Journal of agricultural medicine and community health (농촌의학ㆍ지역보건)

Korean Society for Rural Medicine and Community Health (한국농촌의학지역보건학회)
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Necessity of Education for Emergency Medical Technicians to Improve Awareness of Early Symptoms of Stroke and Assessment of Stroke Patients

응급구급대원에서 뇌졸중 조기증상 인지 및 환자평가 향상을 위한 교육 필요성

  • Lee, Jeong-Mi (Department of Preventive Medicine, Wonkwang University, School of Medicine) ;
  • Lee, Jang-Yeol (Department of Preventive Medicine, Wonkwang University, School of Medicine) ;
  • Park, Seong-Bin (Department of Preventive Medicine, Wonkwang University, School of Medicine) ;
  • Lee, Young-Hoon (Department of Preventive Medicine, Wonkwang University, School of Medicine) ;
  • Oh, Gyung-Jae (Department of Preventive Medicine, Wonkwang University, School of Medicine)
  • 이정미 (원광대학교 의과대학 예방의학교실) ;
  • 이장열 (원광대학교 의과대학 예방의학교실) ;
  • 박성빈 (원광대학교 의과대학 예방의학교실) ;
  • 이영훈 (원광대학교 의과대학 예방의학교실) ;
  • 오경재 (원광대학교 의과대학 예방의학교실)
  • Received : 2013.04.02
  • Accepted : 2013.06.13
  • Published : 2013.06.30
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Abstract

Objectives: The purpose of this study was to reconsider the necessity of stroke-related educational programs by investigating early symptoms of stroke that emergency medical technicians (EMTs) may experience. Methods: An interview survey was carried out, targeting all EMTs 298 people who were working at 119 fire safety centers and local units in Jeollabuk-do province, from April 1 to 30, 2011. An interviewer administered questionnaire was used to obtain data on ETMs' demographic characteristics, educational level on stroke, and awareness level about early symptoms of stroke and treatment-related characteristics of stroke patients. Results: The results showed that 63.2% of those surveyed had completed the required educational programs on stroke during the past year. The level of awareness about early symptoms of stroke and assessment of stroke patients' condition was relatively high for women, those who were 30 years under, low position people, emergency service practitioners, emergency medical technicians, and people who have completed education, respectively. It was also turned out that 82.8% of those surveyed took stroke patients to the nearest hospitals first so that they could receive appropriate treatment. The level of awareness about early symptoms of stroke and assessment of stroke patients' condition in people who have completed education were higher than non-complete. The level of awareness about early symptoms of stroke was positively correlated with confidence, satisfaction and appropriateness in treatment of stroke patients. Conclusions: These results strongly suggest that it is necessary to operate specialized educational programs to enhance EMTs' appropriate awareness of the early symptoms of stroke and assessment of stroke patient's condition.

이 연구는 응급구급대원들을 대상으로 뇌졸중과 관련된 교육에 대한 특성 및 뇌졸중 조기증상 인지수준을 파악함으로써 이와 관련된 교육프로그램 운영의 필요성과 방향을 제시하고자 수행하였다. 연구 대상자는 전라북도 전체 응급구급대원 298명이었으며 설문조사는 직접면접법을 통해 이뤄졌다. 조사기간은 2011년 4월 1일-30일까지 1개월 동안 이루어졌다. 연구결과 뇌졸중 관련 교육 이수율은 63.2%로 나타났으며 주로 소방학교(63.1%)를 통해 이수하고 있었다. 그러나 대상자들의 뇌졸중 관련 교육 실시요구도(85.0%)는 상대적으로 높게 나타났다. 뇌졸중 조기증상에 대한 전반적인 조기인지 수준 및 뇌졸중 환자 상태평가 점수는 여자에서, 30대 미만, 소방사에서, 구급업무를 직접 담당자에서, 응급구조사에서 뇌졸중 환자 상태평가 수준이 높게 나타났다. 뇌졸중 환자 발생 시 우선적 조치사항으로는 전문치료가 가능한 최근접 병원으로의 환자 이송이 82.8%로 나타났다. 뇌졸중 조기증상에 대한 인지수준, 환자 상태평가, 환자처치에 대한 적절성은 뇌졸중 관련 교육 이수자에서 비이수자보다 높게 나타났다. 응급구급대원은 뇌졸중 조기증상에 대한 조기인지 수준이 증가할수록 뇌졸중 환자 처치에 대한 자신감, 처치 만족도, 처치 적절성이 향상되는 것으로 나타났다. 결론적으로 응급구급대원들을 대상으로 하는 뇌졸중 관련 교육 프로그램 개발 및 운영이 필요하다. 교육 프로그램 개발 및 운영 시에는 기존 교육프로그램에 대한 심층분석을 통해 대상자들의 특성을 고려한 교육내용과 적절한 교육과정을 확보함으로써 교육 대상자들의 요구도를 충족시키고, 교육 이수율을 높여 궁극적으로는 응급구급대원들의 실질적인 역량 강화를 이룰 수 있도록 해야겠다.

