1
|
Kharaba Z, Alfoteih Y, Jirjees F, Albarbandi M, Hussain Z, Al Obaidi H, Mansour S, Ahmed M, Eltayib E, Barakat M, AlSalamat HA, Alzayer R, El Khatib S, Al-Mohammad S, Hallit S, Malaeb D, Hosseini H. Assessment of knowledge and awareness of stroke among the Syrian population: unveiling the current landscape in Syria through the first nationally representative study. Sci Rep 2024; 14:15426. [PMID: 38965262 PMCID: PMC11224319 DOI: 10.1038/s41598-024-64935-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 06/14/2024] [Indexed: 07/06/2024] Open
Abstract
Stroke is a global public health concern, contributing to high rates of morbidity and mortality. In Syria, the current conflict and associated challenges have had a profound impact on healthcare infrastructure, including education and awareness programs related to stroke. An essential aspect of preventing stroke is the awareness of individuals. The study aimed to investigate factors associated with knowledge and awareness of stroke among Syrian people. A cross-sectional national representative study was conducted in Syria. The questionnaire was created on Google form and disseminated as a link through online platform social media like Facebook, WhatsApp, and Twitter. The population of the study was divided using proportionate random sampling into the 14 governorates. A random sample was selected from each area. The STROBE reporting guideline for cross-sectional studies was followed. Logistic regression analysis was performed to identify the factors associated with poor knowledge of stroke. A total of 1013 Syrian adults participated in the study. With more than half of them were females (53.5%) and employed (55.6%). Significant associations were found between ability to identify at least one correct risk factor and employability status (p = 0.029), single group (p = 0.036) and smokers (p < 0.001). In addition, significant associations were found between identifying at least one correct stroke symptom and smokers (p < 0.001) and no-obese people (p = 0.048). Furthermore, younger age group (below 30 years) were significantly able to list at least one correct stroke consequence compared to the older age groups (p = 0.025). Moreover, a significantly higher number of smokers compared to non-smokers correctly identified at least one stroke consequence (p = 0.019). The study revealed that there is a relatively weak understanding of the preventable nature of stroke among Syrian population. The overall awareness is still inadequate and varies depending on lifestyle factors and employment status.
Collapse
Affiliation(s)
- Zelal Kharaba
- Department of Clinical Pharmacy, College of Pharmacy, Al Ain University, 64141, Abu Dhabi, United Arab Emirates
- Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
- Department of Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah, Sharjah, United Arab Emirates
| | - Yassen Alfoteih
- College of Dental Surgery, City University Ajman, 18484, Ajman, United Arab Emirates
- College of General Education, City University Ajman, 18484, Ajman, United Arab Emirates
| | - Feras Jirjees
- Department of Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah, Sharjah, United Arab Emirates
| | - Mohammad Albarbandi
- Department of Neurosurgery, Ibn Al-Nafees Hospital, Damascus, Syria
- Department of Neurosurgery, Damascus Hospital, Damascus, Syria
| | - Zainab Hussain
- Department of Biology, College of Science, University of Baghdad, Baghdad, Iraq
| | | | - Sara Mansour
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Munazza Ahmed
- Department of Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah, Sharjah, United Arab Emirates
| | - Eyman Eltayib
- College of Pharmacy, Al Jouf University, Jouf, Saudi Arabia
| | - Muna Barakat
- Department of Clinical Pharmacy and Therapeutics, School of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Husam A AlSalamat
- Department of Basic Medical Sciences, Faculty of Medicine, Al-Balqa Applied University, Al-Salt, 19117, Jordan
- Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, University of Jordan, Amman, Jordan
| | - Reem Alzayer
- Clinical Pharmacy Practice, Mohammed Al-Mana College for Medical Sciences, Dammam, Saudi Arabia
| | - Sami El Khatib
- Department of Biomedical Sciences, Lebanese International University, Bekaa, Lebanon
- Center for Applied Mathematics and Bioinformatics (CAMB), Gulf University for Science and Technology, Mubarak Al-Abdullah, Kuwait
| | | | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O Box 446, Jounieh, Lebanon
- Department of Psychology, College of Humanities, Effat University, 21478, Jeddah, Saudi Arabia
- Applied Science Research Center, Applied Science Private University, Amman, Jordan
| | - Diana Malaeb
- College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates.
