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Sakr F, Safwan J, Cherfane M, Salameh P, Sacre H, Haddad C, El Khatib S, Rahal M, Dia M, Harb A, Hosseini H, Iskandar K. Knowledge and Awareness of Stroke among the Elderly Population: Analysis of Data from a Sample of Older Adults in a Developing Country. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:2172. [PMID: 38138275 PMCID: PMC10744528 DOI: 10.3390/medicina59122172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 12/03/2023] [Accepted: 12/11/2023] [Indexed: 12/24/2023]
Abstract
Background and Objectives: Stroke prevention has traditionally concentrated on research to improve knowledge and awareness of the disease in the general population. Since stroke incidents increase with age, there is a need to focus on the elderly, a high-risk group for developing the disease. This study aimed to examine the level of stroke awareness and knowledge, their predictors, and their source of information. Materials and Methods: A prospective cross-sectional study targeted Lebanese senior citizens aged 65 years and above. A total of 513 participants enrolled in the study through a self-administered survey distributed using a snowball sampling technique. Results: Most participants had appropriate baseline knowledge (more than 75% correct answers) of stroke, including risk factors, alarming signs, and preventive measures. Better knowledge of disease risks was significantly associated with having a university degree (ORa = 1.609; p = 0.029). Participants who had previous ischemic attacks showed significantly lower knowledge of the alarming signs (ORa = 0.467; p = 0.036) and prevention measures (ORa = 0.427; p = 0.029). Those suffering from depression had better knowledge of stroke alarming signs (ORa = 2.060.; p = 0.050). Seeking information from pharmacists, physicians, or the internet was not significantly associated with better knowledge of stroke risks, alarming signs, and preventive measures. Conclusions: The present study showed that seniors had fair knowledge of stroke, despite gaps in stroke prevention measures. Healthcare providers could play a leading role in improving public health by educating seniors to enhance awareness about prevention measures, detecting alarming signs, and acting fast to save a life.
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Affiliation(s)
- Fouad Sakr
- School of Pharmacy, Lebanese International University, Beirut 1105, Lebanon; (J.S.); (M.R.); (M.D.); (A.H.); (K.I.)
- UMR U955 INSERM, Institut Mondor de Recherche Biomédicale, Université Paris-Est Créteil, 94010 Créteil, France;
- École Doctorale Sciences de la Vie et de la Santé, Université Paris-Est Créteil, 94010 Créteil, France
- Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban (INSPECT-LB), Beirut 1103, Lebanon; (M.C.); (P.S.); (H.S.); (C.H.); (S.E.K.)
| | - Jihan Safwan
- School of Pharmacy, Lebanese International University, Beirut 1105, Lebanon; (J.S.); (M.R.); (M.D.); (A.H.); (K.I.)
- Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban (INSPECT-LB), Beirut 1103, Lebanon; (M.C.); (P.S.); (H.S.); (C.H.); (S.E.K.)
| | - Michelle Cherfane
- Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban (INSPECT-LB), Beirut 1103, Lebanon; (M.C.); (P.S.); (H.S.); (C.H.); (S.E.K.)
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos 4504, Lebanon
- College of Health Sciences, Abu Dhabi University, Abu Dhabi 25586, United Arab Emirates
| | - Pascale Salameh
- Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban (INSPECT-LB), Beirut 1103, Lebanon; (M.C.); (P.S.); (H.S.); (C.H.); (S.E.K.)
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos 4504, Lebanon
- Faculty of Pharmacy, Lebanese University, Beirut 1103, Lebanon
- Department of Primary Care and Population Health, University of Nicosia Medical School, 2417 Nicosia, Cyprus
| | - Hala Sacre
- Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban (INSPECT-LB), Beirut 1103, Lebanon; (M.C.); (P.S.); (H.S.); (C.H.); (S.E.K.)
| | - Chadia Haddad
- Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban (INSPECT-LB), Beirut 1103, Lebanon; (M.C.); (P.S.); (H.S.); (C.H.); (S.E.K.)
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib 1525, Lebanon
- School of Health Sciences, Modern University for Business and Science, Beirut 7501, Lebanon
| | - Sarah El Khatib
- Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban (INSPECT-LB), Beirut 1103, Lebanon; (M.C.); (P.S.); (H.S.); (C.H.); (S.E.K.)
- Faculty of Public Health, Lebanese University, Tripoli 1300, Lebanon
| | - Mohamad Rahal
- School of Pharmacy, Lebanese International University, Beirut 1105, Lebanon; (J.S.); (M.R.); (M.D.); (A.H.); (K.I.)
| | - Mohammad Dia
- School of Pharmacy, Lebanese International University, Beirut 1105, Lebanon; (J.S.); (M.R.); (M.D.); (A.H.); (K.I.)
| | - Ahmad Harb
- School of Pharmacy, Lebanese International University, Beirut 1105, Lebanon; (J.S.); (M.R.); (M.D.); (A.H.); (K.I.)
| | - Hassan Hosseini
- UMR U955 INSERM, Institut Mondor de Recherche Biomédicale, Université Paris-Est Créteil, 94010 Créteil, France;
- École Doctorale Sciences de la Vie et de la Santé, Université Paris-Est Créteil, 94010 Créteil, France
- Service de Neurologie, Hôpital Henri Mondor, AP-HP, 94010 Créteil, France
| | - Katia Iskandar
- School of Pharmacy, Lebanese International University, Beirut 1105, Lebanon; (J.S.); (M.R.); (M.D.); (A.H.); (K.I.)
- Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban (INSPECT-LB), Beirut 1103, Lebanon; (M.C.); (P.S.); (H.S.); (C.H.); (S.E.K.)
- Faculty of Pharmacy, Lebanese University, Beirut 1103, Lebanon
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Ramadan A, Kharaba Z, Ghemrawi R, Elnour AA, Hussain N, Kouhgard P, Al-Damook N, Abou Hait S, Al Ghanem L, Atassi R, Chkh Sobeh R, Z. Al Meslamani A. Assessment of Knowledge and attitude towards Stroke among the UAE population during the COVID-19 pandemic: A cross-sectional study. F1000Res 2023; 12:322. [PMID: 37854872 PMCID: PMC10579853 DOI: 10.12688/f1000research.129873.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/11/2023] [Indexed: 10/20/2023] Open
Abstract
Background: Despite significant advancements in healthcare, the burden of stroke continues to rise in the developed world, especially during the COVID-19 pandemic. Association between COVID-19 infection and stroke is well established. Factors identified for the delay in presentation and management include a lack of awareness regarding stroke. We aimed to assess the general public knowledge and attitudes on stroke and stroke risk factors in the United Arab Emirates during the COVID-19 pandemic. Methods: A cross-sectional study was conducted between September 2021 and January 2022 among adults≥ 18 years old. Participants completed a self-administered questionnaire on sociodemographic characteristics and stroke knowledge and attitudes. Knowledge and attitude scores were calculated based on the number of correct responses. Linear regression analysis was performed to determine the factors related to knowledge and attitude towards stroke. Results: Of the 500 respondents, 69.4% were females, 53.4% were aged between 18 and 25, and nearly half were students (48.4%). The mean knowledge score was 13.66 (range 2-24). Hypertension (69%), smoking (63.2%), stress (56.4%) obesity/overweight (54.4%), and heart disease (53.6%) were identified as risk factors. Overall, the knowledge of signs/symptoms was suboptimal. The mean attitude score was 4.41 (range, 1-6); 70.2% would call an ambulance if someone were having a stroke. A monthly income of 11,000-50,000 AED and being a student were associated with positive knowledge. Being a non-health worker and lacking access to electronic media sources were associated with worse attitudes. Conclusion: Overall, we identified poor knowledge and suboptimal attitudes toward stroke. These findings reflect the need for effective public health approaches to improve stroke awareness, knowledge, and attitudes for effective prevention in the community. Presently, this is of utmost necessity, given the increased occurrence of stroke and its severity among COVID-19 patients.
