Stroke Symptoms and the Decision to Call for an Ambulance: Turn on People’s Minds!
To the Editor:
We read with great interest the article by Mosley et al1 on factors related to calling an ambulance for stroke patients. The authors reported that “stroke” was referred as the problem (unprompted) by ≈50% of callers, whereas fewer than half of the calls were made within 1 hour from symptom onset. We agree with the authors on the necessity of interventions to more strongly link stroke recognition to immediate action to increase the number of stroke patients eligible for acute treatment.
With the aim of evaluating the impact of a community intervention on stroke perception among people, we have administered a structured questionnaire to all participants in 2 distinct stroke initiatives, in which people were given a free screening for cerebrovascular risk assessment.
These initiatives, which included clinical and instrumental (carotid and vertebral ultrasound scanning) examinations, took place in Pisa in May and September 2006, and were potentially addressed to all inhabitants of the city (≈85 000 people). Before the screening, all participants were asked to fill in a questionnaire composed of multi-option questions about stroke definition, incidence, symptoms, consequences, and behavior in case of stroke. In the months between the 2 initiatives, a widespread stroke information campaign (specific posters, leaflets an booklets dispensed in drugstores and in offices of General Practitioners, in addition to those given at the end of the screening during the first stoke initiative in May 2006; articles published in local newspapers; announcements and Neurologist interviews shown by local television) was implemented.
The characteristics of the participants to these 2 initiatives (before and after stroke information campaign) and the answers given to the questionnaires are shown in the Table. Despite the older age and a comparable educational level, the participants in the second stroke initiative showed an overall better knowledge about stroke than the participants to the previous one.
Our data show that information campaigns addressed to the community represent a powerful tool to enhance people knowledge about stroke. In particular, in accordance with a previous study,2 we think that providing continuous, full, and at the same time concise information about stroke (explaining all the items of our questionnaire, for instance) is an educationally correct method to link stroke recognition to rapid call for ambulance and acute treatment implementation.
Mosley I, Nicol M, Donnan G, Patrick I, Dewey H. Stroke symptoms and the decision to call for an ambulance. Stroke. 2007; 38: 361–366.
Morgenstern LB, Staub L, Chan WY, Wein TH, Bartholomew LK, King M, Felberg RA, Burgin WS, Groff J, Hickenbottom SL. Improving delivery of acute stroke therapy: the TLL Temple Foundation Stroke Project. Stroke. 2002; 33: 160–166.