| | - Hassan Hosseini
- UPEC-University Paris-Est, Creteil, France
- RAMSAY SANTÉ, HPPE, Champigny sur Marne, France
| |
Collapse
|
2
|
KAZADI KABANDA I, KIANGEBENI NGONZO C, EMEKA BOWAMOU CK, DIVENGI NZAMBI JP, KIATOKO PONTE N, TUYINAMA MADODA O, NKODILA NATUHOYILA A, M’BUYAMBA-KABANGU JR, LONGO-MBENZA B, BANZULU BOMBA D, KIANU PHANZU B. Stroke signs knowledge and factors associated with a delayed hospital arrival of patients with acute stroke in Kinshasa. Heliyon 2024; 10:e28311. [PMID: 38571603 PMCID: PMC10988012 DOI: 10.1016/j.heliyon.2024.e28311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 03/13/2024] [Accepted: 03/15/2024] [Indexed: 04/05/2024] Open
Abstract
Background Rapid recognition and early medical intervention are essential to reduce stroke-related mortality and long-term disability. This study aimed to evaluate awareness of stroke symptoms/signs and determine factors delaying the hospital arrival of patients with acute stroke in Kinshasa. Methods Patients with stroke and/or accompanying family members were interviewed using a standard questionnaire, and their medical records were reviewed. Factors independently associated with a late arrival (≥4.5 h) to the hospital were identified using the logistic regression test in forward multivariate analysis. Results Overall, 202 patients with an average age of 57.9 ± 13.1 years were included. Only 27 (13.4%) patients immediately associated the initial symptoms with a stroke episode. Delayed hospital arrival was observed in 180 (89.1%) patients. Unmarried status (adjusted odds ratio [aOR], 2.29; 95% confidence interval [CI], 1.17-4.88; p = 0.007), low education level (aOR, 2.29; 95% CI, (1.12-5.10; p = 0,014), absence of impaired consciousness (aOR, 3.12; 95% CI, 1.52-4.43; p = 0.005), absence of a history of hypertention (aOR, 1.85; 95% CI, 1.18-3.78; p = 0.041), absence of a history of diabetes (aOR, 1.93; 95% CI, 1.15-4.58; p = 0.013), heavy alcohol consumption (aOR, 1.83; 95% CI, 1.12-2.83; p = 0.045), absence of a severe to very severe stroke (aOR, 4.93; 95% CI, 0.82-1.01; p = 0.002), and presence of ischemic stroke (aOR, 2.93; 95% CI, 1.54-4.59; p = 0.001) were identified as independent determinants of delayed hospital arrival. Conclusions This study depicted a low stroke awareness rate and a much longer prehospital delay than evidence-based guidelines recommend and identified eight factors that public health actions could target to promote the earliest management of stroke.
Collapse
Affiliation(s)
- Igor KAZADI KABANDA
- Faculty of Medicine, University of Kinshasa, Kinshasa, the Democratic Republic of the Congo
| | | | | | - Jean-Paul DIVENGI NZAMBI
- Department of Internal Medicine, Reference General Hospital, Kinshasa, the Democratic Republic of the Congo
| | - Nono KIATOKO PONTE
- Unit of Neurology, Centre Hospitalier Initiative Plus de Kinkole, Kinshasa, the Democratic Republic of the Congo
| | - Olivier TUYINAMA MADODA
- Emergency Unit, University Hospital of Kinshasa, Kinshasa, the Democratic Republic of the Congo
| | - Aliocha NKODILA NATUHOYILA
- Department of Biostatistics, Public Health School of Kinshasa, Kinshasa, the Democratic Republic of the Congo
| | | | - Benjamin LONGO-MBENZA
- Cardiology Unit, University of Kinshasa, Kinshasa, the Democratic Republic of the Congo
| | - Degani BANZULU BOMBA
- Department of Neuropsychiatry, University of Kinshasa, Kinshasa, the Democratic Republic of the Congo
| | - Bernard KIANU PHANZU
- Cardiology Unit, University of Kinshasa, Kinshasa, the Democratic Republic of the Congo
| |
Collapse
|
3
|
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.
