Dombrowski Stephan U, Ford Gary A, Morgenstern Lewis B, White Martin, Sniehotta Falko F, Mackintosh Joan E, Gellert Paul, Skolarus Lesli E
From the Division of Psychology, School of Natural Sciences, University of Stirling, Stirling, UK (S.U.D.); Institute for Ageing & Health (G.A.F.) and Institute of Health & Society (M.W., F.F.S., J.E.M.), Newcastle University, Newcastle upon Tyne, UK; Medical Sciences Division, University of Oxford, John Radcliffe Hospital, Oxford, UK (G.A.F.); Stroke Program, Department of Neurology, University of Michigan (L.B.M., L.E.S.); Centre for Diet & Activity Research (CEDAR), MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, UK (M.W.); Fuse, UKCRC Centre for Translation Research in Public Health, Newcastle University, Newcastle upon Tyne, UK (F.F.S.); and Institute of Medical Sociology, Charité-Universitätsmedizin Berlin, Berlin, Germany (P.G.).
Stroke. 2015 Nov;46(11):3220-5. doi: 10.1161/STROKEAHA.115.009997. Epub 2015 Sep 29.
Although time-dependent treatment is available, most people delay contacting emergency medical services for stroke. Given differences in the healthcare system and public health campaigns, exploring between-country differences in stroke preparedness may identify novel ways to increase acute stroke treatment.
A survey was mailed to population-based samples in Ingham County, Michigan, US (n=2500), and Newcastle upon Tyne, UK (n=2500). Surveys included stroke perceptions and stroke/nonstroke scenarios to assess recognition and response to stroke. Between-country differences and associations with stroke preparedness were examined using t tests and linear mixed models.
Overall response rate was 27.4%. The mean age of participants was 55 years, and 58% were female. US participants were better in recognizing stroke (70% versus 63%, d=0.27) and were more likely to call emergency medical services (55% versus 52%, d=0.11). After controlling for demographics and comorbidities, US participants remained more likely to recognize stroke but were not more likely to respond appropriately. A greater belief that medical treatment can help with stroke and understanding of stroke was associated with improved stroke recognition and response.
Overall, stroke recognition and response were moderate. US participants were modestly better at recognizing stroke, although there was little difference in response to stroke. Future stroke awareness interventions could focus more on stroke outcome expectations and developing a greater understanding of stroke among the public.
尽管有时间依赖性治疗方法,但大多数人在中风时会延迟联系紧急医疗服务。鉴于医疗保健系统和公共卫生运动的差异,探索不同国家之间中风准备情况的差异可能会找到增加急性中风治疗的新方法。
向美国密歇根州英厄姆县(n = 2500)和英国泰恩河畔纽卡斯尔(n = 2500)的基于人群的样本邮寄了一份调查问卷。调查包括中风认知以及中风/非中风情景,以评估对中风的识别和反应。使用t检验和线性混合模型检查国家之间的差异以及与中风准备情况的关联。
总体回复率为27.4%。参与者的平均年龄为55岁,58%为女性。美国参与者在识别中风方面表现更好(70%对63%,d = 0.27),并且更有可能拨打紧急医疗服务电话(55%对52%,d = 0.11)。在控制了人口统计学和合并症后,美国参与者仍然更有可能识别中风,但没有更有可能做出适当反应。更相信医疗治疗对中风有帮助以及对中风的了解与改善中风识别和反应有关。
总体而言,中风识别和反应处于中等水平。美国参与者在识别中风方面略胜一筹,尽管在对中风的反应方面差异不大。未来的中风意识干预措施可以更多地关注中风结果期望,并在公众中培养对中风的更深入理解。