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Affiliation(s)
- Azza Ramadan
- AAU Health and Biomedical Research Center, Al Ain University, Abu Dhabi, United Arab Emirates
- Pharmaceutical Sciences, Al Ain University, Abu Dhabi, United Arab Emirates
| | - Zelal Kharaba
- AAU Health and Biomedical Research Center, Al Ain University, Abu Dhabi, United Arab Emirates
- Program of Clinical Pharmacy, Al Ain University, Abu Dhbai, United Arab Emirates
- Honorary Associate Lecturer, Faculty of Medical Sciences, Newcastle University, Newcastle, UK
| | - Rose Ghemrawi
- AAU Health and Biomedical Research Center, Al Ain University, Abu Dhabi, United Arab Emirates
- Pharmaceutical Sciences, Al Ain University, Abu Dhabi, United Arab Emirates
| | - Asim Ahmed Elnour
- AAU Health and Biomedical Research Center, Al Ain University, Abu Dhabi, United Arab Emirates
- Program of Clinical Pharmacy, Al Ain University, Abu Dhbai, United Arab Emirates
| | - Nadia Hussain
- AAU Health and Biomedical Research Center, Al Ain University, Abu Dhabi, United Arab Emirates
- Pharmaceutical Sciences, Al Ain University, Abu Dhabi, United Arab Emirates
| | - Parisa Kouhgard
- Pharmaceutical Sciences, Al Ain University, Abu Dhabi, United Arab Emirates
| | - Nosayba Al-Damook
- Pharmaceutical Sciences, Al Ain University, Abu Dhabi, United Arab Emirates
| | - Shymaa Abou Hait
- Pharmaceutical Sciences, Al Ain University, Abu Dhabi, United Arab Emirates
| | - Lena Al Ghanem
- Pharmaceutical Sciences, Al Ain University, Abu Dhabi, United Arab Emirates
| | - Rawan Atassi
- Cleveland Clinic, Cleveland Hospital, Abu Dhabi, United Arab Emirates
| | - Ranem Chkh Sobeh
- Cleveland Clinic, Cleveland Hospital, Abu Dhabi, United Arab Emirates
| | - Ahmad Z. Al Meslamani
- AAU Health and Biomedical Research Center, Al Ain University, Abu Dhabi, United Arab Emirates
- Program of Clinical Pharmacy, Al Ain University, Abu Dhbai, United Arab Emirates
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Saceleanu VM, Toader C, Ples H, Covache-Busuioc RA, Costin HP, Bratu BG, Dumitrascu DI, Bordeianu A, Corlatescu AD, Ciurea AV. Integrative Approaches in Acute Ischemic Stroke: From Symptom Recognition to Future Innovations. Biomedicines 2023; 11:2617. [PMID: 37892991 PMCID: PMC10604797 DOI: 10.3390/biomedicines11102617] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 09/21/2023] [Accepted: 09/21/2023] [Indexed: 10/29/2023] Open
Abstract
Among the high prevalence of cerebrovascular diseases nowadays, acute ischemic stroke stands out, representing a significant worldwide health issue with important socio-economic implications. Prompt diagnosis and intervention are important milestones for the management of this multifaceted pathology, making understanding the various stroke-onset symptoms crucial. A key role in acute ischemic stroke management is emphasizing the essential role of a multi-disciplinary team, therefore, increasing the efficiency of recognition and treatment. Neuroimaging and neuroradiology have evolved dramatically over the years, with multiple approaches that provide a higher understanding of the morphological aspects as well as timely recognition of cerebral artery occlusions for effective therapy planning. Regarding the treatment matter, the pharmacological approach, particularly fibrinolytic therapy, has its merits and challenges. Endovascular thrombectomy, a game-changer in stroke management, has witnessed significant advances, with technologies like stent retrievers and aspiration catheters playing pivotal roles. For select patients, combining pharmacological and endovascular strategies offers evidence-backed benefits. The aim of our comprehensive study on acute ischemic stroke is to efficiently compare the current therapies, recognize novel possibilities from the literature, and describe the state of the art in the interdisciplinary approach to acute ischemic stroke. As we aspire for holistic patient management, the emphasis is not just on medical intervention but also on physical therapy, mental health, and community engagement. The future holds promising innovations, with artificial intelligence poised to reshape stroke diagnostics and treatments. Bridging the gap between groundbreaking research and clinical practice remains a challenge, urging continuous collaboration and research.
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Affiliation(s)
- Vicentiu Mircea Saceleanu
- Neurosurgery Department, Sibiu County Emergency Hospital, 550245 Sibiu, Romania;
- Neurosurgery Department, “Lucian Blaga” University of Medicine, 550024 Sibiu, Romania
| | - Corneliu Toader
- Department of Neurosurgery, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (R.-A.C.-B.); (H.P.C.); (B.-G.B.); (D.-I.D.); (A.B.); (A.D.C.); (A.V.C.)
- Department of Vascular Neurosurgery, National Institute of Neurology and Neurovascular Diseases, 020022 Bucharest, Romania
| | - Horia Ples
- Centre for Cognitive Research in Neuropsychiatric Pathology (NeuroPsy-Cog), “Victor Babes” University of Medicine and Pharmacy, 300736 Timisoara, Romania
- Department of Neurosurgery, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Razvan-Adrian Covache-Busuioc
- Department of Neurosurgery, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (R.-A.C.-B.); (H.P.C.); (B.-G.B.); (D.-I.D.); (A.B.); (A.D.C.); (A.V.C.)
| | - Horia Petre Costin
- Department of Neurosurgery, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (R.-A.C.-B.); (H.P.C.); (B.-G.B.); (D.-I.D.); (A.B.); (A.D.C.); (A.V.C.)
| | - Bogdan-Gabriel Bratu
- Department of Neurosurgery, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (R.-A.C.-B.); (H.P.C.); (B.-G.B.); (D.-I.D.); (A.B.); (A.D.C.); (A.V.C.)
| | - David-Ioan Dumitrascu
- Department of Neurosurgery, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (R.-A.C.-B.); (H.P.C.); (B.-G.B.); (D.-I.D.); (A.B.); (A.D.C.); (A.V.C.)
| | - Andrei Bordeianu
- Department of Neurosurgery, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (R.-A.C.-B.); (H.P.C.); (B.-G.B.); (D.-I.D.); (A.B.); (A.D.C.); (A.V.C.)
| | - Antonio Daniel Corlatescu
- Department of Neurosurgery, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (R.-A.C.-B.); (H.P.C.); (B.-G.B.); (D.-I.D.); (A.B.); (A.D.C.); (A.V.C.)
| | - Alexandru Vlad Ciurea
- Department of Neurosurgery, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (R.-A.C.-B.); (H.P.C.); (B.-G.B.); (D.-I.D.); (A.B.); (A.D.C.); (A.V.C.)