Collapse
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
| |
Collapse
|
4
|
Jirjees F, Al-Obaidi H, Barakat M, Kharaba Z, AlSalamat H, Khidhair Z, Alfoteih Y, Eltayib E, Mansour S, Hallit S, Malaeb D, Hosseini H. Knowledge and awareness of stroke in the United Arab Emirates: a cross-sectional study of the general population. F1000Res 2023; 12:1112. [PMID: 37868297 PMCID: PMC10587663 DOI: 10.12688/f1000research.134328.2] [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: 10/09/2023] [Indexed: 10/24/2023] Open
Abstract
BACKGROUND The study aimed to assess stroke knowledge among the general population in the United Arab Emirates (UAE) and determine the factors associated with stroke awareness among people. METHODS A cross-sectional study was conducted in the UAE between September and November 2021. The general population has self-administered an online bilingual survey (Arabic and English) distributed via social media platforms. The questionnaire covered general knowledge about stroke risk factors, consequences of stroke, and responding to somebody with acute stroke attack. RESULTS A total of 545 surveys were completed, with more than half of the participants being female (58.5%), married (55.4%) and employed (59.4%). The majority were less than 50 years old (90.5%) and had a university degree (71.0%). Many of the participants (70.8%) had a good general knowledge of stroke; however, around 20% of the participants were able to recognize all symptoms and risk factors of stroke. The most common sources of stroke-related information were the internet/social media (53.6%). Females were better able to correctly identify at least one stroke symptom and outcome than males (p=0.008). University education has significantly affected participants' ability to identify early stroke symptoms (p=0.001) correctly. In addition, diabetic people were more likely to recognize at least one stroke outcome than non-diabetic people (p=0.039). CONCLUSIONS The knowledge of stroke was good among highly educated people and females. However, the awareness of all stroke risk factors, symptoms, consequences and risk factors was inadequate among the general population of the UAE. Thus, there is still a gap between recognition of the relevant stroke and taking action among people.
Collapse
Affiliation(s)
- Feras Jirjees
- University of Sharjah, Sharjah, United Arab Emirates
| | | | - Muna Barakat
- Applied Science Private University, Amman, Jordan
| | | | | | | | | | | | - Sara Mansour
- Lebanese International University, Beqaa, Lebanon
| | | | - Diana Malaeb
- Gulf Medical University, Ajman, United Arab Emirates
| | - Hassan Hosseini
- Universite Paris-Est Creteil Val de Marne, Créteil, Île-de-France, France
| |
Collapse
|
5
|
Alzayer R, Barakat M, Jirjees F, Alhamdan A, Aloraifej S, Cherri S, Mansour S, El Khatib S, Kharaba Z, Rahal M, Hallit S, Malaeb D, Hosseini H. Knowledge and awareness of stroke and associated factors in the Saudi general population: a cross-sectional study. Front Neurol 2023; 14:1225980. [PMID: 37808501 PMCID: PMC10552853 DOI: 10.3389/fneur.2023.1225980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 08/29/2023] [Indexed: 10/10/2023] Open
Abstract
Introduction Stroke is a major cause of death and disability globally and in Saudi Arabia as well. Prevention and management of stroke depend highly on raising knowledge and awareness about the disease. Purpose The purpose of this study was to evaluate Saudi adult's knowledge and awareness about stroke and determine the associated factors. Materials and methods A cross-sectional online survey was conducted in May-July 2022 among Saudi citizens. Assessments of stroke knowledge about risk factors, symptoms, and response to stroke symptoms were evaluated. Logistic regression was conducted to assess the association between the socio-demographic characteristics and knowledge. Results A total of 389 participants were enrolled with the majority (81.7%) being male participants. Less than half of the study subjects (43.3%) identified four out of five correct answers related to general knowledge about stroke. Almost all the participants were able to identify at least one risk factor associated with stroke. The majority of the participants (81.2%) believed that physical inactivity was the most common risk factor associated with stroke. Approximately three-quarters of participants considered difficulty speaking and understanding speech, followed by the sudden loss of consciousness as the most common stroke manifestation. Participants with a history of hypertension, dyslipidemia, and obesity had significantly higher odds of identifying at least one early stroke symptom (OR 2.271 [95% CI 1.402 3.677], 2.059 [95% CI 1.273 3.328], and 2.665 [95% CI 1.431 4.963], respectively). Conclusion Our study revealed that participants have good knowledge about stroke. Nonetheless, further efforts are required to raise awareness and educate the public to optimize and ensure better treatment outcomes.
