J. Med. Internet Res. - Stroke experiences in weblogs: a feasibility study of sex differences.

Tópicos

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Resumo

CKGROUND: Research on cerebral stroke symptoms using hospital records has reported that women experience more nontraditional symptoms of stroke (eg, mental status change, pain) than men do. This is an important issue because nontraditional symptoms may delay the decision to get medical assistance and increase the difficulty of correct diagnosis. In the present study, we investigate sex differences in the stroke experience as described in stories on weblogs.OBJECTIVE: The goal of this study was to investigate the feasibility of using the Internet as a source of data for basic research on stroke experiences.METHODS: Stroke experiences described in blogs were identified by using StoryUpgrade, a program that searches blog posts using a fictional prototype story. In this study, the prototype story was a description of a stroke experience. Retrieved stories coded by the researchers as relevant were used to update the search query and retrieve more stories using relevance feedback. Stories were coded for first- or third-person narrator, traditional and nontraditional patient symptoms, type of stroke, patient sex and age, delay before seeking medical assistance, and delay at hospital and in treatment.RESULTS: There were 191 relevant stroke stories of which 174 stories reported symptoms (52.3% female and 47.7% male patients). There were no sex differences for each traditional or nontraditional stroke symptom by chi-square analysis (all Ps>.05). Type of narrator, however, affected report of traditional and nontraditional symptoms. Female first-person narrators (ie, the patient) were more likely to report mental status change (56.3%, 27/48) than male first-person narrators (36.4%, 16/44), a marginally significant effect by logistic regression (P=.056), whereas reports of third-person narrators did not differ for women (27.9%, 12/43) and men (28.2%, 11/39) patients. There were more reports of at least 1 nontraditional symptom in the 92 first-person reports (44.6%, 41/92) than in the 82 third-person reports (25.6%, 21/82, P=.006). Ischemic or hemorrhagic stroke was reported in 67 and 29 stories, respectively. Nontraditional symptoms varied with stroke type with 1 or more nontraditional symptoms reported for 79.3% (23/29) of hemorrhagic stroke patients and 53.7% (36/67) of ischemic stroke patients (P=.001).CONCLUSIONS: The results replicate previous findings based on hospital interview data supporting the reliability of findings from weblogs. New findings include the effect of first- versus third-person narrator on sex differences in the report of nontraditional symptoms. This result suggests that narrator is an important variable to be examined in future studies. A fragmentary data problem limits some conclusions because important information, such as age, was not consistently reported. Age trends strengthen the feasibility of using the Internet for stroke research because older adults have significantly increased their Internet use in recent years.

Resumo Limpo

ckground research cerebr stroke symptom use hospit record report women experi nontradit symptom stroke eg mental status chang pain men import issu nontradit symptom may delay decis get medic assist increas difficulti correct diagnosi present studi investig sex differ stroke experi describ stori weblogsobject goal studi investig feasibl use internet sourc data basic research stroke experiencesmethod stroke experi describ blog identifi use storyupgrad program search blog post use fiction prototyp stori studi prototyp stori descript stroke experi retriev stori code research relev use updat search queri retriev stori use relev feedback stori code first thirdperson narrat tradit nontradit patient symptom type stroke patient sex age delay seek medic assist delay hospit treatmentresult relev stroke stori stori report symptom femal male patient sex differ tradit nontradit stroke symptom chisquar analysi ps type narrat howev affect report tradit nontradit symptom femal firstperson narrat ie patient like report mental status chang male firstperson narrat margin signific effect logist regress p wherea report thirdperson narrat differ women men patient report least nontradit symptom firstperson report thirdperson report p ischem hemorrhag stroke report stori respect nontradit symptom vari stroke type nontradit symptom report hemorrhag stroke patient ischem stroke patient pconclus result replic previous find base hospit interview data support reliabl find weblog new find includ effect first versus thirdperson narrat sex differ report nontradit symptom result suggest narrat import variabl examin futur studi fragmentari data problem limit conclus import inform age consist report age trend strengthen feasibl use internet stroke research older adult signific increas internet use recent year

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