腦中風病患發病時的自我覺察與尋求醫療處置方式之探討

Preliminary Study of Self-awareness and Medical Management Seeking Behaviors of Stroke Patients at Onset

本研究主在探討中風病患發病當時自我察覺的狀況與其尋求緊急處理的經驗。採描述性相關性研究設計，以立意取樣，選取入住北台灣某醫學中心腦神經科病房之腦中風病患69位。以Glasgow Coma Scale、Barthel Index、modified Rankin Scale及「腦中風病患發病時自我察覺及尋求醫療處置過程登錄表」等工具，共收集69位樣本的狀況。研究結果顯示：樣本發生中風時地點多數在家(75.4％)及當時正在執行日常生活活動(68.1％)。最常見的症狀是手腳無力或步態不穩(36.3％)；到達急診之交通方式以家人開車為最多(79.7％)。發病後兩小時內到達研究醫院急診者僅15.9％；到達急診後10分鐘內即接受醫師診療占61.9%；平均等候接受電腦斷層時間為45.8分鐘。延遲尋求醫療處置的主要原因是不覺此為危急事件(42.4％)。因此應向大眾或中風高危險群強調腦中風的黃金治療時間為發病後三到六小時內，尋求119/EMS(emergency medical services)協助才是最迅速的方式。

The purpose of this study was to identify the awareness of first symptom of stroke and medical seeking behaviors of the hospitalized stroke patients. This descriptive study used Glasgow Coma Scale, Barthel Index, modified Ranking Scale, and questionnaire to collect data. A total of 69 hospitalized stroke patients were selected. Results showed that most patients noted the first stroke symptoms at home (75.4%) while they were doing daily activities (68.1%). The most common symptoms were limb paresis or gait disturbance (36.3%). Up to 79.7% patients were sent to the emergency department (ER) by their family. Only 15.9% patients arrived the ER of the study hospital within 2 hours. On their arrival, 61.9% of the patients were examined by doctors within 10 minutes. The average waiting time for computed tomography examination was 45.8 minutes. Perceiving early symptoms as “not critical” was the major factor (42.4%) of delay in medical help seeking. Therefore, emphasizing the golden time window for stroke treatment (within 3-6 hours after onset) and the need for calling 119/EMS for medical help are major messages that should be provided to the public and the high risk population.