Collapse
Affiliation(s)
- Reem Alzayer
- Clinical Pharmacy Practice, Mohammed Al-Mana College for Medical Sciences (MACHS), Dammam, Saudi Arabia
| | - Muna Barakat
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
- MEU Research Unit, Middle East University, Amman, Jordan
| | - Feras Jirjees
- Clinical Pharmacy and Pharmacy Practice, University of Sharjah, Sharjah, United Arab Emirates
| | | | - Shatha Aloraifej
- Clinical Pharmacy Practice, Mohammed Al-Mana College for Medical Sciences (MACHS), Dammam, Saudi Arabia
| | - Sara Cherri
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Sara Mansour
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Sami El Khatib
- Department of Biomedical Sciences, Lebanese International University, Bekaa, Lebanon
- Center for Applied Mathematics and Bioinformatics (CAMB), Gulf University for Science and Technology, Mubarak Al-Abdullah, Kuwait
| | - Zelal Kharaba
- Department of Clinical Pharmacy, College of Pharmacy, Al Ain University, Abu Dhabi, United Arab Emirates
- Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Mohamad Rahal
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon
- Research Department, Psychiatric Hospital of the Cross, Jal El Dib, Lebanon
| | - Diana Malaeb
- College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates
| | - Hassan Hosseini
- Neurology Department, Henri Mondor Hospital, AP-HP, Créteil, France
- INSERM U955-E01, Institut Mondor de Recherche Biomedicale (IMRB), UPEC-Universite Paris-Est, Créteil, France
| |
Collapse
|
6
|
Gomes OV, Guimarães MP, Barbosa BMB, Marinho CLA, Nicacio JM, Barreira MP, Rodrigues MDS, Santana LFE, Elihimas UF, Schwingel PA. Awareness of stroke among patients with chronic kidney disease on hemodialysis: a cross-sectional study. SAO PAULO MED J 2023; 142:e2022644. [PMID: 37531492 PMCID: PMC10393371 DOI: 10.1590/1516-3180.2022.0644.r1.24042023] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 04/03/2023] [Accepted: 04/24/2023] [Indexed: 08/04/2023] Open
Abstract
BACKGROUND Stroke is a major cause of mortality worldwide. Renal dysfunction is an important risk factor for stroke. Brazilian studies on stroke knowledge are generally population based. Studies stratifying stroke knowledge according to comorbidities are rare. Scientific data are essential to guide the awareness of stroke. OBJECTIVE To assess stroke knowledge in patients with chronic kidney disease (CKD) on hemodialysis. DESIGN AND SETTING Cross-sectional analytical study of patients with CKD on hemodialysis in north-eastern Brazil. METHODS A self-administered questionnaire survey on stroke awareness was administered to patients with CKD on hemodialysis between April and November 2022. The chi-square test and other descriptive statistics were used. Univariate and multivariate analyses were performed using logistic regression. RESULTS A total of 197 patients were included in the analysis. The Brazilian acronym for stroke was used by 53.5% of the participants. Less than 10.0% of the sample showed optimal decision-making ability regarding stroke. Of the participants, 29.9% knew at least one risk factor and one symptom; however, this was considered as having below the minimum capacity because they did not know the emergency service call number. In the analysis adjusted for income and education, females (odds ratio [OR], 0.40%; 95% confidence interval [CI], 0.20-0.82), older patients (OR, 0.24%; 95% CI, 0.09-0.63) and having at most one comorbidity (OR, 0.48%; 95% CI, 0.23-0.98) were factors for lower levels of knowledge or ideal decision-making capacity against stroke. CONCLUSIONS Patients on hemodialysis, especially women and older people, have little knowledge about stroke.
