Moseley Lisa, McMeekin Peter, Price Christopher, Shaw Lisa, Laws Anna, Allen Michael, Ford Gary A, James Martin, McCarthy Stephen, McClelland Graham, Park Laura J, Pearn Kerry, Phillips Daniel, White Phil, Wilson David, Scott Jason
Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom.
Population Health Sciences Institute, Stroke Research Group, Newcastle University, Newcastle upon Tyne, United Kingdom.
PLoS One. 2025 Jan 22;20(1):e0310071. doi: 10.1371/journal.pone.0310071. eCollection 2025.
Evidence for Mobile Stroke Units (MSUs) demonstrates that onset to treatment times for intravenous thrombolysis can be reduced and access to mechanical thrombectomy might be improved. Despite growing use of MSUs internationally, to date there have been no studies in NHS England and NHS Wales exploring the acceptability of MSUs to clinicians, patient and public representatives and other key stakeholders, which are important when considering potential feasibility and implementation.
This study used a mixed methods design with a cross-sectional survey and qualitative workshops and interviews between October 2023 to May 2024. Survey data were collected from clinicians involved in emergency stroke care. Qualitative data involved clinical and non-clinical professionals involved in stroke care alongside patient and public representatives with experience of stroke. Survey data were descriptively analysed while content analysis was used on open-ended questions. Qualitative data were thematically analysed, prior to triangulation using a convergent coding matrix.
The study results, drawn from 25 respondents to the survey and 21 participants in qualitative workshops, found that almost all participants had positive affective attitudes to the concept of MSUs. However, several key areas of concern were identified that need to be addressed prior to implementing MSUs. These concerns included how MSUs would be staffed; whether and how telemedicine could contribute; the types of economic impacts; extent to which triage systems could accurately identify stroke patients for MSUs to attend; where the base location and geographic coverage of MSUs should be, the impact of MSUs on equitable access to stroke care, and how to improve public awareness of MSUs.
Whilst MSUs are mostly acceptable to key stakeholders, numerous areas of concern need to be addressed prior to MSU implementation. We recommend further research to address these issues prior to implementation in the NHS.
移动卒中单元（MSU）的证据表明，静脉溶栓的治疗开始时间可以缩短，机械取栓的可及性可能会提高。尽管国际上对移动卒中单元的使用越来越多，但迄今为止，在英格兰国民保健服务体系（NHS）和威尔士国民保健服务体系中，尚未有研究探讨移动卒中单元对临床医生、患者和公众代表以及其他关键利益相关者的可接受性，而这在考虑潜在可行性和实施时很重要。
本研究采用混合方法设计，在2023年10月至2024年5月期间进行横断面调查、定性研讨会和访谈。调查数据收集自参与急诊卒中护理的临床医生。定性数据涉及参与卒中护理的临床和非临床专业人员以及有卒中经历的患者和公众代表。对调查数据进行描述性分析，同时对开放式问题进行内容分析。在使用收敛编码矩阵进行三角验证之前，对定性数据进行主题分析。
该研究结果来自25名调查受访者和21名定性研讨会参与者，发现几乎所有参与者对移动卒中单元的概念都持积极的情感态度。然而，确定了几个在实施移动卒中单元之前需要解决的关键关注领域。这些问题包括移动卒中单元将如何配备人员；远程医疗是否以及如何发挥作用；经济影响的类型；分诊系统能多准确地识别适合移动卒中单元出诊的卒中患者；移动卒中单元的基地位置和地理覆盖范围应该在哪里，移动卒中单元对卒中护理公平可及性的影响，以及如何提高公众对移动卒中单元的认识。
虽然移动卒中单元大多为关键利益相关者所接受，但在实施移动卒中单元之前，需要解决许多令人关注的领域。我们建议在国民保健服务体系实施之前进行进一步研究以解决这些问题。
