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中国浙江院前延误率高的患者及其家属对中风的认知、态度与院前延误情况:一项横断面研究

Knowledge and attitude towards stroke and prehospital delay among patients and their family members under high prehospital delay in Zhejiang, China: a cross-sectional study.

作者信息

Lin Feng, Wu Gang, Liang Junbo, Chen Jiya, Pang Xiaozhen

机构信息

Department of Neurology, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou, China.

Department of Neurology, Department of Pharmacy, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou, China.

出版信息

BMJ Open. 2025 Jun 4;15(6):e094240. doi: 10.1136/bmjopen-2024-094240.

Abstract

OBJECTIVES

To investigate the knowledge of stroke and the attitudes towards stroke and prehospital delay among patients who had an acute ischaemic stroke (AIS) and their family members.

DESIGN

This cross-sectional study was conducted through a self-designed questionnaire.

SETTING

The study took place in a Grade-A tertiary hospital in Zhejiang Province, China, between July 2023 and November 2023.

PARTICIPANTS

A total of 521 valid questionnaires were collected from 367 patients who had an AIS and 154 family members.

INTERVENTIONS

Participants provided demographic information and answered questions related to stroke knowledge, attitudes towards stroke and prehospital delay.

PRIMARY AND SECONDARY OUTCOME MEASURES

The primary outcome measures included scores on stroke knowledge, attitudes towards stroke and attitudes towards prehospital delay. Secondary outcomes focused on identifying correlations and independent factors influencing prehospital delay.

RESULTS

The average scores for patients were stroke knowledge 8.74±6.16 (range: 0-24), stroke attitude 23.52±2.73 (range: 7-35) and prehospital delay attitude 38.65±7.68 (range: 10-50). Family members scored 12.66±6.85, 23.60±2.57 and 40.02±7.45, respectively. Significant correlations were found between stroke knowledge and attitude (r=0.2262, p<0.001) and between stroke attitude and prehospital delay attitude (r=0.1305, p=0.0028). Multivariate analysis indicated that patients' prehospital delay attitude (OR=0.91) and choice of the first medical facility (OR=0.30) were associated with prehospital delay, while in family members, prehospital delay attitude (OR=0.91) and wake-up stroke (OR=2.91) were significant.

CONCLUSIONS

Both patients who had an AIS and their family members demonstrated insufficient knowledge and moderate attitudes towards stroke and prehospital delay, which were associated with extended prehospital delay. Educational interventions are necessary to enhance stroke knowledge. Targeted stroke awareness programmes and rapid response training could help improve early recognition and timely medical intervention, reducing prehospital delay and improving patient outcomes.

摘要

目的

调查急性缺血性卒中(AIS)患者及其家庭成员对卒中的认知、对卒中和院前延误的态度。

设计

本横断面研究通过自行设计的问卷进行。

背景

研究于2023年7月至2023年11月在中国浙江省一家三级甲等医院开展。

参与者

共收集了367例AIS患者和154名家庭成员的521份有效问卷。

干预措施

参与者提供人口统计学信息,并回答与卒中知识、对卒中和院前延误的态度相关的问题。

主要和次要结局指标

主要结局指标包括卒中知识得分、对卒中和院前延误的态度得分。次要结局侧重于确定影响院前延误的相关性和独立因素。

结果

患者的卒中知识平均得分为8.74±6.16(范围:0 - 24),卒中态度平均得分为23.52±2.73(范围:7 - 35),院前延误态度平均得分为38.65±7.68(范围:10 - 50)。家庭成员的得分分别为12.66±6.85、23.60±2.57和40.02±7.45。卒中知识与态度之间(r = 0.2262,p < 0.001)以及卒中态度与院前延误态度之间(r = 0.1305,p = 0.0028)存在显著相关性。多因素分析表明,患者的院前延误态度(OR = 0.91)和对首诊医疗机构的选择(OR = 0.30)与院前延误相关,而在家庭成员中,院前延误态度(OR = 0.91)和醒后卒中(OR = 2.91)具有显著性。

结论

AIS患者及其家庭成员对卒中和院前延误的知识均不足,态度中等,这与较长的院前延误相关。需要开展教育干预以增强卒中知识。有针对性的卒中认知项目和快速反应培训有助于提高早期识别和及时医疗干预,减少院前延误并改善患者预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fcac/12142093/0fb0402e4333/bmjopen-15-6-g001.jpg

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