- Neurosurgery Department, Sanador Clinical Hospital, 010991 Bucharest, Romania
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de Mélo Silva Júnior ML, Oliveira AGC, Gois WM, Oliveira MFA, de Góis LMD, Ferreira LP, Vilanova MVDS. Different words for stroke: the same concept? an analysis of associated symptoms and intended reaction in Brazil. BMC Neurol 2023; 23:273. [PMID: 37464301 DOI: 10.1186/s12883-023-03327-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 07/10/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND Different names for stroke might mislead physicians and emergency medical service workers. This study aimed to assess the different words for stroke in Brazil and both intended response and related symptoms associated with those names. METHODS Cross-sectional study enrolling healthy individuals from urban areas in Northeast of Brazil for an open-ended survey. We presented a typical clinical case of a stroke (an elderly who had sudden onset of hemiparalysis and slurred speech) and asked "what is happening?", "what would you do?" and "which other symptoms could happen in this condition?". RESUTS From 1,475 interviewed individuals, 1,220 (82,7%) recognized the scenario as a stroke. There were 3 words to correctly identify (based on correct intended response and spontaneously evoked associated symptoms) the stroke, which were "AVC" (acronym for cerebrovascular accident, in Portuguese), "derrame" (spillage) and "trombose" (thrombosis). There were significant differences among them concerning demographic, economic, educational and geographical aspects, but there was no difference according to the intended reaction among them. The most cited associated symptoms (excluding those present in the case) were impaired consciousness (10.6%), headache (8.9%) and dysesthesia (7.7%). "Aneurisma" (aneurism) was also cited, by 3 individuals. CONCLUSION There are at least three words for stroke in Portuguese ("AVC", "derrame" and "trombose"); they were similar in terms of correct intended responses and spontaneously cited accompanying symptoms. Stroke campaigns should apply different names to reach a broader audience and to improve stroke recognition.
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Affiliation(s)
- Mário Luciano de Mélo Silva Júnior
- Medical Sciences Center, Division of Neuropsychiatry, Universidade Federal de Pernambuco, Recife, Pernambuco, Brasil.
- Neurology Unit, Hospital da Restauração, Recife, Pernambuco, Brasil.
- Medical School, Uninassau, Recife, Pernambuco, Brasil.
| | | | - Weslley Medeiros Gois
- Universidade Federal de Sergipe, curso de graduação em Medicina, Lagarto, Sergipe, Brasil
| | | | | | - Lucas Pereira Ferreira
- Universidade Potiguar, curso de graduação em Medicina, Natal, Rio Grande do Norte, Brasil
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Kircher CE, Adeoye O. Prehospital and Emergency Department Care of the Patient With Acute Stroke. Stroke 2022. [DOI: 10.1016/b978-0-323-69424-7.00052-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Agbetou Houessou M, Hountada H, Yahouédéou B, Choki B, Kossi O, Adoukonou T. Knowledge of Stroke Risk Factors and Signs in Parakou, a Northern City of Benin in West Africa. Cerebrovasc Dis 2021; 50:88-93. [PMID: 33423030 DOI: 10.1159/000512715] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Accepted: 10/28/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION We aimed to determine knowledge of stroke risk factors and signs in an urban population of northern Benin. METHODS A door-to-door purposeful sampling survey was conducted in resident population (age ≥15 years) of the district of Titirou in the city of Parakou (N = 255,478) in Benin between March 15 and July 15, 2016. In-person interviews were conducted with data collection on structured questionnaires with close and open questions, according to standard definitions. Multivariable logistic regression was used to assess predictors of good knowledge, defined by provision of a correct response in pre-defined set of questions on stroke risk factors and warning signs. RESULTS Of 4,671 participants (mean age 27.7 ± 12.9 years; females 50.6%), only 404 (8.6%) knew at least 1 stroke risk factor. Knowledge level of stroke risk factors (odds ratio, 95% confidence interval) was related to age (1.37, 1.27-1.48), level of education (2.54, 1.73-3.72), and family history of stroke (3.01, 2.08-4.26). Only 230 (4.9%) were able to cite at least 1 stroke symptom, and this knowledge was great with increasing age (1.04, 1.02-1.06), family (3.63, 2.41-5.49) and personal history of stroke (3.71, 1.86-7.42), and high level of education (4.35, 2.68-7.07). CONCLUSION Knowledge of stroke risk factors and signs is low in northern Benin. Greater public education and awareness campaigns are required to address the burden of stroke.
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Affiliation(s)
- Mendinatou Agbetou Houessou
- Department of Neurology, University of Parakou, Parakou, Benin, .,Clinic of Neurology, University Teaching Hospital of Parakou, Parakou, Benin,
| | - Hospice Hountada
- Clinic of Neurology, University Teaching Hospital of Parakou, Parakou, Benin
| | - Bertrand Yahouédéou
- Clinic of Neurology, University Teaching Hospital of Parakou, Parakou, Benin
| | - Blaise Choki
- Clinic of Neurology, University Teaching Hospital of Parakou, Parakou, Benin
| | - Oyéné Kossi
- Department of Neurology, University of Parakou, Parakou, Benin.,Clinic of Neurology, University Teaching Hospital of Parakou, Parakou, Benin
| | - Thierry Adoukonou
- Department of Neurology, University of Parakou, Parakou, Benin.,Clinic of Neurology, University Teaching Hospital of Parakou, Parakou, Benin.,UMR-1094 INSERM, University of Limoges, CHU Limoges, UMR 1094, Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France
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Adequate Knowledge of Stroke Symptoms, Risk Factors, and Necessary Actions in the General Population of Southern Poland. Brain Sci 2020; 10:brainsci10121009. [PMID: 33353075 PMCID: PMC7766324 DOI: 10.3390/brainsci10121009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 12/04/2020] [Accepted: 12/08/2020] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Stroke is the third most common cause of mortality in developed countries and the primary cause of neurological disability in adults. Recombinant tissue plasminogen activator administered intravenously within 4.5 h from the onset of symptoms constitutes a gold standard in the treatment of acute ischemic stroke. Prompt hospital admission is the prerequisite of effective thrombolysis. Therefore, stroke awareness in the general population is the key factor in timely recognition of the acute stroke victims and determines proper actions. Therefore, the purpose of this study was to determine the awareness of stroke in the general population of the Silesian voivodeship, the most populated region of Poland. We assessed also the "adequate knowledge of stroke", a combined measure of the optimal level of stroke awareness, as a prerequisite for effective stroke management, and aimed to identify most impacting factor for adequate stoke knowledge, to help shaping education strategies. MATERIALS AND METHODS A proprietary anonymous questionnaire consisting of 15 items related to stroke was used in this research. A total of 1134 individuals were surveyed. Additionally to the knowledge of individual aspects of stroke, we assessed "adequate knowledge of stroke", which was combined measure of risk factors, symptoms, and actions in the case of acute stroke. RESULTS The accurate definition of stroke was selected by 834 participants (73.5%). The vast majority of them indicated that a stroke is an emergency (92.8%) and medical assistance is required (97.5%). However, 42.4% of respondents did not know any specific symptom of stroke and only 38.6% participants were able to list two or more risk factors, which resulted in only 36.3% of individuals with adequate knowledge of stroke. Education duration, previous occurrence of stroke in relatives or friends, gender and place of residence were identified as independent predictors of adequate knowledge of stroke. CONCLUSIONS 1. Knowledge of stroke in the population of southern Poland is low and may be considered insufficient to address the needs of timely management in the action chain. 2. Previous occurrence of stroke in the relatives or friends is the most impacting factor for adequate knowledge of stroke.
