A Study of Severity and Perception of Disease’s Severity to Hospital Arrival Time for relatives of Acute Stroke Patient


  • Werayuth Srithumsuk faculty of nursing, Phetchaburi Rajabhat University
  • Saitip Jaipong Phrachomklao Hospital Phetchaburi Province
  • Pornnapa Charoensan The Royal Thai Army Nursing College
  • Sirirat Chamnongchit The Royal Thai Army Nursing College


Stroke’s severity, Perception of stroke’s severity, Acute stroke


This research was descriptive study. The objectives of this study were; to study severity and perception of disease’s severity to hospital arrival time and to study association amomg age, educatinal level, income, severity and perception of disease’s severity to hospital arrival time of acute stroke’s relatives and patient. The sample was 88 relatives of stroke patient admitted at Phrachomklao hospital Phetchaburi province since August 2017 to January 2018. The questionnaire consists of 3 parts were 1) demographic data record form, 2) hospital arrival record form, and 3) perception of stroke’s severity assessment. The data analysis was used descriptive statistics, chi-square test and Pearson’s product moment correlation.

The result showed that the sample was male with 52.30 %, averaged age was 66.97±14.42. Stroke’s symptom making a decision to take a patient to a hospital was one side weakness immediately with 47.5%, the most type of stroke in this study was ischemic stroke with 90.91%. The severity of stroke from NIHSS mean score was 6.43 (S.D. = 6.88). Most of patient had minor severity stroke with 65.91%. Time from stroke scene to hospital was 28.90 minute (S.D. = 15.84). The relationship among age educational level, income, and stroke severity with hospital arrival after stroke onset showed no significant different. Only perception of disease’s severity was negative correlation with with hospital arrival time after stroke onset with significant different (β = -.325, p-value = .040) Therefore, to promote rapid stroke treatment and caring, giving knowledge to patients, relatives, and general population regarding symptoms, emergency management of stroke, and studying factors related rt-PA treatment are important to stroke care’s outcomes.


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World Stroke Organization. World stroke day [Internet]. 2010.

Savini S, Buck HG, Dickson VV, Simeone S, Pucciarelli G, Fida R, et al. Quality of life instroke survivor-caregiver dyads: a new conceptual framework and longitudinal study protocol. Journal of Advanced Nursing. 2015; 71: 676-687.

Hanchaiphiboolkul S, Puthkhao P, Towanabut S, Tantirittisak T, Wangphonphatthanasiri K, Termglinchan T, et al. Factors predicting high estimated 10-year stroke risk: Thai epidemiologic stroke study. Journal of Stroke and Cerebrovascular Disease. 2014; 23: 1969-1974.

Kengsakul K. Treatment of acute stroke patients. Vichaiyut. 2550; 37: 88-91. (in Thai)

Zerwic J, Hwang SY, & Tucco L. Interpretation of symptom and delay in seeking treatment by patients who have had a stroke: Exploratory study. Heart and Lung. 2007; 36(1): 25-34.

American stroke association (ASA). (2560). Understanding risk (Internet). Texas: American stroke association (ASA). (online). 2562.

Gache K, Leleu H, Nitenberg G, Woimant F, Ferrua M, Minvielle E. Main barrires to effective implementation of stroke care pathways in France: a qualitative study. BMC Health Services Research. 2014; 14: 1-10.

Middleton S, Levi C, Dale S, Cheung NW, Mclnnes E, Consideine J, et al. Triage, treatment and transfer of patients with stroke in emergency department trial (the T3 trial): a cluster randomised trial protocol. Implementation Science. 2016; 11: 2-9.

Inatomi Y, Yonehara T, Hashimoto Y, Hirano T, & Uchino M. Pre-hospital delay in the use of intravenous rt-PA for acute ischemic stroke in Japan. Journal of the Neurological Sciences. 2007; 270: 127-132.

Tanaka Y, Nakajima M, Hirano T, & Uchino M. Factors influencing pre-hospital delay after ischemic stroke and transient ischemic attack. Internal Medicine. 2009; 48: 1739-1744.

Suwanwela NC. Stroke epidemiology in Thailand. Journal of Stroke. 2014; 16(1): 1-7. 12. Boontongto S, Vibulchai N, Buthbankhow A. Development of fast track service system for patients with stroke Wapipathum hospital and service network. Mahasarakham hospital journal. 2017; 14(3): 100-113. (in Thai)

Dodd M, Janson S, Facione N, Froelicher ES, Hummphreys J, Lee K, et al. Nursing theory and concept development or analysis advancing the science of symptom management. Journal of Advanced Nursing. 2001; 33(5): 668-676.

Binthaisong T, Panpakdee O, Orathai P, & Ratanakorn D. Factors related to onset arrival time in patients with acute stroke. Kuakarun Journal of Nursing. 2013; 20(1): 15-29. (in Thai)

Pinyosree N. Factors related to seeking treatment after the onset of acute ischemic stroke patients. (thesis). Bangkok: Faculty of Nursing, Chulalongkorn University; 2008. (in Thai)

Srisatisnarakul B. Research methodology in Nursing. Bangkok: U&I Intermedia; 2007. (in Thai)

Cohen J. Statistical power analysis for the behavioral sciences. New Jerseys: Lawrence Earlbaum Associates; 1998.

Kasner SE. Clinical interpretation and use of stroke scales. Lancet Neurology. 2006; 5: 603-612.

Shephard TJ. Exploratory investigation of a model of patient delay in seeking treatment after the onset of acute ischemic stroke. (dissertation). Virginia: Virginia Commonwealth University School of Nursing; 2004.

Jiang B, Ru X, Sun H, Liu H, Sun D, Liu Y, et al. Pre-hospital delay and its associated factors in first-ever stroke registered in communities from three cities in China. Scientific Report. 2016; 6(29795): 1-11.

Hong ES, Kim SH, Kim WY, Ahn R, & Hong JS. Factors associated with prehospital delay in acute stroke. Emergency Medicine Journal. 2011; 28(9): 790-793.

Hsia AW, Castle A, Wing JJ, Edwards DF, Brown NC, Higgins TM, et al. Understanding Reasons for Delay in Seeking Acute Stroke Care in an Underserved Urban Population. Stroke. 2011; 42(6): 1697-1701.

Seremwe F, Kaseke F, Chikwanha TM, & Chikwasha V. Factors associated with hospital arrival time after the onset of stroke symptoms: A cross-sectional study at two teaching hospitals in Harare, Zimbabwe. Madawi Medical Journal. 2017; 29(2): 171-176.

Faiz KW, Sundseth A, Thommessen B, & Ronning OM. Factors Related to Decision Delay in Acute Stroke. Journal of Stroke and Cerebrovascular Diseases. 2014; 23(3): 534-539.

Kim DH, Nah HW, Park HS, Choi JH, Kang MJ, Huh JT, et al. Impact of Prehospital Intervention on Delay Time to Thrombolytic Therapy in a Stroke Center with a Systemized Stroke Code Program. Journal of Stroke and Cerebrovascular Diseases. 2016; 25(7): 1665-1670.



How to Cite

Srithumsuk ว, Jaipong ส, Charoensan พ, Chamnongchit ศ. A Study of Severity and Perception of Disease’s Severity to Hospital Arrival Time for relatives of Acute Stroke Patient. J Royal Thai Army Nurses [Internet]. 2020 Sep. 1 [cited 2022 Jul. 1];21(2):273-85. Available from: https://he01.tci-thaijo.org/index.php/JRTAN/article/view/234916



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