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.
BMJ open · 2025-06-04 · Observational study
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.
Tags
Low- and middle-income settings · Next of kin · Time intervals