Influence of Decision-Makers' Perceived Risk on the Propensity for Intravenous Thrombolysis in Acute Ischemic Stroke: A Cross-Sectional Study.
Jie Yu, Rong Xiao, Jiru Liu and 3 others
PMID 42363748WHAT IT FOUND
Surrogate decision makers who reported higher economic, psychosocial, or physical risk had lower preference for thrombolysis in acute stroke.
Ask about these worries and explain risks plainly.
Key findings
01After adjustment for age, education, and household income, higher perceived economic, psychosocial, and physical risk was associated with lower propensity to choose thrombolysis.
02Surrogate decision makers reported high levels of risk perception across economic, psychosocial, and physical domains.
03Risk perception scores differed by age group, education level, and household income.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The survey was done at one stroke centre in China with convenience sampling, so the findings may not apply to other hospitals or countries. It is cross-sectional, so it shows associations but cannot prove that risk perception caused refusal or that changing communication would change decisions. The questionnaire measured stated preference for thrombolysis, not actual treatment received or patient outcomes. 29 of 230 questionnaires were excluded, and the analysed sample was 201 surrogate decision makers. The authors did not measure what information surrogate decision makers had received, so it is unclear how knowledge affected risk perception. The instrument was developed by the researchers, although they reported content validation and Cronbach's alpha 0.855.
Declared interests
The funding section says the authors have nothing to report, and the authors declare no conflicts of interest.
The easy way to misread this
Do not conclude that explaining thrombolysis to families will increase thrombolysis rates or improve stroke outcomes. This was a survey of stated preference at one centre, and it did not test a communication intervention.