute ischemic stroke (AIS) remains a barrier to the provision of optimal care, including the administration of thrombolytic therapy. Although women report greater knowledge of stroke symptoms and stroke risk factors than men, earlier hospital arrival for women has not been consistently reported. Few studies have focused on women’s responses to AIS onset.
Objective: The purpose of this study was to examine women’s interpretation of and responses to the onset of AIS. Cognitive and behavioral responses to stroke symptoms were compared between women who arrived at the hospital within three hours of symptom onset and women with an arrival time greater than three hours.
Methods: The study utilized a comparative descriptive design. Women age 18 years and older (N = 80) with a diagnosis of AIS were interviewed in a large medical center in the southwestern United States using a questionnaire developed for this study. Data were analyzed using descriptive statistics and fisher exact test. The study was guided by the common sense model of illness representations. IRB approval was obtained.
Results: The majority of participants (56%) were African American. More than half of the participants (55%) arrived at the hospital greater than three hours after first noticing symptoms. Trouble speaking or understanding was attributed to stroke by one-third of the women who had this symptom, which was the symptom with the highest correct symptom attribution. The majority (71%) of participants were unaware of a treatment for stroke. Almost all participants reported stroke risk factors and one-quarter of participants felt at risk for stroke. Women with an arrival time greater than three hours reported self-medicating (p = .03), resting (p <.001), continuing usual activities (p <.001), hiding symptoms from other people (p = .01) and not wanting to trouble other people (p <.001) more often than women with earlier arrival.
Conclusion: The majority of women in this study did not recognize symptoms as due to stroke and were unaware of a treatment for AIS. Cognitive and behavioral responses to stroke onset that could lengthen arrival time were more frequent among women with later arrival.
- © 2013 by American Heart Association, Inc.