ประสบกาณ์การมีอาการ วิธีการจัดการและความรุนแรงของโรคหลอดเลือดสมองของผู้ป่วยโรคหลอดเลือดสมองขาดเลือดเฉียบพลัน

Abstract

This descriptive study aimed to investigate the relationship between symptom experiences, symptom management strategies, and stroke severity among patients with acute ischemic stroke, who were admitted in hospital and received stroke fast tract management within 4.5 hours. The 125 subjects were purposively selected following the inclusion criteria. The set of instruments comprised (1) the Demographic Data and Illness History Sheet, (2) the Acute Ischemic Stroke Symptom Experiences Questionnaire (scale 0-1), (3) the Acute Ischemic Stroke Symptom Management Strategy Record (scale 0-1), and (4) the National Institutes of Health Stroke Scale [NIHSS] (scale 0-42), which were validated by three experts. Test-retest was applied to evaluate the reliability of the Acute Ischemic Stroke Symptom Experiences Questionnaire, and yielded a percentage agreement of .95. The reliability of the Symptom Management Strategies Questionnaire was examined and yielded Kuder-Richardson (KR-20) of 0.72. The inter-rater reliability of the NIHSS was .98. The data were analyzed using descriptive statistics, Pearson Product Moment Correlation, and Spearman Rank Correlation. The result showed the following: 1. The mean score of total symptom experiences was at a moderate level (M = 0.40, SD = 0.17), the mean score of the perception of symptoms was at a moderate level (M = 0.44, SD = 0.16), the mean score of the evaluation of symptoms was at a moderate level (M = 0.39, SD = 0.17), and the mean score of the response to symptoms was at a moderate level (M = 0.39, SD = 0.17) 2. The mean score of total symptom management strategies was at a moderate level (M = 0.66, SD = 0.33), the mean score of pre-hospital symptom management was at a moderate level (M = 0.62, SD = 0.33), and the mean score of in-hospital symptom management was at a high level (M = 0.86, SD = 0.09) 3. The mean score of initial stroke severity was at a moderate level (M = 7.8, SD = 4.7) and the median of stroke severity after 24 hours was at a low level (Mdn = 2.00, IQR = 5.00) 4. There were significant positive correlations between both the symptom experiences and the symptom management strategies and the initial stroke severity (r = .217, p < .05; r = .384, p < .05 respectively) 5. There were significant positive correlations between both the symptom management strategies and the initial stroke severity and the stroke severity 24 hours after treatment (r = .478, p < .05; r = .355, p < .01 respectively) The findings of this study should benefit to nurses and health care providers to promote people’s perception of symptoms of acute ischemic stroke. They would better able to manage and gain immediate access to stroke fast track. This could effectively decrease stroke severity.