PT - JOURNAL ARTICLE AU - Lin, Feng AU - Wu, Gang AU - Liang, Junbo AU - Chen, Jiya AU - Pang, Xiaozhen TI - Knowledge and attitude towards stroke and prehospital delay among patients and their family members under high prehospital delay in Zhejiang, China: a cross-sectional study AID - 10.1136/bmjopen-2024-094240 DP - 2025 Jun 01 TA - BMJ Open PG - e094240 VI - 15 IP - 6 4099 - http://bmjopen.bmj.com/content/15/6/e094240.short 4100 - http://bmjopen.bmj.com/content/15/6/e094240.full SO - BMJ Open2025 Jun 01; 15 AB - Objectives To investigate the knowledge of stroke and the attitudes towards stroke and prehospital delay among patients who had an acute ischaemic stroke (AIS) and their family members.Design This cross-sectional study was conducted through a self-designed questionnaire.Setting The study took place in a Grade-A tertiary hospital in Zhejiang Province, China, between July 2023 and November 2023.Participants A total of 521 valid questionnaires were collected from 367 patients who had an AIS and 154 family members.Interventions Participants provided demographic information and answered questions related to stroke knowledge, attitudes towards stroke and prehospital delay.Primary and secondary outcome measures The primary outcome measures included scores on stroke knowledge, attitudes towards stroke and attitudes towards prehospital delay. Secondary outcomes focused on identifying correlations and independent factors influencing prehospital delay.Results The average scores for patients were stroke knowledge 8.74±6.16 (range: 0–24), stroke attitude 23.52±2.73 (range: 7–35) and prehospital delay attitude 38.65±7.68 (range: 10–50). Family members scored 12.66±6.85, 23.60±2.57 and 40.02±7.45, respectively. Significant correlations were found between stroke knowledge and attitude (r=0.2262, p<0.001) and between stroke attitude and prehospital delay attitude (r=0.1305, p=0.0028). Multivariate analysis indicated that patients’ prehospital delay attitude (OR=0.91) and choice of the first medical facility (OR=0.30) were associated with prehospital delay, while in family members, prehospital delay attitude (OR=0.91) and wake-up stroke (OR=2.91) were significant.Conclusions Both patients who had an AIS and their family members demonstrated insufficient knowledge and moderate attitudes towards stroke and prehospital delay, which were associated with extended prehospital delay. Educational interventions are necessary to enhance stroke knowledge. Targeted stroke awareness programmes and rapid response training could help improve early recognition and timely medical intervention, reducing prehospital delay and improving patient outcomes.All data relevant to the study are included in the article or uploaded as supplementary information. All data generated or analysed during this study are included in this published article.