Shin Cha-Nam, An Kyungeh, Sim Jeongha
College of Nursing and Health Innovation, Arizona State University, 500 N. Third St., Phoenix, AZ 85004, United States.
College of Nursing, Virginia Commonwealth University, 1100 E. Leigh St., Richmond, VA, United States.
Int J Nurs Sci. 2016 Dec 26;4(1):52-57. doi: 10.1016/j.ijnss.2016.12.008. eCollection 2017 Jan 10.
The objective of the study was to identify facilitators and barriers to emergency medical service use among acute ischemic stroke patients in Korea.
This paper presents a secondary analysis of a retrospective survey that collected data from questionnaires and medical records. Among 233 acute ischemic stroke patients enrolled in a large-scale study, 160 patients who had arrived at a hospital within 72 h after symptom onset were included in the data analysis.
Users of emergency medical services needed a shorter time than non-users to arrive at hospital (140 min vs. 625 min., = 0.001) and were more likely to arrive at hospital within 3 h of symptom onset (51.9% vs. 31.5%, = 0.013). For those who first contacted emergency medical service, the facilitators of emergency medical service use were the presence of hemiparesis ( = 0.003), bilateral paralysis ( = 0.040), and loss of balance ( = 0.021). The predominant barrier was the failure to recognize the urgency of symptoms ( = 0.006).
The use of emergency medical services reduced prehospital delay and increased the likelihood of patient arrival at hospital within 3 h. Given that experiencing typical stroke symptoms was a facilitator of emergency medical service use yet failure to recognize the urgency of symptoms was a barrier, public awareness should be raised as regards stroke symptoms and the benefits of using emergency medical services.
本研究的目的是确定韩国急性缺血性中风患者使用紧急医疗服务的促进因素和障碍。
本文对一项回顾性调查进行了二次分析，该调查从问卷和病历中收集数据。在一项大规模研究纳入的233例急性缺血性中风患者中，160例在症状发作后72小时内到达医院的患者被纳入数据分析。
使用紧急医疗服务的患者比未使用者到达医院所需时间更短（140分钟对625分钟，P = 0.001），且更有可能在症状发作后3小时内到达医院（51.9%对31.5%，P = 0.013）。对于首次联系紧急医疗服务的患者，使用紧急医疗服务的促进因素是存在偏瘫（P = 0.003）、双侧瘫痪（P = 0.040）和平衡失调（P = 0.021）。主要障碍是未认识到症状的紧迫性（P = 0.006）。
使用紧急医疗服务减少了院前延误，并增加了患者在3小时内到达医院的可能性。鉴于出现典型中风症状是使用紧急医疗服务的促进因素，但未认识到症状的紧迫性是障碍，应提高公众对中风症状以及使用紧急医疗服务益处的认识。