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Bhat V, Gs T, Kasthuri A. Stroke Awareness among Elderly Hypertensives in a Rural Area of Bangalore District, India. J Stroke Cerebrovasc Dis 2020; 30:105467. [PMID: 33207300 DOI: 10.1016/j.jstrokecerebrovasdis.2020.105467] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 11/04/2020] [Accepted: 11/06/2020] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVES India faces a high and growing burden of hypertension, which is an important cerebrovascular risk factor, especially in elderly persons. Poor awareness contributes to delays in seeking health care, which is undesirable given the emergent nature of stroke. Literature regarding awareness in this subgroup of the population is scarce. Our objective was to assess awareness regarding cerebrovascular disease among elderly persons with hypertension residing in a rural area of Bangalore district, and estimate their individual risk of stroke. MATERIAL & METHODS We randomly selected 144 elderly hypertensives residing in a rural area in Bangalore district from a list of known hypertensives maintained as part of a population-based senior citizen health service. We developed an open-ended, face-validated questionnaire, which was administered following informed consent, to assess stroke awareness. We defined good awareness as knowing at least one risk factor, one warning sign, and having the knowledge that stroke requires immediate treatment. Univariate and multivariate analyses were performed to assess factors associated with good or poor awareness. RESULTS 40% of the study population had not heard of the term 'stroke'. Only 22% could identify the brain as the organ affected. 51% could name at least one symptom. 45% of males and 24% of females believed that their hypertension predisposed them to stroke. 56% could not name a single risk factor. Only 37% of the males and 18% of the females had good overall awareness. Female gender and low literacy were associated with poor overall awareness, while being gainfully employed, a history of alcohol use and doing higher levels of exercise were associated with greater awareness on univariate analysis. None of these factors were statistically significantly related to stroke awareness on multivariate analysis. CONCLUSIONS Awareness of different aspects of stroke was very poor, highlighting the need for stroke education at all levels of care.
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Affiliation(s)
- Vivek Bhat
- St. John's Medical College, Bangalore, India
| | - Thanmayi Gs
- St. John's Medical College, Bangalore, India
| | - Arvind Kasthuri
- Department of Community Medicine, St. John's Medical College, Sarjapur Main Road, Bangalore 560034, India.
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Stack K, Robertson W, Blackburn C. Does socioeconomic position affect knowledge of the risk factors and warning signs of stroke in the WHO European region? A systematic literature review. BMC Public Health 2020; 20:1473. [PMID: 32993624 PMCID: PMC7526368 DOI: 10.1186/s12889-020-09580-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 09/21/2020] [Indexed: 01/13/2023] Open
Abstract
Background Strokes are one of the leading causes of death worldwide. People with a lower socioeconomic position (SEP) (i.e. with regards to education, income and occupation) are at a higher risk of having a stroke and have worse clinical outcomes compared to the general population. Good knowledge levels about stroke risk factors and warning signs are key to prolonging life and reducing health issues caused by stroke. This systematic review examined differences in knowledge of stroke risk factors and warning signs with regards to SEP in the WHO European region. Methods MEDLINE, Embase, Web of Science, PsycINFO and CINAHL were systematically searched using appropriate Medical Subject Headings (MeSH) terms and free text, combining search terms with Boolean operators. Two independent reviewers selected studies in two stages (title and abstract, and full-text), and screened reference lists of included studies. Only studies in English and based in the WHO European region were included. Results Screening identified 2118 records. In the final review, 20 articles were included, with 67,309 study participants between them. Out of 17 studies that looked at stroke risk factors, 11 found increasing knowledge to be associated with higher SEP, four found no difference by SEP, one showed a mixed pattern and one outlier study found increasing knowledge of risk factors to be associated with a lower SEP. Out of 19 studies that looked at stroke warning signs or symptoms, 15 found there to be better knowledge of warning signs with a higher SEP, three found there to be no difference, and the same outlier study found increasing knowledge of warning signs with a lower SEP. Studies that seemed to have a higher quality rating found increasing knowledge of stroke with a higher SEP. A meta-analysis was not possible due to heterogeneity of studies. Conclusions In the WHO European region, better knowledge of stroke risk factors and warning signs is associated with a higher SEP. Public health campaigns and educational interventions aiming to increase stroke knowledge should be targeted at people with a lower SEP.
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Affiliation(s)
- Katie Stack
- Warwick Medical School, University of Warwick, Coventry, CV4 7HL, UK.
| | - Wendy Robertson
- Warwick Medical School, University of Warwick, Coventry, CV4 7HL, UK
| | - Clare Blackburn
- Warwick Medical School, University of Warwick, Coventry, CV4 7HL, UK
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Knowledge on Signs and Risk Factors in Stroke Patients. J Clin Med 2020; 9:jcm9082557. [PMID: 32784554 PMCID: PMC7463706 DOI: 10.3390/jcm9082557] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 07/26/2020] [Accepted: 08/05/2020] [Indexed: 12/20/2022] Open
Abstract
Background: There is a pressing need to contribute evidence to the improvement in the early identification of signs and symptoms associated with strokes, and address the treatment-seeking delays. The objective of this study is to describe the knowledge regarding the warning signs and risk factors (RFs) among stroke patients, as well as of their attitudes toward a suspected event, and the analysis of its possible relationship with the socio-demographic and clinical characteristics of these patients. Method: A cross-sectional study was designed, in which all stroke patients admitted consecutively to the Burgos University Hospital (Spain) were included. The principal outcomes were the patient’s ability to identify two RFs and two warning signs and the patient’s hypothetical response to a possible stroke event. The possible factors associated with the knowledge of warning signs, RFs, and the correct response to a new event were studied using univariate and multivariate regression analysis. Results: A total of 529 patients were included. Having a higher education level or a history of prior stroke were associated with a greater degree of knowledge of warning signs (odds ratio (OR) 3.19, 95% confidence interval (CI) 1.70–5.74, p = 0.003; OR 3.54, 95%CI 2.09–5.99, p ≤ 0.001, respectively), RFs (OR 3.15, 95%CI 1.75–5.67, p = 0.008; OR 4.08, 95%CI 2.41–6.91, p = 0.002, respectively), and the correct response to a possible stroke (OR 1.82, 95%CI 1.16–2.86; p = 0.030; OR 2.11, 95%CI 1.29–3.46, p = 0.022, respectively). Conclusion: Knowledge of warning signs or stroke RFs is low in the hospitalized patients. A previous stroke or secondary/higher education levels are the predictor factors that increase the probability of knowledge of warning signs, RFs, or reaction to possible event.
