1. McNett, Molly PhD RN CNRN

Article Content

One of the research articles published in this issue of Journal of Neuroscience Nursing presents findings from a research study that examined facilitators and barriers to seeking emergent care among individuals experiencing symptoms of a stroke. In this Research Bites commentary, we break down specific aspects of the study to highlight what was done, what the researchers found, and how findings inform clinical practice.


Study Purpose

The primary aim of the study was to identify facilitators and barriers to urgently seeking stroke-related care among individuals who were later determined to have experienced a stroke.



Delays in seeking emergent care for stroke adversely affect disability and stroke-related outcomes. Patient treatment-seeking behaviors are a key factor contributing to delays in timely care for acute stroke. Several quantitative studies have examined clinical and demographic factors associated with delays in care delivery. However, few studies have qualitatively examined facilitators or barriers to seeking care from the perspective of the individual experiencing stroke symptoms.



A qualitative study design was used to obtain data on the experiences of individuals who had experienced a stroke. Sixty-four adult subjects who had experienced a stroke within the previous 2 years were recruited from outpatient clinics. Subjects were English speaking and without secondary neurologic disorders or severe stroke sequelae (i.e., aphasia, vision/hearing loss). Subjects consented to the study and completed an interview survey during their routine clinic appointment. An open-ended question asking them when they first recognized symptoms of a stroke elicited the data that were analyzed qualitatively for this study. During the interview, subjects were encouraged to discuss their personal experience with stroke and their decisions surrounding seeking treatment.


Data points were analyzed using a constructivist grounded theory approach. In this method, data from the interview were constantly compared among subjects to identify recurring themes, which were then indexed into categories. Each category had themes that served as either facilitators or barriers to seeking care.



Three key categorical themes emerged: recognition of symptoms, social support, and knowledge and ability to call emergency medical services. Within each category, there were descriptions of factors that either facilitated emergent care or were barriers for emergent care (see Table 1 in the article). For example, under recognition of symptoms, intensity of symptoms was a factor: For those who experienced severe symptoms, this was a facilitator that caused them to seek emergent care; however, for those whose symptom intensity varied, this was a barrier to seeking care. Individual themes for each category are displayed in Table 1, along with how they were perceived as facilitators or barriers.


Clinical Implications

Findings from this study contribute information on reasons why some individuals emergently seek stroke care, whereas others may delay treatment. Knowledge of facilitators and barriers is important for nurses when educating patients, families, and communities about the different presentations of stroke symptoms. Findings from this study are consistent with those from quantitative studies and contribute to the additional perspective of the individual, which is important when tailoring educational efforts to specific populations.