Awareness and prehospital behavioural patterns of stroke witnesses in the emergency department: A scale development and cross-sectional study

Authors : Betül Akbuğa Özel, Hüseyin Narcı, Ülkü Sibel Benli

Pages : 188-198

Doi:10.54996/anatolianjem.1817827

View : 97 | Download : 221

Publication Date : 2025-12-30

Article Type : Research Paper

Abstract :Aim: This study evaluated the validity and reliability of the 10-item Stroke Awareness Knowledge Scale (SAKS) for assessing stroke recognition among emergency department (ED) witnesses. It examined associations between demographics, SAKS scores, and behavioural patterns (initial response, transport type, prehospital delay). Material and Methods: Content, face, and construct validity and internal consistency of SAKS were assessed. The same sample (n = 255) was used for validation and cross-sectional analyses. Demographics, SAKS scores, and behavioural parameters were examined. Results: SAKS showed strong Scale-level Content Validity Index (S-CVI = 0.94), borderline-acceptable sampling adequacy (Kaiser–Meyer–Olkin Measure [KMO] = 0.71), explained 51.5% of variance, and had borderline-acceptable internal consistency (α = 0.65). Most witnesses were female, close relatives, and had ≤high school education. High scores (≥80) were observed in 63.9% of cases. While 72.2% reported calling 112 emergency medical service (EMS) at symptom onset, 39.2% arrived by ambulance to the ED, and 44.7% arrived more than 4.5 hours after symptom onset. Demographics were not associated with transport or response, except that first- or second-degree relatives had shorter delays; women and lower-educated participants scored higher, but the differences were not statistically significant. Higher scores correlated with EMS calls. The knowledge–response gap was 22.1%, and the knowledge–transport and response–transport gaps were 60.7% and 57.6%, respectively. Delays were more frequent among men, lower-educated participants, non-EMS users, and those with higher scores, though these differences were not significant. The most common delay reason was waiting for symptoms to resolve. Misbelief in 112 EMS ambulance fees persisted even among highly educated and high-scoring groups. Conclusion: SAKS is valid for ED, prehospital, or community use but requires refinement. Greater awareness improved EMS call volume, but substantial knowledge–action gaps remained. Future research should focus on understanding and reducing the gap between knowledge and action.
Keywords : Acil servis, İnme Farkındalığı Bilgi Ölçeği, inme tanığı, hastane öncesi davranış biçimi

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