The Relationship between the Length of Seeking Help and the Severity of Stroke Patients


  • Untung Prayitno STIKES Telogorejo Semarang
  • Sri Puguh Kristiyawati Dosen Program Studi S1 Keperawatan STIKES Telogorejo Semarang
  • Novi Heri Yono Pusat Pengembangan Sumber Daya Manusia Minyak dan Gas Bumi (PPSDM MIGAS), Indonesia

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length of seeking help; response time; severity of stroke


The length of time a stroke patient seeks help from health services plays an important role in the successful treatment of stroke patients. The golden period for stroke treatment is approximately only 3 hours from the start of the attack. Once an attack occurs, the patient must receive comprehensive therapy so that the degree of nerve damage is not severe. The aim of the research was to determine the relationship between the length of time seeking help and the severity of stroke patients at RSUD dr. Loekmono Hadi Kudus. This research is descriptive analytical with a cross-sectional approach. The research sample was taken using a purposive sampling technique. A sample of 65 respondents was obtained. The instruments used were observation sheets and the NIHSS questionnaire, while statistical tests used Spearman Rank. There is a significant relationship between the length of time seeking help and the severity of stroke patients (p-value <0.05). More than half of the respondents sought help from health services after the golden period (>3 hours), and more than half of the respondents experienced a serious stroke. Respondents' or families' ignorance of the signs and symptoms of stroke, as well as consideration of treatment costs, are the dominant factors in patients missing their golden years. Therefore, educating the public about stroke, especially the signs and symptoms of stroke, is very important so that the public can immediately take patients to the hospital. Future researchers are expected to conduct qualitative research to explore knowledge and responses to stroke attacks.


Aigner, A., Grittner, U., Rolfs, A., Norrving, B., Siegerink, B., & Busch, M. A. (2017). Contribution of Established Stroke Risk Factors to the Burden of Stroke in Young Adults. Stroke, 48(7), 1744–1751.

Al Khathaami, A. M., Mohammad, Y. O., Alibrahim, F. S., & Jradi, H. A. (2018). Factors associated with late arrival of acute stroke patients to emergency department in Saudi Arabia. SAGE Open Medicine, 6, 2050312118776719.

Arba, F., Quinn, T., Hankey, G. J., Inzitari, D., Ali, M., Lees, K. R., & VISTA Collaboration. (2017). Determinants of post-stroke cognitive impairment: Analysis from VISTA. Acta Neurologica Scandinavica, 135(6), 603–607.

Aslam, A., Khan, U., Niazi, F., & Anwar, I. (2022). Etiology and risk factors of stroke in young adults: A multicentric study. Annals of Medicine and Surgery, 82, 104647.

Banerjee, C., & Chimowitz, M. I. (2017). Stroke Caused by Atherosclerosis of the Major Intracranial Arteries. Circulation Research, 120(3), 502–513.

BPJS Kesehatan. (2023). Laporan Pengelolaan Program dan Keuangan BPJS Kesehatan Tahun 2022. BPJS KEeehatan RI.

Corbière, S., & Tettenborn, B. (2021). Stroke in women: Is it different? Clinical and Translational Neuroscience, 5(1), 2514183X211014514.

Demel, S. L., Kittner, S., Ley, S. H., McDermott, M., & Rexrode, K. M. (2018). Stroke Risk Factors Unique to Women. Stroke, 49(3), 518–523.

Dinas Kesehatan Provinsi Jawa Tengah. (2022). Profil Kesehatan Jawa Tengah Tahun 2021.

Dinas Kesehatan Provinsi Jawa Tengah. (2023). Profil Kesehatan Provinsi Jawa Tengah Tahun 2022. Dinas Kesehatan Provinsi Jawa Tengah.

El Nahas, N., Aref, H., Kenawy, F. F., Georgy, S., Abushady, E. M., Dawood, N. L., Hamdy, S., Abdelmohsen, N., Hassan Abdel Hamid, Y., Roushdy, T., & Shokri, H. (2023). Stroke in women: Experience in a developing country. BMC Neurology, 23(1), 271.

Ellis, C. (2013). In-hospital delays for stroke care: Losing sight of patient-centered care. European Journal for Person Centered Healthcare, 1(2), Article 2.

Fassbender, K., Balucani, C., Walter, S., Levine, S. R., Haass, A., & Grotta, J. (2013). Streamlining of prehospital stroke management: The golden hour. The Lancet. Neurology, 12(6), 585–596.

Feigin, V. L., Brainin, M., Norrving, B., Martins, S., Sacco, R. L., Hacke, W., Fisher, M., Pandian, J., & Lindsay, P. (2022). World Stroke Organization (WSO): Global Stroke Fact Sheet 2022. International Journal of Stroke, 17(1), 18–29.