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Pitton Rissardo J, Fornari Caprara AL, Cervi Prado AL. Stroke Literacy in a South Brazilian City: A Community Based Survey. J Stroke Cerebrovasc Dis 2018; 27:2513-2518. [PMID: 29805082 DOI: 10.1016/j.jstrokecerebrovasdis.2018.05.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 03/26/2018] [Accepted: 05/07/2018] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND This community-based and cross-sectional study was performed in a Brazilian city and aimed to evaluate stroke literacy. METHODS A stroke knowledge survey was administered to passersby of a public square from December 2015 to October 2016, in Santa Maria, Rio Grande do Sul. Convenience sampling was performed. RESULTS A total of 633 respondents completed the survey. Of the respondents, 33% knew the meaning of "AVC"; 29.5% incorrectly localized stroke in the heart. Any warning sign of stroke (open-ended question) could not be remembered by 50.7% of the respondents; individuals with a higher level of schooling (>7 years of education) and those who localized stroke in the brain were more likely to call an emergency in the case of a stroke (adjusted odds ratio [OR] 1.040, 95% confidence interval [CI] 1.004-1.078 for years of schooling; adjusted OR 1.542, 95% CI 1.102-2.156 for replying "yes" to brain as the organ affected in stroke). CONCLUSIONS Brazilian public knowledge about stroke is still scarce, even in a population with levels of formal education above the national average or in a city where annual promotion of Stroke Awareness Campaigns have taken place for almost a decade. Thus, it might be necessary to design different informative strategies targeted to our study's population to improve stroke campaigns in Brazil. In Brazil, increasing awareness of stroke focused on stroke prevention and recognition of its warning signs should be a national priority in public health as the access to stroke treatment remains limited.
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Affiliation(s)
| | | | - Ana Lucia Cervi Prado
- Universidade Federal de Santa Maria Centro de Ciências da Saúde, Santa Maria, Brazil
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12
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Das S, Hazra A, Ray BK, Ghosal M, Chaudhury A, Banerjee TK, Das SK. Knowledge, attitude, and practice in relation to stroke: A community-based study from Kolkata, West Bengal, India. Ann Indian Acad Neurol 2016; 19:221-7. [PMID: 27293334 PMCID: PMC4888686 DOI: 10.4103/0972-2327.176857] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND The rising incidence of stroke in India indicates the importance of evaluating the existing knowledge, attitude, and practice (KAP) in the community, which is essential for stroke control. OBJECTIVE To explore and compare stroke-related KAP among participants from stroke-affected families (SAFs) and nonstroke-affected families (NSFs). DESIGN Using stratified random sampling, a three-phase house-to-house survey was conducted in Kolkata, West Bengal, India. First, field investigators screened subjects of stroke; second, the neurologist confirmed positive cases; and third, under supervision of the neuropsychologist, a validated questionnaire on KAP was administered to participants from SAFs and age-matched NSAFs from the same neighborhood. RESULTS The KAP questionnaire was administered to 282 participants each from both groups. Knowledge about stroke prevailed in 97% participants and was significantly higher in the SAF group. Both SAF and NSAF groups had better knowledge about prominent symptoms of stroke (loss of consciousness and paralysis) and admitted it as emergency situation requiring hospitalization and that it was potentially preventable. Those persons belonging to the SAF group, however, had lesser knowledge of the risk factors such as diabetes (P < 0.001), smoking (P < 0.014), alcoholism (P < .0.0001), family history (P < .0.0001) and mild stroke symptoms such as headache, (P < 0.001), vomiting (P < 0.001), and fits (P 0.003) as compared to the NSAF group. CONCLUSIONS Persons from both SAF and non-SAF groups are aware about stroke but possess lesser knowledge about the many symptoms of stroke and risk factors, indicating the necessity of enhancement of existence knowledge on symptoms for better diagnosis and of risk factors for better prevention.
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Affiliation(s)
- Sujata Das
- Neuropsychologist, Fortis Hospitals, Kolkata, West Bengal, India
| | - Avijit Hazra
- Department of Pharmacology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - Biman Kanti Ray
- Department of Neurology, RG Kar Medical College, Kolkata, West Bengal, India
| | - Malay Ghosal
- Department of Psychiatry, Medical College and Hospital, Kolkata, West Bengal, India
| | - Arijit Chaudhury
- Department of Applied Statistics, Applied Sampling Unit, Indian Satistical Institute, Kolkata, West Bengal, India
| | - Tapas Kumar Banerjee
- Department of Neurology, National Neuroscience Centre, Kolkata, West Bengal, India
| | - Shyamal Kumar Das
- Department of Neurology, Bangur Institute of Neurosciences, Kolkata, West Bengal, India
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14
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Ramírez-Moreno JM, Alonso-González R, Peral-Pacheco D, Millán-Núñez MV, Aguirre-Sánchez JJ. Knowledge of stroke a study from a sex perspective. BMC Res Notes 2015; 8:604. [PMID: 26499113 PMCID: PMC4620012 DOI: 10.1186/s13104-015-1582-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2015] [Accepted: 10/14/2015] [Indexed: 11/30/2022] Open
Abstract
Background Public health is increasingly concerned with recognising
factors that lead to sex differences in stroke. We conducted a study to determine the effect of sex on knowledge of stroke risk factors and warning signs, and how both are perceived, in a representative sample of adults. Methods A representative sample of the population of Extremadura, Spain was selected using a double randomisation technique. Previously trained medical students carried out face-to-face interviews using a structured questionnaire. Results 2409 subjects were interviewed [59.9 % women; mean age (SD) 49.0 (18.7) years]. Seventy-three percent of all subjects reported at least one correct warning sign of stroke (OR: 1.01; 95 % CI: 0.84–1.21). The most frequently mentioned warning signs were sudden weakness, dizziness, and headache. There were no sex differences regarding the types of warning symptoms that respondents listed. Women displayed better
knowledge of risk factors than men (OR: 1.23; 95 % CI: 1.05–1.46). Women were more likely to name hypertension as a risk factor for stroke whereas men more frequently listed smoking, alcohol consumption and a sedentary lifestyle as risk factors. In response to stroke, women were significantly less likely than men to choose to call an ambulance or to go immediately to hospital (OR: 0.69; 95 % CI: 0.60–0.85). Conclusions Stroke knowledge is suboptimal in both men and women. We detected better knowledge of stroke risk factors in women, as well as differences in the type of risk factors listed by men and women. There were significant sex differences regarding response to stroke or to its warning signs. Electronic supplementary material The online version of this article (doi:10.1186/s13104-015-1582-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- José M Ramírez-Moreno
- Department of Neurology, Hospital Universitario Infanta Cristina, Avda de Elvas s/n, 06080, Badajoz, Spain. .,Department of Biomedical Sciences, University of Extremadura, Badajoz, Spain.
| | - Rafael Alonso-González
- Adult Congenital Heart Centre and Centre for Pulmonary Hypertension, Royal Brompton Hospital, London, UK.
| | - Diego Peral-Pacheco
- Department of History and Bioethics, University of Extremadura, Badajoz, Spain.
| | | | - José J Aguirre-Sánchez
- Department of Neurology, Hospital Universitario Infanta Cristina, Avda de Elvas s/n, 06080, Badajoz, Spain.
