Decisions and delays within stroke patients' route to the hospital: a qualitative study

Mellor, Ruth M., Bailey, Sheila, Sheppard, James, Carr, Peter, Quinn, Tom, Boyal, Amunpreet, Sandler, David, Sims, Don G., Mant, Jonathan, Greenfield, Sheila and McManus, Richard J. (2015) Decisions and delays within stroke patients' route to the hospital: a qualitative study. Annals of Emergency Medicine, 65(3), 279-287.e3. ISSN (print) 0196-0644

Full text available as:
Quinn-T-32888.pdf - Published Version
Available under License Creative Commons Attribution.

Download (1MB) | Preview


STUDY OBJECTIVE: We examine acute stroke patients' decisions and delays en route to the hospital after onset of symptoms. METHODS: This was a qualitative study carried out in the West Midlands, United Kingdom. Semistructured interviews were conducted with 30 patients (6 accompanied by partners). Patients were asked about their previous experience of having had a stroke and their initial engagement with health services. "One sheet of paper" and thematic analyses were used. RESULTS: Three potential types of delay were identified from onset of symptoms to accessing stroke care in the hospital: primary delays caused by lack of recognition of symptoms or not dealing with symptoms immediately, secondary delays caused by initial contact with nonemergency services, and tertiary delays in which health service providers did not interpret the patients' presenting symptoms as suggestive of stroke. The main factors determining the speed of action by patients were the presence and influence of a bystander and the perceived seriousness of symptoms. CONCLUSION: Despite campaigns to increase public awareness of stroke symptoms, the behavior of both patients and health service providers apparently led to delays in the recognition of and response to stroke symptoms, potentially reducing access to optimum and timely acute specialist assessment and treatment for acute stroke.

Item Type: Article
Research Area: Health services research
Faculty, School or Research Centre: Faculty of Health, Social Care and Education (until 2017)
Related URLs:
Depositing User: Clive Allnutt
Date Deposited: 04 Nov 2015 15:14
Last Modified: 04 Nov 2015 15:14

Actions (Repository Editors)

Item Control Page Item Control Page