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

Health Soc Care Community. 2008 Sep;16(5):501-10. doi: 10.1111/j.1365-2524.2008.00771.x. Epub 2008 Mar 18.


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.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Decision Making*
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Health Services Accessibility
  • Health Services, Indigenous / statistics & numerical data*
  • Humans
  • Male
  • Middle Aged
  • New Zealand
  • Oceanic Ancestry Group / psychology*
  • Patient Acceptance of Health Care / ethnology
  • Patient Acceptance of Health Care / psychology*
  • Qualitative Research
  • Stroke / diagnosis*
  • Stroke / therapy
  • Survivors / psychology*
  • Time Factors