Feigin, V. L., Stark, B. A., Johnson, C. O., Roth, G. A., Bisignano, C., Abady, G. G., Abbasifard, M., Abbasi-Kangevari, M., Abd-Allah, F., Abedi, V., Abualhasan, A., Abu-Rmeileh, N. M., Abushouk, A. I., Adebayo, O. M., Agarwal, G., Agasthi, P., Ahinkorah, B. O., Ahmad, S., Ahmadi, S., … Murray, C. J. L. (2021). Global, regional, and national burden of stroke and its risk factors, 1990–2019: A systematic analysis for the Global Burden of Disease Study 2019. The Lancet Neurology, 20(10), 795–820.

Girijala, R. L., Sohrabji, F., & Bush, R. L. (2017). Sex differences in stroke: Review of current knowledge and evidence. Vascular Medicine, 22(2), 135–145.

Hackett, M. L., & Pickles, K. (2014). Part I: Frequency of depression after stroke: an updated systematic review and meta-analysis of observational studies. International Journal of Stroke: Official Journal of the International Stroke Society, 9(8), 1017–1025.

Ishariani, L., & Rachmania, D. (2021). Hubungan Respon Time Keluarga dalam Membawa Pasien Stroke ke Pelayanan Kesehatan dengan Tingkat Keparahan Pasien Stroke. The Indonesian Journal of Health Science, 13(1), Article 1.

Jackson, C. A., Sudlow, C. L. M., & Mishra, G. D. (2018). Education, sex and risk of stroke: A prospective cohort study in New South Wales, Australia. BMJ Open, 8(9), e024070.

Jacobs, M. M., & Ellis, C. (2021). Heterogeneity among women with stroke: Health, demographic and healthcare utilization differentials. BMC Women’s Health, 21(1), 160.

Keller, K., Geyer, M., Münzel, T., & Ostad, M. A. (2018). Gender-differences in prevalence and outcome of ischemic stroke and promoting factors of atrial thrombi. Artery Research, 22(C), 68.

Kementerian Kesehatan RI. (2019). Laporan Riskesdas 2018 Nasional. Lembaga Penerbit Badan Penelitian dan Pengembangan Kesehatan Kementerian KesehatanRI.

Kementerian Kesehatan RI. (2018, July 4). Apa itu Stroke? - Direktorat P2PTM.

Khaku, A. S., & Tadi, P. (2023). Cerebrovascular Disease. In StatPearls. StatPearls Publishing.

Khan, M., Wasay, M., O’Donnell, M. J., Iqbal, R., Langhorne, P., Rosengren, A., Damasceno, A., Oguz, A., Lanas, F., Pogosova, N., Alhussain, F., Oveisgharan, S., Czlonkowska, A., Ryglewicz, D., & Yusuf, S. (2023). Risk Factors for Stroke in the Young (18–45 Years): A Case-Control Analysis of INTERSTROKE Data from 32 Countries. Neuroepidemiology, 57(5), 275–283.

Kusyani, A. (2019). Hubungan Pengetahuan Keluarga Dengan Lama Waktu Kedatangan Pasien Stroke Iskemik Ke Igd Rsud Jombang. Well Being, 4(1), 21–28.

Lekander, I., Willers, C., Euler, M. von, Lilja, M., Sunnerhagen, K. S., Pessah-Rasmussen, H., & Borgström, F. (2017). Relationship between functional disability and costs one and two years post stroke. PLOS ONE, 12(4), e0174861.

Li, A., Ji, Y., Zhu, S., Hu, Z., Xu, X., Wang, Y., & Jian, X. (2022). Risk probability and influencing factors of stroke in followed-up hypertension patients. BMC Cardiovascular Disorders, 22(1), 328.

Madsen, T. E., Howard, G., Kleindorfer, D. O., Furie, K. L., Oparil, S., Manson, J. E., Liu, S., & Howard, V. J. (2019). Sex Differences in Hypertension and Stroke Risk in the REGARDS Study. Hypertension, 74(4), 749–755.

Madsen, T. E., Howard, V. J., Jiménez, M., Rexrode, K. M., Acelajado, M. C., Kleindorfer, D., & Chaturvedi, S. (2018). Impact of Conventional Stroke Risk Factors on Stroke in Women. Stroke, 49(3), 536–542.

Madsen, T. E., Khoury, J. C., Leppert, M., Alwell, K., Moomaw, C. J., Sucharew, H., Woo, D., Ferioli, S., Martini, S., Adeoye, O., Khatri, P., Flaherty, M., De Los Rios La Rosa, F., Mackey, J., Mistry, E., Demel, S. L., Coleman, E., Jasne, A., Slavin, S. J., … Kleindorfer, D. O. (2020). Temporal Trends in Stroke Incidence Over Time by Sex and Age in the GCNKSS. Stroke, 51(4), 1070–1076.

McCarthy, J., Yang, J., Clissold, B., Young, M. J., Fuller, P. J., & Phan, T. (2021). Hypertension Management in Stroke Prevention. Stroke, 52(10), e626–e634.

