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Decisions and Delays Within Stroke Patients' Route to the Hospital: A Qualitative Study

Mellor, R, Bailey, S, Sheppard, J, Carr, P, Quinn, T, Boyal, R, Sandler, D, Sims, D, Mant, J, Greenfield, S and McManus, R (2014) Decisions and Delays Within Stroke Patients' Route to the Hospital: A Qualitative Study Annals of Emergency Medicine.

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Abstract

STUDY OBJECTIVE: We examine acute stroke patients' decisions and delays en route to the hospital after onset of symptoms. METHODS: This was a qualitative study carried out in the West Midlands, United Kingdom. Semistructured interviews were conducted with 30 patients (6 accompanied by partners). Patients were asked about their previous experience of having had a stroke and their initial engagement with health services. "One sheet of paper" and thematic analyses were used. RESULTS: Three potential types of delay were identified from onset of symptoms to accessing stroke care in the hospital: primary delays caused by lack of recognition of symptoms or not dealing with symptoms immediately, secondary delays caused by initial contact with nonemergency services, and tertiary delays in which health service providers did not interpret the patients' presenting symptoms as suggestive of stroke. The main factors determining the speed of action by patients were the presence and influence of a bystander and the perceived seriousness of symptoms. CONCLUSION: Despite campaigns to increase public awareness of stroke symptoms, the behavior of both patients and health service providers apparently led to delays in the recognition of and response to stroke symptoms, potentially reducing access to optimum and timely acute specialist assessment and treatment for acute stroke.

Item Type: Article
Divisions : Faculty of Health and Medical Sciences
Authors :
AuthorsEmailORCID
Mellor, RUNSPECIFIEDUNSPECIFIED
Bailey, SUNSPECIFIEDUNSPECIFIED
Sheppard, JUNSPECIFIEDUNSPECIFIED
Carr, PUNSPECIFIEDUNSPECIFIED
Quinn, TUNSPECIFIEDUNSPECIFIED
Boyal, RUNSPECIFIEDUNSPECIFIED
Sandler, DUNSPECIFIEDUNSPECIFIED
Sims, DUNSPECIFIEDUNSPECIFIED
Mant, JUNSPECIFIEDUNSPECIFIED
Greenfield, SUNSPECIFIEDUNSPECIFIED
McManus, RUNSPECIFIEDUNSPECIFIED
Date : 15 November 2014
Identification Number : 10.1016/j.annemergmed.2014.10.018
Additional Information : NOTICE: this is the author’s version of a work that was accepted for publication in Annals of Emergency Medicine. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Annals of Emergency Medicine, November 2014, DOI 10.1016/j.annemergmed.2014.10.018.
Depositing User : Symplectic Elements
Date Deposited : 17 Dec 2014 09:23
Last Modified : 17 Dec 2014 14:33
URI: http://epubs.surrey.ac.uk/id/eprint/806897

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