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Ramírez-Moreno JM, Alonso-González R, Peral-Pacheco D, Millán-Núñez MV, Aguirre-Sánchez JJ. Stroke Awareness Is Worse among the Old and Poorly Educated: A Population-Based Survey. J Stroke Cerebrovasc Dis 2015; 24:1038-46. [DOI: 10.1016/j.jstrokecerebrovasdis.2014.12.031] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Revised: 12/10/2014] [Accepted: 12/29/2014] [Indexed: 10/23/2022] Open
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Tang YH, Hung CH, Chen HM, Lin TH, Liu Y. The effect of health education on Taiwanese hypertensive patients' knowledge and cognition of stroke. Worldviews Evid Based Nurs 2015; 12:116-25. [PMID: 25817269 DOI: 10.1111/wvn.12083] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/17/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND Hypertension is a risk factor for stroke. Increasing patient knowledge and cognition about stroke among hypertensive patients is essential. AIMS To explore the effect of a health education intervention on the knowledge and cognition of stroke in hypertensive patients. METHODS A quasi-experimental design was used with 103 patients with hypertension. The sample was recruited from a cardiologist's outpatient office at a medical center in Kaohsiung city, southern Taiwan. Half the patients (experimental group, n = 52) received health education, whereas the others received only conventional general outpatient care (control group, n = 51). All patients underwent a pretest followed by posttests at 4 and 8 weeks after the intervention. A stroke knowledge scale and stroke cognition scale were used for data collection. RESULTS The experimental group scored significantly higher than the control group in level of knowledge and cognition of stroke. DISCUSSION This study supports that a health education CD-ROM and printed information provided in the outpatient clinical improves knowledge of and cognition of stroke among hypertensive patients. IMPLICATIONS FOR PRACTICE In outpatient clinical practice, nurses can help improve patients' knowledge and cognition of the risks of stroke by playing the health education CD-ROM and providing printed information during the patients' wait time before appointments. CONCLUSIONS Further studies with a longer follow-up (6 months or 1 year) are needed to evaluate the long-term effects of health education on stroke knowledge and cognition among patients with hypertension. LINKING EVIDENCE TO ACTION An outpatient health education program using a CD-ROM and printed information for hypertensive patients can improve the patients' knowledge and cognition of stroke.
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Affiliation(s)
- Yu-Hsuan Tang
- Registered Nurse, Department of Nursing, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan
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Zhao Q, Yang L, Zhang X, Zhu X, Zuo Q, Wu Y, Yang L, Gao W, Li M, Cheng S. Development and validation of the Pre-hospital Stroke Symptoms Coping Test. PLoS One 2014; 9:e110022. [PMID: 25330453 PMCID: PMC4201517 DOI: 10.1371/journal.pone.0110022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Accepted: 09/11/2014] [Indexed: 11/18/2022] Open
Abstract
Background and Purpose Measures of specific knowledge of coping with pre-hospital stroke symptoms can help educate high-risk patients and family caregivers. This study aimed to develop and validate the Pre-hospital Stroke Symptoms Coping Test (PSSCT). Materials and Methods Reliability and validity were analyzed using multiple data sources. The Delphi expert consultation method was applied to assess the test’s surface validity and content validity index. The final edition of the 19-item PSSCT contained 3 sections assessing coping with typical symptoms and symptoms associated with vomiting and twitching. Its psychometric properties were investigated in a community sample of 300 high-risk patients and family members. Results The PSSCT was readily accepted by participants. It demonstrated adequate surface validity and content validity, and good internal consistency (KR20 = 0.822) and test-retest reliability (0.769), with difficulty (P) and degree of differentiation (D) ranges of 0.28–0.83 and 0.15–0.66, respectively. It was also able to distinguish between individuals who had/had not experienced a stroke. Experienced individuals scored significantly higher overall and on coping with typical symptoms and twitching (P<0.01). Conclusions The PSSCT can practically and directly assess critical knowledge regarding coping with pre-hospital stroke symptoms and has good reliability and validity.
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Affiliation(s)
- Qiuli Zhao
- School of Nursing, The 2nd Affiliated Hospital of Harbin Medical University, Harbin Medical University, Harbin, China
- * E-mail:
| | - Li Yang
- School of Nursing, The 2nd Affiliated Hospital of Harbin Medical University, Harbin Medical University, Harbin, China
| | - Xiao Zhang
- School of Nursing, The 2nd Affiliated Hospital of Harbin Medical University, Harbin Medical University, Harbin, China
| | - Xuemei Zhu
- School of Nursing, The 2nd Affiliated Hospital of Harbin Medical University, Harbin Medical University, Harbin, China
| | - Qingqing Zuo
- School of Nursing, The 2nd Affiliated Hospital of Harbin Medical University, Harbin Medical University, Harbin, China
| | - Yanni Wu
- Department of Nursing department, The 2nd Affiliated Hospital of Harbin Medical University, Harbin Medical University, Harbin, China
| | - Liu Yang
- School of Nursing, The 2nd Affiliated Hospital of Harbin Medical University, Harbin Medical University, Harbin, China
| | - Wei Gao
- School of Nursing, The 2nd Affiliated Hospital of Harbin Medical University, Harbin Medical University, Harbin, China
| | - Minghui Li
- School of Nursing, The 2nd Affiliated Hospital of Harbin Medical University, Harbin Medical University, Harbin, China
| | - Shanshan Cheng
- School of Nursing, The 2nd Affiliated Hospital of Harbin Medical University, Harbin Medical University, Harbin, China
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Malek AM, Adams RJ, Debenham E, Boan AD, Kazley AS, Hyacinth HI, Voeks JH, Lackland DT. Patient awareness and perception of stroke symptoms and the use of 911. J Stroke Cerebrovasc Dis 2014; 23:2362-71. [PMID: 25213451 DOI: 10.1016/j.jstrokecerebrovasdis.2014.05.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Revised: 04/29/2014] [Accepted: 05/09/2014] [Indexed: 10/24/2022] Open
Abstract
BACKGROUND Response to stroke symptoms and the use of 911 can vary by race/ethnicity. The quickness with which a patient responds to such symptoms has implications for the outcome and treatment. We sought to examine a sample of patients receiving a Remote Evaluation of Acute isCHemic stroke (REACH) telestroke consult in South Carolina regarding their awareness and perception of stroke symptoms related to the use of 911 and to assess possible racial/ethnic disparities. METHODS As of September 2013, 2325 REACH telestroke consults were conducted in 13 centers throughout South Carolina. Telephone surveys assessing use of 911 were administered from March 2012-January 2013 among 197 patients receiving REACH consults. Univariate and multivariate logistic regression was performed to assess factors associated with use of 911. RESULTS Most participants (73%) were Caucasian (27% were African-American) and male (54%). The mean age was 66 ± 14.3 years. Factors associated with use of 911 included National Institutes of Health Stroke Scale scores >4 (odds ratio [OR], 5.4; 95% confidence interval [CI], 2.63-11.25), unknown insurance which includes self-pay or not charged (OR, 2.90; 95% CI, 1.15-7.28), and perception of stroke-like symptoms as an emergency (OR, 4.58; 95% CI, 1.65-12.67). African-Americans were significantly more likely than Caucasians to call 911 (62% vs. 43%, P = .02). CONCLUSIONS African-Americans used 911 at a significantly higher rate. Use of 911 may be related to access to transportation, lack of insurance, or proximity to the hospital although this information was not available. Interventions are needed to improve patient arrival times to telemedicine equipped emergency departments after stroke.
