研究生: |
郭川華 Kuo, Chuan-Hua |
---|---|
論文名稱: |
大學生中風症狀認知與預期因應行為研究-以新北市某大專校院為例 A Study on College Students' Stroke Symptom Knowledge and Action: A Case Study of a College in New Taipei City |
指導教授: |
張晏蓉
Chang, Yen-Jung |
學位類別: |
碩士 Master |
系所名稱: |
健康促進與衛生教育學系 Department of Health Promotion and Health Education |
論文出版年: | 2019 |
畢業學年度: | 107 |
語文別: | 中文 |
論文頁數: | 210 |
中文關鍵詞: | 中風症狀認知 、中風預期因應行為 、大專校院學生 |
英文關鍵詞: | stroke symptom knowledge and action |
DOI URL: | http://doi.org/10.6345/NTNU201900215 |
論文種類: | 學術論文 |
相關次數: | 點閱:191 下載:0 |
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本研究旨在探討年滿二十歲大學生的「中風症狀認知」與「中風預期因應行為」現況及影響的相關因素。本研究為橫斷式及描述性設計,參閱原文The Stroke Action Test(STAT)及中譯「中風症狀認知與因應行為問卷」後自擬問卷,為設計進行施測。
本研究以SPSS軟體進行統計分析,研究結果顯示中風症狀認知答對率為63.0%±26.7,有中風家族史者優於無家族史(p=0.046),研究對象之中有三成以上將心臟症狀誤認為中風症狀;預期因應行為答對率30.4%±22.9,男性答對率較女性高(p=0.017);健康情境中答對率最高的前三題皆與辛辛那提中風症狀(一側臉無力、一側肢體無力、說話困難)有關。有中風家族病史及中風症狀認知程度較高者,預期因應行為的正確填答率較高(p<0.001)。
因中風症狀認知程度與中風家族病史是預期因應行為的主要相關因素,且本研究對象有三成以上將心臟症狀視為中風症狀,建議急救訓練加入辛辛那提中風辨識或中風口訣。
The purpose of this study was to explore the factors related to the current status and impact of "stroke symptom perception" and "stroke expected response behavior" among college students over the age of 20. This is a cross-sectional and descriptive study. This study collected data from 216 surveyed students and assessed (variables including gender, BMI, family history of stroke, stroke learning experience, source of stroke information, and stroke symptoms knowledge and action, which was measured using The Stroke Action Test (STAT).
This study used SPSS software for statistical analysis. The correct rate of stroke symptom knowledge was 63.0%±26.7, and those with family history of stroke reported better knowledge than those without family history (p=0.046). More than one-third of surveyed students failed to distinguish the symptoms of heart disease and stroke. The correct rate of stroke action was 30.4%±22.9, and the rate of male students was higher than that of female (p=0.017). The questions with the highest correct rate were related to Cincinnati's stroke symptoms (i.e., weak of one side face, weak of one side limb, and difficulty speaking). Those with family history of stroke or with better knowledge of stroke symptoms were likely to have a higher correct rate of response action (p < 0.001).
Stroke symptom knowledge and family history of stroke might be the predictors of stroke response action. Findings also revealed that more than one-third of surveyed students mistook heart disease symptoms as stroke symptoms. This study recommends that the education of stroke symptom identification should be added to current first-aid training.
中華急救教育推廣協會(2016)。 ACLS高級心臟救命術。高雄市:中華急救教育推廣協會。
王榮德 (2012)。長期照護需求量之評估:方法之發展及實際運用(中風與癌症為例)。行政院國家科學委員會專題研究計畫報告(NSC 101-2314-B-006-077)。台南市:國立成功大學。
台北榮民總醫院腦中風防治中心(2004)。醫護人員腦中風教育手冊。台北市:衛生福利部國民健康署。
胡漢華(2008)。台灣腦中風防治指引2008,第1版, 148。
馬惠明(2014)。緊急醫療救護體系三大重症(腦中風、心肌梗塞、重大創傷)區域化運作與到院前檢傷措施整體評估。 GBR政府研究資訊系統(NSC101-2314-B002-120-MY3)。台北市:國立臺灣大學。
黃如詩(2012)。城鄉地區中風病人與家屬對中風症狀的認知與預期因應行為(未出版之碩士論文)。國立臺灣大學醫學院護理學系,台北市。
衛生福利部(2017)。104年健康促進統計年報。台北市:衛生福利部,168.
