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Factors Influencing Health Seeking Behaviors of African Americans experiencing Stroke Symptoms A Systematic Review - Research Paper Example

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Delayed admission time is considered one of the most important factors why African Americans do not receive thrombolytic therapy for their strokes (Lisabeth and Kleindorfer, 2009). Stroke literacy is identified as individual's awareness of stroke risk factors and symptoms (Lisabeth and Kleindorfer, 2009)…
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Factors Influencing Health Seeking Behaviors of African Americans experiencing Stroke Symptoms A Systematic Review
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Factors Influencing Health Seeking Behaviors of African Americans experiencing Stroke Symptoms Delayed admission time is considered one of the most important factors why African Americans do not receive thrombolytic therapy for their strokes (Lisabeth and Kleindorfer, 2009). Stroke literacy is identified as individual's awareness of stroke risk factors and symptoms (Lisabeth and Kleindorfer, 2009). There is a pressing need to improve stroke prevention and provide an access to acute stroke therapy for minorities groups, particularly African American (Lisabeth and Kleindorfer, 2009).
Wiley et al (2009) in their study surveyed with Stroke Knowledge questionnaire African American participants (n=672), which comprised 65.7% of the survey cohort. According to Wiley (2009), only 56.3% of African American respondents identified brain as the organ where stroke occurs. Among stroke symptoms, hemiparesis, speech disturbance, headache and blurred vision were the best recognized. Primary risk factors for stroke were correctly identified and included hypertension, family history of stroke, obesity, smoking and cocaine abuse. From the perspective on study results, Wiley et al (2009) found significant deficiencies in stroke literacy among African American study sample. Because of poor stroke literacy in Wiley's et al study (2009), participants were not likely to activate EMS. Consequently, poor literacy on stroke symptoms among African American population jeopardizes the effectiveness of early prevention therapy.
King et al (2001) in their study aimed to determine whether African American individuals suffered from stroke (n=103) presented for treatment within the first 3 hours, a critical period needed for effective treatment with recombinant tissue plasminogen activator (rt-PA). Through Stroke Survey Tool, King et al (2001) determined that an average time needed for African American victims to present for treatment constituted 24.68 hours. Percentage analysis revealed that 49% of stroke victims were admitted within first 3 hours, 54% presented within 12 hours and 83% sought medical help within 24 hours. Most common reasons for delay or not presenting for treatment at all were identified misunderstanding of symptoms, confusing them with diabetes manifestation, sleeping in awkward position, elevated sugar, etc. King et al (2001) indicated that as a result of late admission for treatment 97% of participants did not receive thrombolytic therapy. King et al (2001) stressed that the patients' knowledge on stroke symptoms and their attempts to seek medical assistance are detrimental in stroke successful treatment.
The similar statement was emphasized in the study conducted by Kleindorfer and colleagues (2008). They revealed that educational strategies aimed to inform African American individuals (women, n=383) on stroke are effective methods to increase stroke awareness and seek medical assistance once symptoms occur. After 5 months of educational intervention, participants improved significantly in knowledge on stroke (50% increase from baseline) and the importance of seeking medical assistance early.
Zerwic and Hwang (2007) interviewed patients (n=38) suffered from an ischemic stroke in order to determine participants' knowledge on symptoms, causes of stroke as well as patterns of symptoms recognition and seeking medical assistance. Zerwic and Hwang (2007) found that 55.3% of respondents were able to correctly identify at least one stroke symptom, while ten patients (26.3%) were not aware of any of stroke symptoms. Research identified a mean delay in admission to emergency department to be 16 hours. The main reasons for delay in presentation for treatment were race, no history of stroke, lack of information on stroke symptoms, awoke with manifested symptoms, and did not use 911. Zerwic and Hwang (2007) identified the lack of general information on stroke and its symptoms as the most contributing factor causing the delay in ED admission.
Kothari et al (1999) conducted a study identifying factors associated with admission to emergency department within 3 hours of stroke symptoms onset, time window for thrombolytic therapy eligibility. The data collection has been conducted through EMS runsheets, ED records and interview with participants (n=151, 41% African American). According to Kothari et al (1999), one third of participants were admitted to ED within 3 hours of stroke symptoms onset, qualifying patients for thrombolytic therapy. Kothari et al (1999) found an association between race of patients and their ED arrival time. After stroke symptoms onset African American patients were found to contact 911 later, and thus they were admitted to the ED significantly later than whites. Kothari et al (1999) explained this finding with several factors, particularly blacks living alone, being uninformed on stroke symptoms, being resistant to seek medical attention, and transformation difficulties.
King DF, Trouth AJ, Adams AO. Factors preventing African Americans from seeking early
intervention in the treatment of ischemic strokes. Journal of National Medical Association. 2001 Feb; 93(2):43-6.
Kleindorfer D, Miller Rosie, Sailor-Smith Sharion, Moomaw Charles, Khoury J, Frankel M.
The Challenges of Community Based Research. The beauty shop stroke education project. Stroke 2008; 39: 2331-2335.
Kothari R, Jauch E, Broderick J, Brott T, Sauerbeck L, Khoury J, et al. Acute stroke: delays to
presentation and emergency department evaluation. Annals of Emergency Medicine. 1999 Jan;33(1):3-8
Lisabeth LD, Kleindorfer D. Stroke literacy in high-risk populations: A call for action. Neurology. 2009; 73(23):1940-1.
Wiley Joshua, William O, Boden-Albala, B. Neurology 2009; 73: 1950-1956.
Zerwic J, Hwang Seon- Young. Interpretation of symptoms and delay in seeking treatment by
patients who have had a stroke: Exploratory study. Heart and Lung. 2007;36(1): 25-34 Read More
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