Prehospital delay after stroke symptom onset is a primary barrier to eligibility for reperfusion therapies. Decision delay is an understudied contributor to prehospital delay. We aimed to explore decision delay as a component of prehospital delay. For this correlational study, 170 Thai acute stroke patients were interviewed to explore their treatment-seeking decision factors: prior stroke knowledge, onset context, and cognitive, emotional, and behavioral factors. Participants’ mean age was 61.2 years, and 46% were women. Median decision delay and prehospital delay times were 120 and 372 minutes. Decision delay represented 49% of prehospital delays. Factors shortening decision delay were atrial fibrillation, prior stroke knowledge, perceived cause of symptoms as stroke, perceived severity of symptoms, and advice from bystanders to seek treatment. In contrast, seeking support from others and self-treatment affected prolonged decision delay. Shortening decision delay, often under the patient or bystander control, can reduce overall prehospital delay.

Background: National stroke campaigns have been implemented to improve stroke knowledge and awareness for the Thai public. Despite these efforts, only a minority of people recognize stroke symptoms and seek treatments within 4.5 hours after symptom onset. Studies reveal sex differences in stroke knowledge, which contributes to delayed treatment-seeking actions. Purpose: This study aimed to examine sex differences in stroke knowledge, symptoms, stroke recognition, and initial action between men and women after experiencing acute strokes. Methods: A cross-sectional study was conducted at three hospitals in Thailand between September and November 2020. Medical record reviews and patient interviews were completed within seven days of admission. Standardized questionnaires for prior stroke knowledge (stroke warning signs & proper actions), clinical manifestation, stroke recognition, first action, and the activation of the emergency medical service (EMS) were used. Results: A total of 170 patients (54% men) with a median age of 63 years were included. Mean scores for prior stroke knowledge were higher in men compared to women (2.97 vs. 2.23, p = .02). Men were more likely than women to identify sudden numbness or weakness and sudden trouble walking or dizziness as stroke warning signs (62% vs. 42%, p = .01; 57% vs. 40%, p = .03, respectively). Women more frequently experienced severe headache (37% vs. 18%, p < .01). No significant differences between men and women were found in stroke recognition (20% vs. 26%) and activation of the EMS system (22% vs. 19%). Seeking support from someone nearby or on the phone was the most frequent first action in men (47%) and women (55%), which often delayed EMS activation. Conclusion: Even though men scored higher in stroke knowledge than women, challenges to activating the EMS were found in both sexes, highlighting the need to explore targeted educational material and knowledge translation among high-risk stroke patients and their relatives, regardless of sex.

This descriptive research aimed develop caregiver's knowledge about stroke and stroke caregiving skills tools. The study samples are caregivers of stroke patients at Neurological outpatient unit of Muhammadiyah Hospital Palembang, South Sumatera,Indonesia. Content validity was tested by five experts and Reliability was tested in 30 stroke caregivers.The reliability was tested using SPSS and internal consistency would be analyzed by . The finding of content validity showed that stroke diseasedimensions' there were four items not agreed by expertsI-CVIs = 0.80, however another items was agreed by all experts I-CVIs = 1.00. Mean of I-CVI for all experts were 0.92. The experts mentioned that the stroke dimensions were clear and relevant to assess caregiver knowledge about stroke. In reliability test, the mean score was 11.73 (SD=4.75) with variance 22.55 and KR-20 was 0.75. For stroke caregiving skills, mean of I-CVI for all experts were 0.90. In reliability test, using cronbach's alpha was 0.75. In conclusion, the

Background: Diabetic Foot Ulcer (DFU) is common problem in Diabetes Mellitus (DM)  patients in which early detection of DFU is very important. The screening tool for DFU had been developed by researcher previously in 2016. Purpose: This study aimed to test validities and reliabilities of the tool. Methods: The method in this study which  included content validity by 4 experts, construct validity with 180 patients, internal consistency in 60 patients and intra-rater reliability. Results: The results showed that: 1) content validity was acceptable, I-CVI was 1.00 and S-CVI was 1.00; 2) internal consistency used Kuder-Richardson (KR – 20) was 0.806; 3) Intra-rater reliability used Intra-class Coefficient Correlation (ICC) for total score was 0.996 and Kappa 1.00 for duration of DM, history of ulceration, history of claudication, neuropathy sensory, abnormal skin, foot care, Kappa 0.93 for foot deformities, Kappa 0.92 for history of amputation, and Kappa 0.89 for peripheral vascular disease; and 4) constructed group approach revealed that 8 items (duration of DM, history of ulceration, history of amputation, history of claudication, neuropathy sensory, peripheral vascular disease, abnormal skin, and foot deformities) showed statistical significance ( P= < 0.000 – P =0.025), only one item which is foot care showed no significance (P= 0.161). Conclusion: The screening tool for DFU among diabetic patients has good validities and reliabilities. Nurses who work with DM patients can use the tool to detect risk for DFU to prevent DFU and provide early intervention tailored with risk factors. Further study should examine predictive validity of the tool and develop appropriate foot care assessment tool.