Keywords

References

  1. KCDC. Study on the factors influencing long-term functional level and quality of life in patients with the first-ever stroke. KCDC, 2012, pp.8 (Korean)
  2. National Health Insurance Corporation . Trend of medical treatment in the elderly with geriatric disease. National Health Insurance Corporation, 2010, pp.1-7 (Korean)
  3. The National Institute of Neurologic Disorder and Stroke t-PA Stroke Study Group: Tissue plaminogen activator for acute ischemic stroke. N Engl J Med 1995;333:1581-1587 https://doi.org/10.1056/NEJM199512143332401
  4. Antman EM, Anbe DT, Armstrong PW, Bates ER, Green LA, Hand M, et al. ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction-executive summary. A report of the American College of Cardiology/ American Heart Association Task Force on Practice Guidelines (Writing committee to Revise the 1999 Guidelines for the Management of Patients With Acute Myocardial Infarction). J Am Coll Cardiol 2004;44(3):671-719 https://doi.org/10.1016/j.jacc.2004.07.002
  5. Doh HB, Lee BC, Lee IH, Kim JH, Kim SM, Kwon KH. Presentation time to hospital and recognition of stroke in patients with ischemic stroke. J Korean Neurol Assoc 2000;18(2):125-131 (Korean)
  6. Anderson NE, Broad JB, Bonita R. Delay in hospital admission and investigation in acute stroke. BMJ 1995;311(6998):162 https://doi.org/10.1136/bmj.311.6998.162
  7. Salisbury HR, Banks BJ, Footitt DR, Winner SJ, Reynolds DJ. Delay in presentation of patients with acute stroke to hospital in Oxford. QJM 1998;91(9):635-640 https://doi.org/10.1093/qjmed/91.9.635
  8. Kothari R, Jauch E, Broderick J, Brott T, Sauerbeck L, Khoury J et al. Acute stroke: delays to presentation and emergency department evaluaion. Ann Emerg Med 1999;33(1):3-8 https://doi.org/10.1016/S0196-0644(99)70431-2
  9. Moser DK, Kimble LP, Alberts MJ, Alonzo A, Croft JB, Dracup K, et al. Reducing delay in seeking treatment by patients with acute coronary syndrome and stroke: a scientific statement from the American Heart Association Council on cardiovascular nursing and stroke council. J Cardiovasc Nurs 2007;22(4):326-343 https://doi.org/10.1097/01.JCN.0000278963.28619.4a
  10. Croquelois A, Bogousslavsky J. Risk awareness and knowledge of patients with stroke: results of a questionnaire survey 3 months after stroke. J Neurol Neurosurg Psychiatry 2006;77(6):726-728 https://doi.org/10.1136/jnnp.2005.078618
  11. Campos-Sousa RN, Soares VY, Almeida KJ, Carvalho LI, Jacobina KS, Athayde Netto AE, et al. Knowledge of stroke among a Brazilian urban population. Arq Neuropsiquiatr 2007;65(3A):587-591 https://doi.org/10.1590/S0004-282X2007000400007
  12. Aly Z, Abbas K, Kazim SF, Taj F, Aziz F, Irfan A, et al. Awareness of stroke risk factors, signs and treatment in a Pakistani population. J Pak Med Assoc 2009;59(7): 495-499
  13. Regional Cardiocerebrovascular Center. The cognitive level of early symptoms of cardio-cerebrovascular disease. Regional Cardiocerebrovascular Center, 2012, pp.10 (Korean)
  14. Community Health Research. Health and drug laws. Gyechukpub, 2013, pp.160 (Korean)
  15. KCDC. Awareness survey of the early symptoms of cardiocerebrovascular disease in Gyeongsangbuk-do. Osong, KCDC, 2011, pp.22-23 (Korean)
  16. Kothari RU, Pancioli A, Liu T, Brott T, Broderick J. Cincinnati Prehospital Stroke Scale: reproducibility and validity. Ann Emerg Med 1999;33(4):373-378 https://doi.org/10.1016/S0196-0644(99)70299-4
  17. Kidwell CS, Starkman S, Eckstein M, Weems K, Saver JL. Identifying stroke in the field. prospective validation of the Los Angeles prehospital stroke screen(LAPSS). Stroke 2000;31(1):71-76 https://doi.org/10.1161/01.STR.31.1.71
  18. Community Health Research. Health and pharmaceutical laws and regulations. Gyechukpub, 2012, pp.135-204 (Korean)
  19. Albrts MJ, Perry A, Dawson DV, Bertels C. Effects of public and professional education on reducing the delay in presentation and referral of stroke patients. Stroke 1992;23(3):352-356 https://doi.org/10.1161/01.STR.23.3.352
  20. Oh GJ. Characteristics of prehospital care against severe emergency patients in emergency medical technicians. Wonkwang University school of Medicine and Hospital, 2011, pp.94-95 (Korean)
  21. Caro JJ, Huybrechts KF, Duchesne I. Management patterns and costs of acute ischemic stroke : An international study. For the stroke economic analysis group. Stroke 2000;31(3):582-590 https://doi.org/10.1161/01.STR.31.3.582
  22. Jo MW, Bae HJ. One-Year Health Related Quality of Life and Its Comparison With Various Clinical and Functional Scale in Hospitalized Patients With Acute Ischemic Stroke: Seoul National University Bundang Stroke Registry Study. J Korean Neurol Assoc 2009;27(1):28-35 (Korean)
  23. Yoo JH, Eo EK, Kim YJ, Song HS. Educational Effect on Prehospital Personnel for Prehospital Stroke Management. J Korean Society of Emergency Medicine 2002;13(1):23-30 (Korean)
  24. Jeong SG, Kim KS, Cho SH, Kang MG, Han MA. The Contents of Emergency Treatment Practice Conducted by Emergency Medical Technician and Related Factors. J Agri Med & Community Health 2009;34(3): 346-358 (Korean) https://doi.org/10.5393/JAMCH.2009.34.3.346
  25. The National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group. Tissue plasminogen activator for acute ischemic stroke. N Engl J Med 1995;333:1581-1587 https://doi.org/10.1056/NEJM199512143332401
  26. Engelstein E, Margulies J, Jeret JS. Lack of t-PA use for acute ischemic stroke in a community hospital: high incidence of exclusion criteria. Am J Emerg Med 2000;18(3):257-260

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