Date of Award
Spring 5-24-2025
Document Type
Doctor of Nursing Practice Final Manuscript
Degree Name
Doctor of Nursing Practice
Department
Nursing
First Advisor
Joseph Burkard, DNSc, CRNA, EBP-C, AACN Health Policy Fellow
Abstract
Purpose: The purpose of this evidence-based practice Doctor of Nursing Practice (DNP) project is to review research-based evidence evaluating the inequities in women’s stroke research and treatments and how this effects women’s stroke outcomes. This paper sought to identify current recommendations for improving sex equity for women’s stroke research and identify further areas of policy change to ensure that women’s health outcomes are prioritized in this historically underrepresented population.
Background: An area of critical importance to society is the significant cause of gender-based inequity in healthcare and research. Historically medical research has primarily involved males and the findings have been generalized to females. An area of healthcare that remains a major cause of morbidity and mortality for women despite decades of research is stroke. Women have different risk factors, presentation, response to treatment and outcomes when compared with their male counterparts and are more likely to experience delays in care.
Methods: The LEAD framework was used to guide decisions related to this policy work. Research articles were compiled and categorized between August 2024 to March 2025.
Results: Women are under-represented in randomized clinical trials for acute stroke treatments. They are more likely to present with headache or altered mental status when compared to men. Women experience higher delays in diagnosis and treatment including onset-to door and door to endovascular puncture times and undergo fewer diagnostic exams. Those with ischemic stroke are less likely to receive thrombolysis or thrombectomy. Women have a lower incidence of intracranial hemorrhage; however, they have a higher 1-year case fatality rate. Women with stroke have higher rates of mortality and use of palliative care and hospice.
Evaluation: Further policy must be enacted to ensure funds are allocated to improve women’s stroke outcomes. Additional research is needed to investigate reasons for under enrollment of women in stroke clinical trials and to promote increased participation. Policy must outline a strategic initiative to ensure equity to lifesaving interventions, promoting health equity in women’s stroke outcomes.
Keywords: Stroke, health equity, sex differences, Women’s research, clinical trials representation
Digital USD Citation
Warner, Lindsay M., "Improving Equity in Women's Stroke Outcomes" (2025). Doctor of Nursing Practice Final Manuscripts. 292.
https://digital.sandiego.edu/dnp/292
Copyright
Copyright held by the author
