title: Help-seeking at the time of stroke: stroke survivors' perspectives on their decisions.
abstract: Stroke is a major cause of death and disability in many countries. Early access to the most appropriate medical treatment can improve health outcomes. Despite this, only 30-60% of people who experience a stroke seek medical help within the recommended 3-hour timeframe. This study used open-ended interviews to explore patients' views on factors that influenced their decision to seek help at the time of stroke. Twenty participants were recruited from five centres: three hospitals, a community-based stroke support service and a primary healthcare service focused on providing health care for Maori. A qualitative methodology drawing on Grounded Theory informed data collection and analysis. Four main themes influenced the decision to seek help: making sense of symptoms, maintaining a sense of normality, presence and influence of another person and perception of medical services. Participants appeared to go through a process of recognition, interpretation and negotiation during their decision-making. Each of the four themes seemed to influence this process, either assisting or delaying help-seeking behaviour. The more time spent going through this process (or repeating each step), the longer the delay appeared to be. Our key findings which add to current help-seeking literature, include: (1) people tended to prioritise everyday commitments and responsibilities over their own health; (2) at times the presence and influence of another person contributed to delays in seeking help; and (3) people had different personal thresholds for when they perceived themselves to be 'sick enough' to seek medical help.
authors: Health and Rehabilitation Research Centre, Auckland University of Technology, Auckland, New Zealand. natasha.moloczij@aut.ac.nz
authors: Natasha
authors: N
authors: Moloczij
authors: Kathryn M
authors: KM
authors: McPherson
authors: John F
authors: JF
authors: Smith
authors: Nicola M
authors: NM
authors: Kayes
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003657:Decision Making; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006303:Health Services, Indigenous / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009520:New Zealand; D010342:Patient Acceptance of Health Care / Q000208:ethnology / Q000523:psychology*; D036301:Qualitative Research; D020521:Stroke / Q000175:diagnosis* / Q000628:therapy; D017741:Survivors / Q000523:psychology*; D013997:Time Factors