衛生福利部國民健康署(2002)。 民國91年台灣地區國民健康促進知識、態度與行為調查。台北市:衛生福利部國民健康署。
衛生福利部國民健康署(2014)。民國一百年台灣地區中老年身心社會生活狀況長期追蹤(第七次)調查成果報告。台北市:衛生福利部國民健康署。
衛生福利部統計處(2017)。106年度全民健康保險醫療統計年報。台北市:衛生福利部。
衛生福利部統計處(2016)。民國105年度死因統計年報。台北市:衛生福利部。
衛生福利部統計處(2017)。106年國人死因統計結果。台北市:衛生福利部。
Amano, T., Yokota, C., Sakamoto, Y., Shigehatake, Y., Inoue, Y., Ishigami, A., . . . Minematsu, K. (2014). Stroke education program of act FAST for junior high school students and their parents. J Stroke Cerebrovasc Dis, 23(5), 1040-1045. doi:10.1016/j.jstrokecerebrovasdis.2013.08.021
Association, T. A. H. STROKE RISKS.
Baldereschi, M., Di Carlo, A., Vaccaro, C., Polizzi, B., Inzitari, D., & Promotion Implementation of Stroke Care in Italy Project Working, G. (2015). S_003 Stroke knowledge in Italy. Neurol Sci, 36(3), 415-421. doi:10.1007/s10072-014-1964-5
Bejot, Y., Delpont, B., & Giroud, M. (2016). Rising Stroke Incidence in Young Adults: More Epidemiological Evidence, More Questions to Be Answered. J Am Heart Assoc, 5(5). doi:10.1161/JAHA.116.003661
Bhatia, R., Hill, M. D., Shobha, N., Menon, B., Bal, S., Kochar, P., . . . Demchuk, A. M. (2010). Low rates of acute recanalization with intravenous recombinant tissue plasminogen activator in ischemic stroke: real-world experience and a call for action. Stroke, 41(10), 2254-2258. doi:10.1161/STROKEAHA.110.592535
Billings-Gagliardi, S., & Mazor, K. M. (2005). Development and validation of the stroke action test. Stroke, 36(5), 1035-1039. doi:10.1161/01.STR.0000162716.82295.ac
Chang, K. C., & Tseng, M. C. (2003). Costs of acute care of first-ever ischemic stroke in Taiwan. Stroke, 34(11), e219-221. doi:10.1161/01.STR.0000095565.12945.18
Chang, K. C., Tseng, M. C., & Tan, T. Y. (2004). Prehospital delay after acute stroke in Kaohsiung, Taiwan. Stroke, 35(3), 700-704. doi:10.1161/01.STR.0000117236.90827.17
Cheng, T. J., Peng, G. S., Jhao, W. S., Lee, J. T., & Wang, T. H. (2017). Nationwide "Hospital Emergent Capability Accreditation by Level-Stroke" Improves Stroke Treatment in Taiwan. J Stroke, 19(2), 205-212. doi:10.5853/jos.2016.01655
Chiu, L., Pai, L., Shyu, W. C., Jayne Chen, T. R., & Chang, T. P. (1998). Analysis of costs borne by families of patients hospitalized for stroke. Zhonghua Yi Xue Za Zhi (Taipei), 61(5), 267-275.
Denti, L., Marcomini, B., Riva, S., Schulz, P. J., Caminiti, C., & for, E. s. g. (2015). Cross-cultural adaptation of the stroke action test for Italian--speaking people. BMC Neurol, 15, 76. doi:10.1186/s12883-015-0335-z
Dombrowski, S. U., Ford, G. A., Morgenstern, L. B., White, M., Sniehotta, F. F., Mackintosh, J. E., . . . Skolarus, L. E. (2015). Differences Between US and UK Adults in Stroke Preparedness: Evidence From Parallel Population-Based Community Surveys. Stroke, 46(11), 3220-3225. doi:10.1161/STROKEAHA.115.009997
Focht, K. L., Gogue, A. M., White, B. M., & Ellis, C. (2014). Gender differences in stroke recognition among stroke survivors. J Neurosci Nurs, 46(1), 18-22.
