Abstract TP365: Gender Differences in Symptom Perception and Care-Seeking Behavior in Acute Stroke

Abstract

Background: Evidence suggests gender differences in: care seeking behaviors during stroke; stroke knowledge; perceptions of stroke symptoms; physical location at the time of event and decision making, and the impact of having a witness. Aims: To determine the impact of gender on the time to presentation (greater or equal to 4.5 hours or greater than 4.5 hours), symptom perception and clinical signs, stroke knowledge and decision making, physical location at the time of stroke, and the presence and impact of having a witnessed stroke. Study Design: A descriptive study based on a convenience sample of 60 subjects admitted to an academic medical center for stroke. Methods: Patients were asked a series of questions regarding the care seeking decision process, the role of others in the decision process, physical location at the time of event and the decision to seek care, and general stroke knowledge. They also answered a 28 symptom questionnaire which was compared to medical findings. Results: There were approximately equal number of men and women in the late and early presenting groups. Early presenting men were more likely to: have a higher admission NIHSS score (7.7 vs 4.8), to receive alteplase (71% vs 20%), to arrive by EMS, and have a witnessed stroke compared to early arriving women. Men were more likely to take an active role in the decision making process to seek care, while care seeking decision making in females was more likely to be transferred to nonspousal family members. Both early and late presenting women reported more non-focal symptoms than men. While most patients had at least one sign or symptom associated with national used stroke symptom acronyms, both genders delayed care because they didn’t perceive their symptoms as being urgent. Limitations: Small convenience sample from a single hospital with no control for stroke etiology. Conclusion: More research is needed to better understand the influence of gender on patient perception of stroke and care seeking behaviors.