Stroke Survivor and Caregiver Perspectives on Seeking Emergency Medical Care.

Abstract

Early recognition of acute stroke and activation of emergency medical services (EMS) are critical for timely treatment and improved patient outcomes. We aimed to identify facilitators and barriers to calling 9-1-1 for acute stroke from the perspectives of stroke survivors and caregivers. We conducted 42 semi-structured interviews of stroke survivors and caregivers in North Carolina, recruited from an online platform and stroke support groups. Interviews explored recognition of stroke signs and care-seeking decisions. Interviews were analyzed thematically. Facilitators of timely 9-1-1 calls included prior stroke experience, knowledge of stroke signs, severe/rapid-onset symptoms, and the presence of bystanders. Barriers included perceiving mild symptoms, believing EMS was unnecessary, fear of overreacting, financial concerns, and distrust of healthcare providers. Early recognition and EMS activation were sometimes facilitated by contacting a healthcare professional within the patient's social network. Public stroke education needs to address common misperceptions about symptom severity, appropriate use of EMS, and ambulance costs.