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Affiliation(s)
- Angela M Malek
- Department of Neurosciences, Medical University of South Carolina, Charleston, South Carolina.
| | - Robert J Adams
- Department of Neurosciences, Medical University of South Carolina, Charleston, South Carolina
| | - Ellen Debenham
- Department of Neurosciences, Medical University of South Carolina, Charleston, South Carolina
| | - Andrea D Boan
- Department of Neurosciences, Medical University of South Carolina, Charleston, South Carolina
| | - Abby S Kazley
- Department of Healthcare Leadership & Management, Medical University of South Carolina, Charleston, South Carolina
| | - Hyacinth I Hyacinth
- Department of Neurosciences, Medical University of South Carolina, Charleston, South Carolina
| | - Jenifer H Voeks
- Department of Neurosciences, Medical University of South Carolina, Charleston, South Carolina
| | - Daniel T Lackland
- Department of Neurosciences, Medical University of South Carolina, Charleston, South Carolina
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Hatzitolios AI, Spanou M, Dambali R, Vraka K, Doumarapis E, Petratos K, Savopoulos C, Tziomalos K. Public Awareness of Stroke Symptoms and Risk Factors and Response to Acute Stroke in Northern Greece. Int J Stroke 2014; 9:E15. [DOI: 10.1111/ijs.12261] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Apostolos I. Hatzitolios
- First Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
| | - Marianna Spanou
- First Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
| | - Roxani Dambali
- First Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
| | - Katerina Vraka
- First Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
| | - Eugenios Doumarapis
- First Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
| | - Konstantinos Petratos
- First Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
| | - Christos Savopoulos
- First Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
| | - Konstantinos Tziomalos
- First Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
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Das S, Das SK. Knowledge, attitude and practice of stroke in India versus other developed and developing countries. Ann Indian Acad Neurol 2014; 16:488-93. [PMID: 24339565 PMCID: PMC3841586 DOI: 10.4103/0972-2327.120431] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2013] [Revised: 05/07/2013] [Accepted: 08/12/2013] [Indexed: 11/18/2022] Open
Abstract
Rising stroke and higher mortality among Indian population needs focused attention for prevention and early management of stroke. In India, very few studies have been carried out to determine the causes of deficiencies in knowledge, attitude and practice (KAP) of stroke among Indians. Study on KAP is essential to improve the awareness about stroke, early diagnosis and institution of appropriate management. In this article, we have reviewed the existing literature on this issue and tried to compare it with those of developed countries and suggested the measures we need to adopt in India to improve awareness and knowledge base.
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Affiliation(s)
- Sujata Das
- Department of Neuropsychology, Fortis Hospitals, Anandapur, Kolkata, India
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Status and costs of primary prevention for ischemic stroke in China. J Clin Neurosci 2013; 20:1427-32. [PMID: 23938016 DOI: 10.1016/j.jocn.2013.01.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2012] [Revised: 12/22/2012] [Accepted: 01/03/2013] [Indexed: 02/05/2023]
Abstract
Despite the benefits in reducing the risk of stroke, primary prevention is not well translated into practice. We sought to evaluate patient compliance with guidelines and the cost of primary stroke prevention in southwest China. We consecutively enrolled 305 patients with headaches and/or dizziness who were at high risk of stroke from our hospital. We retrospectively obtained their information, including the extent of their knowledge of stroke risk factors, adherence to guidelines, medications taken, and costs of primary prevention for stroke within the past year. Only 45.9% of patients had any knowledge of primary prevention, and only 17.0% had completely followed guidelines. Moreover, 79.0% of the patients were using medications, but only 39.3% took their medication as recommended. In patients who took medication, 89.6% were prescribed by physicians. The annual costs of primary prevention were estimated to be US$517.8 per capita, which included direct medical costs (US$435.4), direct non-medical costs (US$18.1), and indirect costs (US$64.3). Costs in the hypertension group were less than those reported by a similar international study. Although our population sample may not be representative of the population at high risk of stroke in China, it is appropriate for the evaluation of our primary prevention system. Primary prevention for stroke in southwest China is very challenging, with few medical resource investments. There is a current urgency to improve patient knowledge of primary prevention, which would bridge the gaps between guidelines and practice and increase medical resource investments.
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Bietzk E, Davies R, Floyd A, Lindsay A, Greenstone H, Symonds A, Greenfield S. FAST enough? The U.K. general public's understanding of stroke. Clin Med (Lond) 2012; 12:410-5. [PMID: 23101138 PMCID: PMC4953760 DOI: 10.7861/clinmedicine.12-5-410] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Good public awareness of stroke symptoms and the need for rapid admission to hospital can improve patient outcomes. However, evidence suggests that this awareness is currently inadequate. Therefore, it is important to identify gaps in public knowledge to target public health campaigns appropriately. This questionnaire study of 356 adults in Birmingham city centre assessed the general public's understanding of stroke, whether demographic factors affect this and the influence of a national campaign (FAST) on knowledge. The mean overall knowledge score was 11.8 out of 15; however, only 54.2% of those questioned knew that diabetes, hypertension and high cholesterol were stroke risk factors. Of those questioned, 60.2% were aware of the FAST campaign. General understanding of stroke was fairly good, although it was found to be worse in the youngest, oldest age and nonwhite groups. Although there was good awareness of the FAST campaign, many people did not know what the individual letters meant. Based on the results of our study, we conclude that it might take considerable time for public awareness campaigns to achieve their full impact.
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Worthmann H, Schwartz A, Heidenreich F, Sindern E, Lorenz R, Adams HA, Flemming A, Luettje K, Walter U, Haertle B, Dengler R. Educational Campaign on Stroke in an Urban Population in Northern Germany: Influence on Public Stroke Awareness and Knowledge. Int J Stroke 2012; 8:286-92. [DOI: 10.1111/j.1747-4949.2012.00809.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Background Public stroke awareness and knowledge may be supportive for stroke prevention and emergency care-seeking behavior after the acute event, which is highly important for early treatment onset. Aims In an urban population in Northern Germany (Hannover), a six-month stroke educational campaign was conducted. We expected an increase in stroke knowledge and awareness thereafter. Methods Computer-assisted telephone interviews were randomly conducted among 1004 representative participants before and 1010 immediately after the educational multimedia campaign. The computer-assisted telephone interviews focused on questions about stroke knowledge and interventions remembered. Results Knowledge of stroke risk factors increased during the campaign for overweight, physical inactivity, old age, and stroke in family ( P < 0·05). The knowledge of stroke warning signs was low, although it significantly increased during the campaign ( P < 0·001) as paresis/weakness (46%) and speech problems (31%) were most frequently named. The majority of respondents indicated that the first action after suffering from stroke should be calling emergency care (74% before vs. 84% after campaign, P < 0·001). Conclusions Our data indicate that stroke knowledge and awareness, which could provide earlier presentation to the emergency unit for timely treatment onset, are still low in urban Northern Germany but may decisively be increased by educational campaigns.
