Factors Predicting Stroke Pre-hospital Delay Behavior Intention among People with High Risk of Stroke

Authors

  • Wanpen Waelveerakup RN, M.Sc, DrPH Candidate, Department of Public Health Nursing, Faculty of Public Health, Mahidol University, Thailand.
  • Punyarat Lapvongwatana RN, PhD, Associate Professor, Department of Public Health Nursing, Faculty of Public Health, Mahidol University, Thailand.
  • Sirirat Leelacharas RN, PhD, Assistant Professor, Ramathibodi School of Nursing, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Thailand.
  • Jean Davison RN, DNP, FNP-C, Associate Professor, School of Nursing, University of North Carolina at Chapel Hill, North Carolina,USA.

Keywords:

Behavior intention, Dependence, Family, High stroke risk, Stroke, Stroke literacy

Abstract

                   Recombinant tissue plasminogen activator has been recommended and widely used in treating acute ischemic stroke. Unfortunately, the critical period for medical effectiveness is relatively short, and many people with stroke cannot access a hospital in time. This study aimed to determine factors predicting stroke pre-hospital delay behavior intention among people with high risk of stroke. In this cross-sectional study, people with high risk of stroke and their family members (n = 93 pairs) were recruited from a semi-rural province in central Thailand. The questionnaires used in this study included socio-demographic, dependency, stroke literacy, family relationship, and stroke pre-hospital delay behavior intention scales. Data were analyzed using descriptive statistics, Pearson’s product-moment correlation coefficient, and multiple regressions.

                   The results revealed that dependency, number of family members, stroke literacy and family members’ stroke literacy were negatively correlated with stroke pre-hospital delay behavior intention among people with high risk of stroke. The latter was positively correlated with family members’ stroke pre-hospital delay behavior intention. In a regression analysis, the family members’ stroke pre-hospital delay behavior intention, stroke literacy, and dependence collectively accounted for 58.2% of stroke pre-hospital delay behavior intention. The findings suggest that nurses can develop an intervention to decrease stroke pre-hospital delay behavior intention by increasing stroke literacy of both people with high risk of stroke and family members, and promptly ask for help (dependency). These actions may help facilitate people to receive timely medical treatment.

References

1. World Health Organization, The top 10 causes of death [Internet]. 2018 [cited 2018 May 24]. Available from https://www.who.int/news-room/fact-sheets/detail/ the-top-10-causes-of-death.

2. Kongbunkiat K, Kasemsap N, Thepsuthammarat K, Tiamkao, S, Sawanyawisuth K. National data on stroke outcomes in Thailand. J Clin Neurosci. 2015; 22: 493-97.

3. Ministry of Public Health. Annual report 2015 [Internet]. 2015 [cited 2016 June 16]. Available from: http://www. thaincd.com/document/file/download/paper-manual/ Annual-report-2015.pdf (in Thai).

4. Suwanwela NC. Stroke Epidemiology in Thailand. J Stroke. 2014;16(1):1-7.

5. Nilanont Y, Nidhinandana S, Suwanwela NC, Hanchaiphiboolkul S, Pimpak T, Tatsanavivat P, et al. Quality of acute ischemic stroke care in Thailand: a prospective multicenter countrywide cohort study. J Stroke Cerebrovasc Dis. 2014; 23(2): 213-9.

6. Jauch EC, Saver JL, Adams HP, Jr., Bruno A, Connors JJ, Demaerschalk BM, et al. Guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke; a journal of cerebral circulation. 2013; 44(3): 870-947.

7. Gurman P, Miranda O, Nathan A, Washington C, Rosen Y, Elman N. Recombinant tissue plasminogen activators (rtPA): A review. Clinical pharmacology & therapeutics. 2015; 97(3): 274-85.

8. Pulvers JN, Watson JDG. If time is brain where is the improvement in pre-hospital time after stroke? Frontiers in Neurology. 2017; 8(617): 1-9.

9. Ashraf VV, Maneesh M, Praveenkumar R, Saifudheen K, Girija AS. Factors delaying hospital arrival of patients with acute stroke. Annals of Indian Academy of Neurology. 2015;18(2): 162-6.

10. Paul CL, Ryan A, Rose S, Attia JR, Kerr E, Koller C, et al. How can we improve stroke thrombolysis rates? A review of health system factors and approaches associated with thrombolysis administration rates in acute stroke care. Implementation Science. 2016; 11(1): 51.

11. Prasat Neurological Institute. Clinical guidelines for ischemic stroke. [Internet]. 2007 [cited 2016 Feb 14]. Available from http://pni.go.th/cpg/ischemic-stroke 2007.pdf

12. Binthaisong T, Panpakdee O, Orathai P, Ratanakorn D. Factors related to one set arrival time in patients with acute stroke. Kuakarun Journal of Nursing. 2013; 20(1): 15-29 (in Thai).

13. Kamsareeruk J, Jitpanya C, Factors related to pre-hospital time in patients with acute ischemic stroke. Journal of the Police Nurse, 2015; 7(2): 107-119 (in Thai).

14. Panyaprachoom P, Harnirattisai T, Muengtaweepongsa S. The factors related to seeking treatment at a hospital using a stroke fast-track referral network system with acute stroke patients. Thammasat Medical Journal. 2017; 17(4): 540-547 (in Thai).

