Help-seeking at the time of stroke: stroke survivors' perspectives on their decisions

• Published in: Health & social care in the community Vol. 16; no. 5; pp. 501 - 510
• Main Authors: Moloczij, Natasha, McPherson, Kathryn M., Smith, John F., Kayes, Nicola M.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.09.2008
• Subjects: Aged; Aged, 80 and over; Decision Making; delay; Female; Health Knowledge, Attitudes, Practice; Health Services Accessibility; Health Services, Indigenous - utilization; Heart; Help Seeking Behavior; help-seeking; Humans; Male; Medical Decision Making; Middle Aged; Negotiation; New Zealand; Oceanic Ancestry Group - psychology; Patient Acceptance of Health Care - ethnology; Patient Acceptance of Health Care - psychology; qualitative; Qualitative Research; stroke; Stroke - diagnosis; Stroke - therapy; Survivors - psychology; Time Factors; Treatment; Victims; New Zealand
• ISSN: 0966-0410; 1365-2524
• DOI: 10.1111/j.1365-2524.2008.00771.x

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.