Collapse
Affiliation(s)
- Orlando Vieira Gomes
- MD, MSc. Nephrologist and Assistant Professor, University
Hospital, School of Medicine, Universidade Federal do Vale do São Francisco
(UNIVASF), Petrolina (PE), Brazil
| | - Manoel Pereira Guimarães
- Undergraduate Medicine Student, School of Medicine,
Universidade Federal do Vale do São Francisco (UNIVASF), Petrolina (PE),
Brazil
| | - Bárbara Maria Batista Barbosa
- MD. Physician and Specialist in Internal Medicine, University
Hospital, School of Medicine, Universidade Federal do Vale do São Francisco
(UNIVASF), Petrolina (PE), Brazil
| | | | - Jandir Mendonça Nicacio
- MD, MSc. Hematologist and Assistant Professor, University
Hospital, School of Medicine, Universidade Federal do Vale do São Francisco
(UNIVASF), Petrolina, Brazil
| | - Matheus Pereira Barreira
- Undergraduate Medicine Student, School of Medicine,
Universidade Federal of Vale do São Francisco (UNIVASF), Petrolina (PE),
Brazil
| | - Mateus de Sousa Rodrigues
- MD. Physician and Neurosurgery Resident, University Hospital,
School of Medicine, Universidade Federal do Vale do São Francisco (UNIVASF),
Petrolina (PE), Brazil
| | - Leonardo Fernandes e Santana
- MD. Physician and Internal Medicine Resident, University
Hospital, School of Medicine, Universidade Federal do Vale do São Francisco
(UNIVASF), Petrolina (PE), Brazil
| | - Ubiracé Fernando Elihimas
- MD, MSc, PhD. Nephrologist, Nephrology Service, University
Hospital, Universidade Federal de Pernambuco (UFPE), Recife (PE), Brazil
| | - Paulo Adriano Schwingel
- PhD. Sports Physiologist and Associate Professor, Human
Performance Research Laboratory, Universidade de Pernambuco (UPE), Petrolina
(PE), Brazil
| |
Collapse
|
7
|
Gao Z, Liu Q, Yang L, Zhu X. Identification of high-risk factors for prehospital delay for patients with stroke using the risk matrix methods. Front Public Health 2022; 10:858926. [PMID: 36438229 PMCID: PMC9691690 DOI: 10.3389/fpubh.2022.858926] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 10/21/2022] [Indexed: 11/13/2022] Open
Abstract
Background Stroke has become a leading cause of mortality and adult disability in China. The key to treating acute ischemic stroke (AIS) is to open the obstructed blood vessels as soon as possible and save the ischemic penumbra. However, the thrombolytic rate in China is only 2.5%. Research has been devoted to investigating the causes of prehospital delay, but the exact controllable risk factors for prehospital delay remain uncertain, and a consensus is lacking. We aimed to develop a risk assessment tool to identify the most critical risk factors for prehospital delay for AIS patients. Methods From November 2018 to July 2019, 450 patients with AIS were recruited. Both qualitative and quantitative data were collected. The Delphi technique was used to obtain expert opinions about the importance of the risk indices in two rounds of Delphi consultation. Then, we used the risk matrix to identify high-risk factors for prehospital delay for AIS patients. Results The risk matrix identified the following five critical risk factors that account for prehospital delay after AIS: living in a rural area; no bystanders when stroke occurs; patients and their families lacking an understanding of the urgency of stroke treatment; patients and their families not knowing that stroke requires thrombolysis or that there is a thrombolysis time window; and the patient self-medicating, unaware of the seriousness of the symptoms, and waiting for spontaneous remission. Conclusions The risk analysis tool used during this study may help prevent prehospital delays for patients with AIS.
Collapse
Affiliation(s)
- Zihan Gao
- School of Nursing, Qingdao University, Qingdao, China
| | - Qinqin Liu
- School of Nursing, Peking University, Beijing, China
| | - Li Yang
- School of Nursing, Qingdao University, Qingdao, China,*Correspondence: Li Yang
| | - Xuemei Zhu
- School of Nursing, Harbin Medical University, Heilongjiang, China
| |
Collapse
|
8
|
Basheti IA, Ayasrah SM, Ahmad MM, Abu-Snieneh HM, Abuadas FH. Medications adherence and associated factors among patients with stroke in the Kingdom of Saudi Arabia. Pharm Pract (Granada) 2022; 20:2736. [PMID: 36793903 PMCID: PMC9891775 DOI: 10.18549/pharmpract.2022.4.2736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 09/27/2022] [Indexed: 12/14/2022] Open
Abstract
Background Stroke is one of the most significant neurological problems around the world, and is considered a leading cause of death. Due to polypharmacy and multimorbidity, stroke patients are susceptible to have lower levels of adherence to their medications and self-care activities. Methods Patients who have suffered a stroke and had recently been admitted to public hospital were approached for recruitment. Patients' adherence to their medications was examined using a validated questionnaire during an interview between the principal investigator and the patients, where patients' adherence to their self-care activities was assessed using a developed, validated and previously published questionnaire as well. Reasons for lack of adherence was explored from the patients. Verification of patient's details and medications was done via the patient's hospital file. Results The mean age of the participants (n=173) was 53.21 (SD= 8.61) years. Assessing patients' adherence to medications showed that more than half of them stated that they sometimes/often forgot to take their medication/s, while 41.0% sometimes/often stopped their medication/s from time to time. The mean adherence to medications score (out of 28) was 18.39 (SD=2.1), with 83.8% having a low adherence level. It is found that patients who did not take their medications were due to forgetfulness (46.8%) and complications from taking the medications (20.2%). Better adherence was associated with higher educational level, higher number of medical conditions, and higher frequency of glucose monitoring. Adherence to self-care activities showed that majority of patients performed correct self-care activities three times a week. Conclusion Post-stroke patients in Saudi Arabia have indicated low levels of medication adherence, while reporting good adherence to their self-care activities. Better adherence was associated with certain patient characteristics such as higher educational level. These findings can help in focusing the efforts to improve adherence and health outcomes for stroke patients in the future.