15. Potisopha W. Relationships among response to symptoms and hospital arrival time of acute stroke patients. Journal of Nursing Science and Health. 2015; 38(1): 9-0 (in Thai).

16. Zhao Q, Yang L, Zuo Q, Zhu X, Zhang X, Wu Y, et al. Instrument development and validation of the stroke prehospital delay behavior intention scale in a Chinese urban population. Health and Quality of Life Outcomes. 2014; 170(12): 1-9.

17. Faiz KW, Sundseth A, Thommessen B, Ronning OM. Factors related to decision delay in acute stroke. Journal of stroke and cerebrovascular diseases: the official journal of National Stroke Association. 2014; 23(3): 534-9.

18. Mackintosh JE, Murtagh MJ, Rodgers H, Thomson RG, Ford GA, White M. Why people do, or do not, immediately contact emergency medical services following the onset of acute stroke: qualitative interview study. PLoS One. 2012; 7(10):e46124.

19. Yang L, Zhao Q, Zhu X, Shen X, Zhu Y, Yang L, et al. Effect of a comprehensive health education program on pre-hospital delay intentions in high-risk stroke population and caregivers. Quality of Life Research. 2017;26(8): 2153-60.

20. Yanagida T, Fujimoto S, Inoue T, Suzuki S. Causes of pre-hospital delay in stroke patients in an urban aging society. Journal of Clinical Gerontology & Geriatrics. 2014;5(3):77-81.

21. Morren JA, Salgado ED. Stroke literacy, behavior, and proficiency in a South Florida population. J Stroke Cerebrovasc Dis. 2013; 22(7): 962-8.

22. Muengtaweepongsa S, Hunghok W, Harnirattisai T. Poor recognition of prompted treatment seeking even with good knowledge of stroke warning signs contributes to the delayed arrival of acute ischemic stroke patients in Thailand. J Stroke Cerebrovasc Dis. 2014; 23(5): 948-52.

23. Mellon L, Doyle F, Rohde D, Williams D, Hickey A. Stroke warning campaigns: delivering better patient outcomes? A systematic review. Patient-related outcome measures. 2015; 6: 61-73.

24. Neuman, B. Fawcett, J. The Neuman Systems Model. (5th ed) , USA, Upper Saddle River, NJ: Prentice Hall; 2011.

25. Nakhon Pathom Hospital, The stroke fast-track committee report, Nakhon Pathom Province, Thailand. 2015 (in Thai).

26. Faul F, Erdfelder E, Lang A.-G, Buchner A. G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods. 2007; 39: 175-191.

27. The CV Risk Score Development Group, Thai CKD risk score [Internet]. 2016 [cited 2016 March 20]. Available from https://med.mahidol.ac.th/cvmc/thaicv/

28. Bloom, B, S., Hastings, J, T., Madaus, G, F. Handbook on the formative and summative evaluation of student learning, New York: McGraw-Hill; 1971.

29. Waelveerakup, W. Thumapiroj, T., Suwannasarn, K. Related factors and relationship between students in secondary school and elders in their families. JGG. 2012; 13(3): 11-26 (in Thai).

30. Yaowapanon N, Buddhirakkul P, Srisuphan W, Senaratana W, Potempa K, Chontawan R. Situational Analysis: Community Care for Survivors of Stroke and Suggestions for Improving the Provision of Care. Pacific Rim International Journal of Nursing Research. 2018; 22(4): 372-85.

31. Poaremath, J., Udol, K., Nilamont, Y., Sujirarat, D. Effect of emergency medical services (EMS) utilization on pretreatment time, rate of thrombolytic therapy and 3-month clinical outcomes in acute ischemic stroke patients. GRC 2014 Khon Kaen University Graduate Research Conference, MMP84-1-MMP84-9, 2014 [cited 2015 Jan 12]. Available from http://phep.ph.mahidol.ac.th/Academics.

32. Kim HJ, Ahn JH, Kim SH, Hong ES. Factors associated with pre-hospital delay for acute stroke in Ulsan, Korea. J Emerg Med. 2011; 41(1): 59-63.

33. Chuenjairuang P, Sritanyarat W. Development of primary health care services for stroke prevention in persons with warning signs of stroke. Pacific Rim Int J Nurs Res 2012; 16 (4): 313-25.

34. Pothiban L, Khampolsiri T, Srirat C. Knowledge and awareness of stroke impacts among Northern Thai population. Pacific Rim International Journal of Nursing Research [Internet]. 7 Jun. 2018 [cited 15 Dec.2018]; 22(3):212-2. Available from: https://tci-thaijo.org/index.php/PRIJNR/article/ view/79600

35. Fowler JC, Brunnschweiler B, Swales S, Brock J. Assessment of Rorschach dependency measures in female inpatients diagnosed with borderline personality disorder. J Pers Assess. 2005; 85(2): 146-53.

Downloads

Published

2019-06-19

How to Cite

1.
Waelveerakup W, Lapvongwatana P, Leelacharas S, Davison J. Factors Predicting Stroke Pre-hospital Delay Behavior Intention among People with High Risk of Stroke. PRIJNR [Internet]. 2019 Jun. 19 [cited 2024 Dec. 19];23(3):271-84. Available from: https://he02.tci-thaijo.org/index.php/PRIJNR/article/view/114716

Issue

Section

Original paper