Why Patients Delay Their First Contact with Health Services After Stroke? A Qualitative Focus Group-Based Study.
BACKGROUND
Despite national and local French information campaigns, when acute stroke occurs, waiting times before calling mobile emergency medical services (EMS) to receive appropriate treatment (i.e. thrombolysis) and decrease the risk of physical disability, remain long. We aimed to identify the representations of stroke in the general population and to determine barriers to and facilitators for rapidly contacting EMS.


METHODS
We conducted a qualitative study among the general population with 10 focus groups, 5 comprising employed people (N = 29) and 5 comprising retirees (N = 32). The themes discussed were general knowledge about stroke and its risk factors, symptoms, appropriate management and the awareness that stroke is an emergency issue.


RESULTS
In addition to a lack of knowledge about stroke, other barriers to rapidly contacting the EMS were difficulties in recognizing symptoms and understanding that these symptoms constitute an emergency. Furthermore, when faced with stroke, a feeling of inevitability and fatalism about the consequences of a stroke was highlighted. Participants were unaware of the existence of an effective treatment and they mistrusted medical competences. Finally, we found a strong presence and participant appreciation of common knowledge, resulting in the sharing of experiences of stroke. This could partly compensate for the lack of specific knowledge about symptom recognition and appropriate action.


CONCLUSIONS
Information campaigns should not only inform the public about stroke symptoms in order to ensure people act appropriately, but should also focus on increasing public awareness about the fact that an effective treatment exists.
Hospices Civils de Lyon, Pôle Information Médicale Evaluation Recherche, Lyon, France.|Laboratoire Epsylon EA4556, Université Paul Valéry Montpellier, Montpellier, France.|Groupe de Recherche en Psychologie Sociale (GRePS) EA4163, Université Lumière Lyon 2, Lyon, France.
Alice
A
Le Bonniec
Hospices Civils de Lyon, Pôle Information Médicale Evaluation Recherche, Lyon, France.|Universite de Lyon, Equipe d'Accueil HESPER 7425, F-69003, Lyon, France.
Julie
J
Haesebaert
Hospices Civils de Lyon, Unité de neurologie vasculaire, Hôpital Pierre Wertheimer, Lyon, France.|Universite de Lyon, Equipe d'Accueil HESPER 7425, F-69003, Lyon, France.
Laurent
L
Derex
SAMU du Rhône, Hospices Civils de Lyon, 69000, Lyon, France.
Sylvie
S
Porthault
Groupe de Recherche en Psychologie Sociale (GRePS) EA4163, Université Lumière Lyon 2, Lyon, France.|Institut National de la Santé et de la Recherche Médicale U912 (SESSTIM), Marseille, France.
Marie
M
Préau
Hospices Civils de Lyon, Pôle Information Médicale Evaluation Recherche, Lyon, France.|Universite de Lyon, Equipe d'Accueil HESPER 7425, F-69003, Lyon, France.
Anne-Marie
AM
Schott
D000328:Adult; D000368:Aged; D001294:Attitude to Health; D004632:Emergency Medical Services; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D012307:Risk Factors; D020521:Stroke / Q000523:psychology*