Collapse
Affiliation(s)
- Iman A Basheti
- Faculty of Pharmacy, Applied Science Private University, 11931, Amman, Jordan; Faculty of Pharmacy, The University of Sydney, 2006, Sydney, Australia.
| | - Shahnaz M Ayasrah
- PhD. Associate professor, Department of Applied Science/Nursing, Al-Balqa Applied University, Al-Salt - Jordan.
| | - Muayyad M Ahmad
- PhD. Professor, Clinical Nursing Department, School of Nursing, University of Jordan, Amman 11942 - Jordan.
| | - Hana M Abu-Snieneh
- RN, PhD. Assistant professor, Faculty of Nursing/ The University of Jordan/ Aqaba Campus Aqaba- Jordan. ;
| | - Fuad H Abuadas
- Assistant professor, College of Nursing, Community Health Nursing Department, Jouf University, Sakaka, 72388, Saudi Arabia.
| |
Collapse
|
9
|
Dolenc Šparovec E, Slabe D, Eržen I, Kovačič U. The importance of elderly people knowing basic first-aid measures. BMC Emerg Med 2022; 22:128. [PMID: 35836111 PMCID: PMC9281334 DOI: 10.1186/s12873-022-00675-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 06/21/2022] [Indexed: 11/10/2022] Open
Abstract
Background In the event of a sudden illness or injury, elderly individuals are often dependent on self-help and mutual assistance from partners. With poor access to medical services during natural and other disasters, the importance of first aid knowledge of elderly individuals increases even more. We assessed the opinions of different generations of Slovenian population regarding the importance of knowing the basic first aid measures. In addition, we aimed to examine the knowledge of first aid in the most common emergencies that threaten elderly people’s health and lives, focusing on the knowledge of elderly. Methods A structured questionnaire was conducted with a representative Slovenian adult population (n = 1079). Statistically significant differences in average ratings of the importance of first aid knowledge were compared among different age groups with one-way ANOVA followed by a post hoc test. Significant differences in percentages of correct answers in particular cases of health conditions between different age groups were determined using the χ 2 test followed by post hoc tests. Results Slovenes are well aware of the importance of first aid knowledge and feel personally responsible for acquiring this knowledge. The general opinion is that older retirees need less first aid knowledge than individuals in younger populations. We found a high level of knowledge about symptoms and first aid measures for some of the most common health conditions that occur in old age. The level of knowledge in the group of the oldest respondents was comparable with that of younger age groups. However, their recognition of health conditions was also somewhat worse, especially when recognising the symptoms and signs of hypoglycaemia and heart attack. Most of the tested knowledge did not depend on a person’s age but on the time since that person was last educated in first aid. Conclusions The knowledge of people older than 80 years is somewhat poorer than that in the younger population, mainly because too much time has passed since they were last educated in first aid. Public awareness of first aid needs to be increased and appropriate guidelines should be given with a focus on the elderly population. Supplementary Information The online version contains supplementary material available at 10.1186/s12873-022-00675-9.
Collapse
Affiliation(s)
- Eva Dolenc Šparovec
- Faculty of Health Sciences, Sanitary Engineering Department, Public Health Division, University of Ljubljana, Zdravstvena pot 5, 1000, Ljubljana, Slovenia.