Meng, Q., Li, Y., Ji, T., Chao, Y., Li, J., Fu, Y., Wang, S., Chen, Q., Chen, W., Huang, F., Wang, Y., Zhang, Q., Wang, X., & Bian, H. (2021). Estrogen prevent atherosclerosis by attenuating endothelial cell pyroptosis via activation of estrogen receptor α-mediated autophagy. Journal of Advanced Research, 28, 149–164.

Mondal, M. B. A., Hasan, A. T. M. H., Khan, N., & Mohammad, Q. D. (2022). Prevalence and risk factors of stroke in Bangladesh: A nationwide population-based survey. ENeurologicalSci, 28, 100414.

Muchada, M., Rubiera, M., Rodriguez-Luna, D., Pagola, J., Flores, A., Kallas, J., Sanjuan, E., Meler, P., Alvarez-Sabin, J., Ribo, M., & Molina, C. A. (2014). Baseline National Institutes of Health Stroke Scale–Adjusted Time Window for Intravenous Tissue-Type Plasminogen Activator in Acute Ischemic Stroke. Stroke, 45(4), 1059–1063.

Olvera Lopez, E., Ballard, B. D., & Jan, A. (2023). Cardiovascular Disease. In StatPearls. StatPearls Publishing.

Rachmawati, D., Andarini, S., & Ningsih, D. K. (2017). Pengetahuan Keluarga Berperan terhadap Keterlambatan Kedatangan Pasien Stroke Iskemik Akut di Instalasi Gawat Darurat. Jurnal Kedokteran Brawijaya, 369–376.

Rahayu, E. O. (2016). Perbedaan Risiko Stroke Berdasarkan Faktor Risiko Biologi pada Usia Produktif. Jurnal Berkala Epidemiologi, 4(September 2016), 113–125.

Ramos-Lima, M. J. M., Brasileiro, I. de C., de Lima, T. L., & Braga-Neto, P. (2018). Quality of life after stroke: Impact of clinical and sociodemographic factors. Clinics, 73, e418.

Rexrode, K. M., Madsen, T. E., Yu, A. Y. X., Carcel, C., Lichtman, J. H., & Miller, E. C. (2022). The Impact of Sex and Gender on Stroke. Circulation Research, 130(4), 512–528.

Rizaldy Pinzon, L. A. (2019). Awas stroke!: Pengertian, gejala tindakan, perawatan dan pencegahan (1st ed.). Penerbit Andi.

Sarfo, F. S., Agbenorku, M., Adamu, S., Obese, V., Berchie, P., & Ovbiagele, B. (2019). The Dynamics of Poststroke Depression among Ghanaians. Journal of the Neurological Sciences, 405, 116410.


Vyas, M. V., Hackam, D. G., Silver, F. L., Laporte, A., & Kapral, M. K. (2016). Lost Productivity in Stroke Survivors: An Econometrics Analysis. Neuroepidemiology, 47(3–4), 164–170.

Wandira, R. D., Amalia, L., & Fuadi, I. (2018). HUBUNGAN ANTARA DERAJAT KEPARAHAN STROKE DENGAN KEJADIAN STROKE-ASSOCIATED PNEUMONIA. Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia, 35(2), Article 2.

Xie, F., Li, X., Xu, Y., Cheng, D., Xia, X., Lv, X., Yuan, G., & Peng, C. (2022). Estrogen Mediates an Atherosclerotic-Protective Action via Estrogen Receptor Alpha/SREBP-1 Signaling. Frontiers in Cardiovascular Medicine, 9, 895916.

Xiuyun, W., Qian, W., Minjun, X., Weidong, L., & Lizhen, L. (2020). Education and stroke: Evidence from epidemiology and Mendelian randomization study. Scientific Reports, 10(1), Article 1.

Yi, X., Luo, H., Zhou, J., Yu, M., Chen, X., Tan, L., Wei, W., & Li, J. (2020). Prevalence of stroke and stroke related risk factors: A population based cross sectional survey in southwestern China. BMC Neurology, 20(1), 5.

Yousufuddin, M., & Young, N. (2019). Aging and ischemic stroke. Aging (Albany NY), 11(9), 2542–2544.

Zhang, F.-L., Guo, Z.-N., Wu, Y.-H., Liu, H.-Y., Luo, Y., Sun, M.-S., Xing, Y.-Q., & Yang, Y. (2017). Prevalence of stroke and associated risk factors: A population based cross sectional study from northeast China. BMJ Open, 7(9), e015758.




How to Cite

Prayitno, U., Kristiyawati, S. P., & Yono, N. H. (2023). The Relationship between the Length of Seeking Help and the Severity of Stroke Patients. Jurnal Kebidanan Dan Keperawatan Aisyiyah, 19(2), 63–71.



Original Research