Evidence mapPaperPMID 42328365Full record

ArticleJournal of education and health promotion2026

Exploring the reasons stroke patients do not use emergency medical services: A qualitative study.

Behzad Moradi, Ali Darvishpoor Kakhki, Hamid Reza Khankeh, Mitra Zandi

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Article in Journal of education and health promotion, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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4 authors.

Behzad MoradiStudent Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Ali Darvishpoor KakhkiDepartment of Medical-Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Hamid Reza KhankehDepartment of Clinical Science and Education, Karolinska Institute, Stockholm, Sweden.
Mitra ZandiDepartment of Medical-Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDespite the well-established benefits of using Emergency Medical Services (EMS) in the management of stroke, the rate of EMS usage among stroke patients remains significantly low. This study was undertaken to explore and elucidate the underlying reasons for the underutilization of EMS by individuals experiencing stroke. MATERIALS AND

methodsThis qualitative content analysis was conducted in 2025 in hospitals affiliated with Lorestan University of Medical Sciences and Shahid Beheshti University of Medical Sciences, Iran, with 17 participants, including stroke patients and their family members. Participants were purposively selected, and data were collected through semi-structured interviews. The data were analyzed using Graneheim and Lundman.s conventional content analysis approach. To ensure the trustworthiness of the findings, the recommendations of Lincoln and Guba were followed. MAXQDA version 18 software (VERBI Software, Berlin, Germany) was used for data management.

resultsAfter the analysis of the interviews, the findings were categorized into three main themes: deficiency in awareness, inappropriate organizational context, and attitudes and misconceptions. Seven subcategories were also identified, namely, lack of knowledge of EMS, symptom underestimation, negative experiences with EMS, limited access to EMS services, secrecy, fatalism, and high threshold for seeking help.

conclusionThe findings indicate that patients often lack sufficient knowledge about stroke and the benefits of using EMS. Factors such as limited awareness of EMS, inadequate access, and various cultural and social influences contribute to the underutilization of these services. It is recommended that targeted community education initiatives be implemented to enhance public awareness of stroke symptoms and emphasize the critical role of EMS in the prehospital management of stroke patients.

Indexed as

Cerebral infarctionemergency medical servicesstroke

Identifiers

PMID42328365
PMCPMC13278491

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