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Affiliation(s)
- Hans Worthmann
- Department of Neurology, Hannover Medical School, Hannover, Germany
| | | | - Fedor Heidenreich
- Department of Neurology, Diakoniekrankenhaus Henriettenstiftung, Hannover, Germany
| | - Eckhart Sindern
- Department of Neurology, Diakoniekrankenhaus Friederikenstift gGmbH, Hannover, Germany
| | - Reinhard Lorenz
- Department of Neurology, Klinikum Agnes Karll Laatzen, Laatzen, Germany
| | - Hans-Anton Adams
- Stabsstelle für Interdisziplinäre Notfall- und Katastrophenmedizin, Hannover Medical School, Hannover, Germany
| | - Andreas Flemming
- Stabsstelle für Interdisziplinäre Notfall- und Katastrophenmedizin, Hannover Medical School, Hannover, Germany
| | | | - Ulla Walter
- Institute for Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School, Hannover, Germany
| | - Birgit Haertle
- Boehringer Ingelheim Pharma GmbH & Co. KG, Ingelheim, Germany
| | - Reinhard Dengler
- Department of Neurology, Hannover Medical School, Hannover, Germany
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Morren JA, Salgado ED. Stroke literacy, behavior, and proficiency in a South Florida population. J Stroke Cerebrovasc Dis 2012; 22:962-8. [PMID: 22244691 DOI: 10.1016/j.jstrokecerebrovasdis.2011.12.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2011] [Revised: 12/17/2011] [Accepted: 12/17/2011] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Our goal was to assess stroke literacy, behavior, and proficiency in our South Florida service population. METHODS Data were obtained from the 2006 to 2010 Cleveland Clinic Florida annual "stroke prevention screening" questionnaires. "Stroke risk factor awareness" was attributed to participants correctly identifying at least 5 out of the 7 stroke risk factors presented. "Stroke symptom awareness" was assigned if one correctly selected all 5 listed stroke symptoms and not any of the 3 inappropriate responses. Participants had "stroke literacy" if they: (1) demonstrated stroke risk factor awareness; (2) demonstrated stroke symptom awareness; and (3) they correctly identified the brain as where a stroke occurs. To assess appropriate "stroke behavior," respondents had to choose "call 911 immediately" if one were to experience stroke symptoms. "Stroke proficiency" was attributed to individuals showing both stroke literacy and appropriate stroke behavior. RESULTS There were a total of 298 participants. Sixty-seven percent of participants correctly identified the brain as the organ where stroke occurs. Almost three-fourths (74.2%) demonstrated stroke risk factor awareness, 28.2% had stroke symptom awareness, 17.8% had stroke literacy, 87.9% declared appropriate stroke behavior, and 16.1% had stroke proficiency. CONCLUSIONS Stroke behavior and stroke proficiency are useful novel concepts in stroke epidemiology. Although our South Florida community is relatively well-educated and affluent, there are tangible gaps in knowledge, attitudes, and behavior as it pertains to stroke, similar to that seen in less advantaged populations. We recommend intensified usage of the media with information provided by qualified health professionals in a variety of formats and languages appropriate to the ethnic and cultural diversities that define this population.
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Affiliation(s)
- John A Morren
- Department of Neurology, Cleveland Clinic Florida, Weston, Florida.
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Wiszniewska M, Głuszkiewicz M, Kobayashi A, Włodek A, Jezierska-Ostapczuk A, Fryze W, Członkowska A. Knowledge of Risk Factors and Stroke Symptoms among Nonstroke Patients. Eur Neurol 2012; 67:220-5. [DOI: 10.1159/000335569] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2011] [Accepted: 12/04/2011] [Indexed: 11/19/2022]
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Hickey A, Holly D, McGee H, Conroy R, Shelley E. Knowledge of Stroke Risk Factors and Warning Signs in Ireland: Development and Application of the Stroke Awareness Questionnaire (SAQ). Int J Stroke 2011; 7:298-306. [DOI: 10.1111/j.1747-4949.2011.00698.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Background Inability to recognize stroke warning signs and delay in seeking medical attention for recognized symptoms contribute to treatment delay, thus limiting the potential for intervention and impacting negatively on potential stroke outcome. Aim To examine knowledge of stroke risk factors and warning signs in the adult population in Ireland. Methods In 2009, 1000 members of the general public were interviewed by telephone using quota-based population sampling of adults (≥18 years). Information was gathered using the Stroke Awareness Questionnaire (SAQ). Results 71% of participants could correctly list two or more risk factors for stroke, typically generic lifestyle risk factors. Two-thirds could not identify two warning signs for stroke. While 31% could identify two or more stroke warning signs, there was no consistency in warning signs identified. Less than 50% stated they would call an ambulance if having a stroke. Overall, there were significant gaps in knowledge, with poorest levels evident in those aged ≥65 years. Conclusions Survey findings provide first evidence on levels of knowledge of stroke risk factors and warning signs in the Irish adult population. Awareness of stroke warning signs was poor, as was awareness of the need to call emergency services and the potential for acute stroke intervention. These factors contribute to delay in seeking medical attention following stroke, with resulting implications for stroke outcome.
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Affiliation(s)
- Anne Hickey
- Department of Psychology, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Deirdre Holly
- Department of Psychology, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Hannah McGee
- Department of Psychology, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Ronan Conroy
- Department of Epidemiology and Public Health Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Emer Shelley
- Department of Epidemiology and Public Health Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
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DeVon HA, Saban KL, Garrett DK. Recognizing and Responding to Symptoms of Acute Coronary Syndromes and Stroke in Women. J Obstet Gynecol Neonatal Nurs 2011; 40:372-82. [DOI: 10.1111/j.1552-6909.2011.01241.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Maasland L, Brouwer-Goossensen D, den Hertog HM, Koudstaal PJ, Dippel DWJ. Health education in patients with a recent stroke or transient ischaemic attack: a comprehensive review. Int J Stroke 2011; 6:67-74. [PMID: 21205243 DOI: 10.1111/j.1747-4949.2010.00541.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Health education aims at the acquisition of skills and attitudes to modify behaviour that influences health, leads to a modification of risk factors and ultimately to a decrease in disability and case fatality from stroke. Health education is an underdeveloped but important aspect of stroke care. Health education could promote compliance and healthy behaviour, improve patients' understanding of their health status and treatment options and facilitate communication. We reviewed the effect of health education in stroke and transient ischaemic attack patients, aiming at feasibility, effectiveness at the level of knowledge, attitude and skills, health behaviour changes and stroke outcome. We also describe the current status of health education for patients with recent coronary artery disease and public health education in stroke. Basic knowledge of stroke and transient ischaemic attack patients of their disease and associated risk factors is not sufficient. This is also observed in patients with coronary artery disease and in the general population. A beneficial effect of health education in stroke and transient ischaemic attack patients on health behaviour, risk reduction or stroke outcome has not been proven. Trials in patients with coronary artery disease, however, have shown that health education could result in a change of lifestyle. No specific method is superior, although the individualised, repetitive and active methods appear more successful. More intervention studies of health education in stroke and transient ischaemic attack patients are needed. Future trials should be large, have a long follow-up, should use an intensive and repetitive approach and involve patients' relatives to induce and maintain a healthy lifestyle.
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Affiliation(s)
- Lisette Maasland
- Department of Neurology, Erasmus Medical Center, Rotterdam, The Netherlands.
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Kelly-Irving M, Mulot S, Inamo J, Ruidavets JB, Atallah A, Lang T. Improving stroke prevention in the French West Indies: limits to lay knowledge of risk factors. Stroke 2010; 41:2637-44. [PMID: 20884867 DOI: 10.1161/strokeaha.110.592659] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE We sought to evaluate lay knowledge and understanding of cardiovascular diseases in the French West Indies. METHODS In 2007, a cross-sectional study of 1005 randomly selected men and women (54%) age 25 to 74 years from Guadeloupe and stratified by sex, age, and region was established to ascertain the population's knowledge and awareness of chronic diseases. Questions were asked about the respondent's knowledge of cardiovascular risk factors as well as their opinions and beliefs about measures to prevent these diseases. RESULTS Knowledge about stroke prevention in this sample was lower than for heart disease, with 69% of women and 65% of men reporting that precautions can be taken to avoid a stroke versus 84% and 77%, respectively, for heart disease. "Avoid stress" was the most commonly cited stroke prevention measure, with 35% of women and 27% of men reporting it. The first spontaneous item cited for heart disease prevention was "physical exercise or sport," reported by 47% of women and 45% of men. We hypothesize that knowledge of stroke and stroke risk factors is poor in Guadeloupe or that it reflects culturally adapted health promotion messages from doctors. CONCLUSIONS Knowledge and awareness were found to be lower for stroke than for heart diseases. Changes in health promotion strategies are required in the French West Indies to improve the population's overall awareness of these diseases and to narrow the gap between knowledge and practice.
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