doi: 10.1097/JNN.0000000000000026
Fussman, C., Rafferty, A. P., Lyon-Callo, S., Morgenstern, L. B., & Reeves, M. J. (2010). Lack of association between stroke symptom knowledge and intent to call 911: a population-based survey. Stroke, 41(7), 1501-1507. doi:10.1161/STROKEAHA.110.578195
Goyal, M., Menon, B. K., van Zwam, W. H., Dippel, D. W., Mitchell, P. J., Demchuk, A. M., . . . collaborators, H. (2016). Endovascular thrombectomy after large-vessel ischaemic stroke: a meta-analysis of individual patient data from five randomised trials. Lancet, 387(10029), 1723-1731. doi:10.1016/S0140-6736(16)00163-X
Gutierrez-Jimenez, E., Gongora-Rivera, F., Martinez, H. R., Escamilla-Garza, J. M., Villarreal, H. J., & Investigators, G. (2011). Knowledge of ischemic stroke risk factors and warning signs after a health education program by medical students. Stroke, 42(4), 897-901. doi:10.1161/STROKEAHA.110.597062
Hacke, W., Kaste, M., Bluhmki, E., Brozman, M., Davalos, A., Guidetti, D., . . . Investigators, E. (2008). Thrombolysis with alteplase 3 to 4.5 hours after acute ischemic stroke. N Engl J Med, 359(13), 1317-1329. doi:10.1056/NEJMoa0804656
Hsieh, C. L., & Lee, M. H. (1997). Factors influencing vocational outcomes following stroke in Taiwan: a medical centre-based study. Scand J Rehabil Med, 29(2), 113-120.
Hsieh, C. Y., Chen, C. H., Chen, Y. C., & Kao Yang, Y. H. (2013). National survey of thrombolytic therapy for acute ischemic stroke in Taiwan 2003-2010. J Stroke Cerebrovasc Dis, 22(8), e620-627. doi:10.1016/j.jstrokecerebrovasdis.2013.07.043
Hsieh, F. I., Lien, L. M., Chen, S. T., Bai, C. H., Sun, M. C., Tseng, H. P., . . . Taiwan Stroke Registry, I. (2010). Get With the Guidelines-Stroke performance indicators: surveillance of stroke care in the Taiwan Stroke Registry: Get With the Guidelines-Stroke in Taiwan. Circulation, 122(11), 1116-1123. doi:10.1161/CIRCULATIONAHA.110.936526
Hu, H. H., Sheng, W. Y., Chu, F. L., Lan, C. F., & Chiang, B. N. (1992). Incidence of stroke in Taiwan. Stroke, 23(9), 1237-1241.
Itzhaki, M., Melnikov, S., & Koton, S. (2016). Gender differences in feelings and knowledge about stroke. J Clin Nurs, 25(19-20), 2958-2966. doi:10.1111/jocn.13366
Jones, S. P., Jenkinson, A. J., Leathley, M. J., & Watkins, C. L. (2010). Stroke knowledge and awareness: an integrative review of the evidence. Age Ageing, 39(1), 11-22. doi:10.1093/ageing/afp196
Kissela, B. M., Khoury, J. C., Alwell, K., Moomaw, C. J., Woo, D., Adeoye, O., . . . Kleindorfer, D. O. (2012). Age at stroke: temporal trends in stroke incidence in a large, biracial population. Neurology, 79(17), 1781-1787. doi:10.1212/WNL.0b013e318270401d
Kothari, R. U., Pancioli, A., Liu, T., Brott, T., & Broderick, J. (1999). Cincinnati Prehospital Stroke Scale: reproducibility and validity. Ann Emerg Med, 33(4), 373-378.
Kuklina, E. V., Tong, X., George, M. G., & Bansil, P. (2012). Epidemiology and prevention of stroke: a worldwide perspective. Expert Rev Neurother, 12(2), 199-208. doi:10.1586/ern.11.99
Kwan, J., Hand, P., & Sandercock, P. (2004). A systematic review of barriers to delivery of thrombolysis for acute stroke. Age Ageing, 33(2), 116-121. doi:10.1093/ageing/afh064
Lee, M., Wu, Y. L., & Ovbiagele, B. (2016). Trends in Incident and Recurrent Rates of First-Ever Ischemic Stroke in Taiwan between 2000 and 2011. J Stroke, 18(1), 60-65. doi:10.5853/jos.2015.01326
Lin, H. C., Xirasagar, S., Chen, C. H., Lin, C. C., & Lee, H. C. (2007). Association between physician volume and hospitalization costs for patients with stroke in Taiwan: a nationwide population-based study. Stroke, 38(5), 1565-1569. doi:10.1161/STROKEAHA.106.474841
Magin, P., Dunbabin, J., Goode, S., Valderas, J. M., Levi, C., D'Souza, M., . . . Lasserson, D. (2015). Patients' responses to transient ischaemic attack symptoms: a cross-sectional questionnaire study in Australian general practices. Br J Gen Pract, 65(630), e24-31. doi:10.3399/bjgp15X683125