| | - Damjan Slabe
- Faculty of Health Sciences, Sanitary Engineering Department, Public Health Division, University of Ljubljana, Zdravstvena pot 5, 1000, Ljubljana, Slovenia
| | - Ivan Eržen
- National Institute of Public Health, Trubarjeva cesta 2, 1000, Ljubljana, Slovenia
| | - Uroš Kovačič
- Faculty of Medicine, University of Ljubljana, Institute of Pathophysiology, Zaloška cesta 4, 1000, Ljubljana, Slovenia
| |
Collapse
|
10
|
Malaeb D, Dia N, Haddad C, Hallit S, Sacre H, Barakat M, Mansour S, Salameh P, Hosseini H. Factors associated with knowledge and awareness of stroke among the Lebanese population: A cross-sectional study. F1000Res 2022; 11:425. [PMID: 35677174 PMCID: PMC9160706 DOI: 10.12688/f1000research.108734.2] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/08/2022] [Indexed: 11/25/2022] Open
Abstract
Background: Evaluation of the knowledge about stroke in the general population is extremely vital as it prevents stroke development, limits complications, and achieves better quality of life. We assume that the general Lebanese population lacks awareness about stroke and its associated complications. This study aims to evaluate stroke knowledge and determine the factors associated with stroke awareness among the general Lebanese population. Methods: This cross-sectional study assessed respondents’ sociodemographic characteristics and the identification of risk factors, warning signs, stroke consequences, and early response to stroke symptoms. A total of 551 Lebanese adults without a history of stroke filled in an online self-reported questionnaire publicly shared on social applications. Logistic regression analysis was performed to identify the factors associated with poor knowledge of stroke. Results: Among the 551 participants enrolled, 403 (74.2%) were females and 312 (56.7%) were under 30 years of age. Females compared to males and employed compared to unemployed had significantly higher odds of identifying at least one risk factor (OR=4.3 [95%CI=1.1;16.8] and 6 [95%CI=1.2;29.6], respectively). Also, when compared to unemployed, employed participants had significantly higher odds of recognizing at least one of the early stroke symptoms (OR=3.3 [95%CI=1.2;8.9]) and identifying at least one of the stroke consequences (OR=5.3 [95%CI=1.1;25.9]). Reaching a university level of education compared to a school level was associated with significantly higher odds (OR=2.3 [95%CI=1.1;4.8]) of taking a patient to a hospital. Conclusion: Well-educated, employed, and female participants were more knowledgeable about stroke. Tailored interventions focusing on individuals with inadequate stroke literacy are needed. Further studies, more representative of the general Lebanese population with a larger sample size, are necessary to confirm our findings.
Collapse
Affiliation(s)
- Diana Malaeb
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
- Life Sciences and Health Department, Paris-Est University, Paris, France
- College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates
| | - Nada Dia
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Chadia Haddad
- Research department, Psychiatric Hospital of the Cross, JalEddib, Lebanon
- INSERM, Univ. Limoges, CH Esquirol, IRD, U1094 tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France
| | - Souheil Hallit
- Research department, Psychiatric Hospital of the Cross, JalEddib, Lebanon
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, P.O Box 446, Lebanon
- Psychology Department, College of Humanities, Effat University, Jaddah, 21478, Saudi Arabia
| | - Hala Sacre
- Epidémiologie Clinique et Toxicologie, INSPECT-LB: Institut National de Santé Publique, Beirut, Lebanon
| | - Muna Barakat
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Sara Mansour
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Pascale Salameh
- Epidémiologie Clinique et Toxicologie, INSPECT-LB: Institut National de Santé Publique, Beirut, Lebanon
- Faculty of Pharmacy, Lebanese University, Hadat, Lebanon
- University of Nicosia Medical School, Nicosia, Cyprus
- School of Medicine, Lebanese American University, Byblos, Lebanon
| | - Hassan Hosseini
- Stroke Unit, Service de Neurologie, CHU Henri Mondor- 94010, Créteil Cedex, France
- UPE-C, Faculté de Santé, Université Paris-Est Créteil, Paris, France
- INSERM U955-E01, IMRB, Créteil, France
| |
Collapse
|
11
|
Saade S, Hallit S, Salameh P, Hosseini H. Knowledge and Response to Stroke Among Lebanese Adults: A Population-Based Survey. Front Public Health 2022; 10:891073. [PMID: 35719671 PMCID: PMC9203897 DOI: 10.3389/fpubh.2022.891073] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 04/19/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives To date, research on public awareness of stroke warning symptoms, risk factors and practice in the general adult population in Lebanon is scarce. The aim of our study is to identify the level of stroke awareness in order to develop and implement preventive measures particularly in relationship to primary stroke prevention. Methods It is a cross-sectional study conducted among 410 adult participants from the five main governorates of Lebanon. Stroke knowledge and practice were assessed using two validated questionnaires namely the Stroke Knowledge Test (SKT) and the Stroke Action Test (STAT). Multivariable linear regression models were conducted to examine socio-demographic, social habits, and clinical factors independently associated with the SKT and the STAT scores. Results The mean SKT score of the participants was 9.16. 48.5% showed a poor stroke-related knowledge level and 51.5% a good knowledge level. Living in Mount Lebanon and occasional smokers showed statistically significant lower mean SKT scores; whereas, university degree and suffering from diabetes mellitus were associated with higher mean SKT scores. The mean overall STAT score was 41.3%. For 36.8% of the stroke symptoms, respondents selected call 112. The mean STAT scores of participants who get their information from the internet was statistically significantly lower. However, no association was found between the SKT score and the STAT score. Conclusion Knowledge of stroke risk factors was low, as was awareness of the need to call 112 in response to stroke symptoms. Hence, it is essential to develop health education programs in order to decrease stroke morbidity and mortality.
