A Survey on the Management of Patients with Acute Stroke among Emergency Medical Technicians：A Case Study in New Taipei City

• Main Authors: WU,PO-CHING, 吳柏青
• Other Authors: YEH,RONG-SHENG
• Format: Others
• Language: zh-TW
• Published: 2017
• Online Access: http://ndltd.ncl.edu.tw/handle/y668zk

碩士 === 東南科技大學 === 營建與空間設計系營建科技與防災碩士班 === 105 === Introduction The behavior of delivering the right patients (i.e. acute stroke) to the right hospitals (i.e. capable with thrombolytic therapy) has been highly valued in the prehospital management of patients with acute stroke because it will benefit the patients most in the survival and functional outcomes. This study aimed to access the associations between the aspects of knowledge, attitude, the confidence of emergency medical technicians (EMT) and their correct behaviors toward the management of patients with acute stroke in New Taipei City. Methods We conducted a survey by a well-designed structured questionnaire comprising of 4-domain questions regarding the knowledge, attitude, confidence and behavior of EMT toward the management of acute stroke through the online Google Docs targeting at EMTs in New Taipei City. The questionnaire was developed with content validity by Delphi's method and the steady reliability by the test-retest method. The background data of the respondents and the responses in the 4-domain questions were analyzed by cross-tables to find the associations. Factor analysis was applied for collapsing a large number of variables into a few interpretable underlying factors in the domain of non-quantifiable questions. The factors (from the analyses of background and the questionnaire of knowledge, attitude, and confidence) affecting correct behaviors (defined by seven questions) toward the management of acute stroke were analyzed by logistic regression. Results After a 30-day period, there were total 168 responses by the Google Docs system. Excluding the respondents with missing data or obviously reckless responses, a total 159 pieces of the questionnaire were included in the final analysis. The percentages of respondents were similarly among the seven major ambulance brigades. Among the respondents, 153 (96.2%) of them were male, and 123 (77.3%) of them were EMT-Ps (paramedics). The cross-table analyses showed the better performances of knowledge, attitude, and confidence in the younger age of 20-30 (compared with older than 31 years old) and level of paramedics (compared with non-paramedic level). The result of multivariate analyses found that level of paramedic was significantly associated with many correct behaviors (4 out of 7) toward acute stroke. Moreover, the performance of knowledge domain was significantly associated with the most important behavior (defined by the experience of delivering the right patient to the right place within the past 3 months), with odds ratio 1.03 (95% confidence interval 1.002-1.055). It indicated that the one more question was correctly answered in knowledge domain would have the 1.34 times (i.e. 1.03 of the 10th power) the chance of having the correct behavior. Conclusions The paramedic level of EMT has the best performance of knowledge, attitude, confidence and correct behavior toward patients with acute stroke. To all EMTs, enhanced their knowledge regarding acute stroke will significantly increase the chance of delivery of patients with acute stroke to the hospitals capable with thrombolytic therapy.