Mandelzweig, L., Goldbourt, U., Boyko, V., & Tanne, D. (2006). Perceptual, social, and behavioral factors associated with delays in seeking medical care in patients with symptoms of acute stroke. Stroke, 37(5), 1248-1253. doi:10.1161/01.STR.0000217200.61167.39
Matsuzono, K., Yokota, C., Takekawa, H., Okamura, T., Miyamatsu, N., Nakayama, H., . . . Participating Investigators of Tochigi Junior High School Stroke Education, G. (2015). Effects of stroke education of junior high school students on stroke knowledge of their parents: Tochigi project. Stroke, 46(2), 572-574. doi:10.1161/STROKEAHA.114.007907
Mikulik, R., Bunt, L., Hrdlicka, D., Dusek, L., Vaclavik, D., & Kryza, J. (2008). Calling 911 in response to stroke: a nationwide study assessing definitive individual behavior. Stroke, 39(6), 1844-1849. doi:10.1161/STROKEAHA.107.499806
Mikulik, R., Goldemund, D., Reif, M., Brichta, J., Neumann, J., Jarkovsky, J., & Kryza, J. (2011). Calling 911 in response to stroke: no change following a four-year educational campaign. Cerebrovasc Dis, 32(4), 342-348. doi:10.1159/000330339
Miyamatsu, N., Kimura, K., Okamura, T., Iguchi, Y., Nakayama, H., Toyota, A., . . . Yamaguchi, T. (2012). Effects of public education by television on knowledge of early stroke symptoms among a Japanese population aged 40 to 74 years: a controlled study. Stroke, 43(2), 545-549. doi:10.1161/STROKEAHA.111.634196
Mochari-Greenberger, H., Towfighi, A., & Mosca, L.(2014). National women's knowledge of stroke warning signs, overall and by race/ethnic group. Strok, 45(4), 1180-2.
doi: 10.1161/STROKEAHA.113.004242
Morris, D. L., Rosamond, W., Madden, K., Schultz, C., & Hamilton, S. (2000). Prehospital and emergency department delays after acute stroke: the Genentech Stroke Presentation Survey. Stroke, 31(11), 2585-2590.
National Institute of Neurological, D., & Stroke rt, P. A. S. S. G. (1995). Tissue plasminogen activator for acute ischemic stroke. N Engl J Med, 333(24), 1581-1587. doi:10.1056/NEJM199512143332401
Nogueira, R. G., Gupta, R., & Davalos, A. (2013). IMS-III and SYNTHESIS Expansion trials of endovascular therapy in acute ischemic stroke: how can we improve? Stroke, 44(11), 3272-3274. doi:10.1161/STROKEAHA.113.002380
Organization, W. H. (2004). The global burden of disease: 2004 update.
Organization, W. H. (2017). STEPwise approach to stroke surveillance.
Ramirez, L., Kim-Tenser, M. A., Sanossian, N., Cen, S., Wen, G., He, S., . . . Towfighi, A. (2016). Trends in Acute Ischemic Stroke Hospitalizations in the United States. J Am Heart Assoc, 5(5). doi:10.1161/JAHA.116.003233
Ramirez, M., Teresi, J. A., Ogedegbe, G., & Williams, O. (2016). Using Qualitative Methods to Assess the Conceptual Equivalence of the Spanish and English Stroke Action Test (STAT). Qual Health Res. doi:10.1177/1049732316636362
Richards, C. T., Huebinger, R., Tataris, K. L., Weber, J. M., Eggers, L., Markul, E., . . . Prabhakaran, S. (2018). Cincinnati Prehospital Stroke Scale Can Identify Large Vessel Occlusion Stroke. Prehosp Emerg Care, 22(3), 312-318. doi:10.1080/10903127.2017.1387629
Skolarus, L. E., Mazor, K. M., Sanchez, B. N., Dome, M., Biller, J., & Morgenstern, L. B. (2017). Development and Validation of a Bilingual Stroke Preparedness Assessment Instrument. Stroke, 48(4), 1020-1025. doi:10.1161/STROKEAHA.116.015107
Tan, T. Y., Chang, K. C., & Liou, C. W. (2002). Factors delaying hospital arrival after acute stroke in southern Taiwan. Chang Gung Med J, 25(7), 458-463.
Tibaek, M., Dehlendorff, C., Jorgensen, H. S., Forchhammer, H. B., Johnsen, S. P., & Kammersgaard, L. P. (2016). Increasing Incidence of Hospitalization for Stroke and Transient Ischemic Attack in Young Adults: A Registry-Based Study. J Am Heart Assoc, 5(5). doi:10.1161/JAHA.115.003158
Yamagami, H., & Sakai, N. (2013). [Current status of endovascular therapy for acute ischemic stroke]. Rinsho Shinkeigaku, 53(11), 1166-1168.
Zhang, B., Sun, X. J., & Ju, C. H. (2011). Thrombolysis with alteplase 4.5-6 hours after acute ischemic stroke. Eur Neurol, 65(3), 170-174. doi:10.1159/000324291