Collapse
Affiliation(s)
- Sylvia Saade
- Life Sciences and Health Department, Paris-Est University, Paris, France
- Health and Sciences Department, American University of Health and Sciences, Beirut, Lebanon
- *Correspondence: Sylvia Saade
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon
- Psychology Department, College of Humanities, Effat University, Jeddah, Saudi Arabia
- Research Department, Psychiatric Hospital of the Cross, Jal El Dib, Lebanon
| | - Pascale Salameh
- INSPECT-LB: Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie-Liban, Beirut, Lebanon
- Faculty of Public Health, Lebanese University, Beirut, Lebanon
- Faculty of Medicine, University of Nicosia, Nicosia, Cyprus
- Faculty of Pharmacy, Lebanese University, Beirut, Lebanon
| | - Hassan Hosseini
- Life Sciences and Health Department, Paris-Est University, Paris, France
| |
Collapse
|
12
|
Malaeb D, Dia N, Haddad C, Hallit S, Sacre H, Barakat M, Mansour S, Salameh P, Hosseini H. Factors associated with knowledge and awareness of stroke among the Lebanese population: A cross-sectional study. F1000Res 2022; 11:425. [PMID: 35677174 PMCID: PMC9160706 DOI: 10.12688/f1000research.108734.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/08/2022] [Indexed: 10/24/2023] Open
Abstract
Background: Evaluation of the knowledge about stroke in the general population is extremely vital as it prevents stroke development, limits complications, and achieves better quality of life. We assume that the general Lebanese population lacks awareness about stroke and its associated complications. This study aims to evaluate stroke knowledge and determine the factors associated with stroke awareness among the general Lebanese population. Methods: This cross-sectional study assessed respondents' sociodemographic characteristics and the identification of risk factors, warning signs, stroke consequences, and early response to stroke symptoms. A total of 551 Lebanese adults without a history of stroke filled in an online self-reported questionnaire publicly shared on social applications. Logistic regression analysis was performed to identify the factors associated with poor knowledge of stroke. Results: Among the 551 participants enrolled, 403 (74.2%) were females and 312 (56.7%) were under 30 years of age. Females compared to males and employed compared to unemployed had significantly higher odds of identifying at least one risk factor (OR=4.3 [95%CI=1.1;16.8] and 6 [95%CI=1.2;29.6], respectively). Also, when compared to unemployed, employed participants had significantly higher odds of recognizing at least one of the early stroke symptoms (OR=3.3 [95%CI=1.2;8.9]) and identifying at least one of the stroke consequences (OR=5.3 [95%CI=1.1;25.9]). Reaching a university level of education compared to a school level was associated with significantly higher odds (OR=2.3 [95%CI=1.1;4.8]) of taking a patient to a hospital. Conclusion: Well-educated, employed, and female participants were more knowledgeable about stroke. Tailored interventions focusing on individuals with inadequate stroke literacy are needed. Further studies, more representative of the general Lebanese population with a larger sample size, are necessary to confirm our findings.
Collapse
Affiliation(s)
- Diana Malaeb
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
- Life Sciences and Health Department, Paris-Est University, Paris, France
- College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates
| | - Nada Dia
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Chadia Haddad
- Research department, Psychiatric Hospital of the Cross, JalEddib, Lebanon
- INSERM, Univ. Limoges, CH Esquirol, IRD, U1094 tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France
| | - Souheil Hallit
- Research department, Psychiatric Hospital of the Cross, JalEddib, Lebanon
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, P.O Box 446, Lebanon
- Psychology Department, College of Humanities, Effat University, Jaddah, 21478, Saudi Arabia
| | - Hala Sacre
- Epidémiologie Clinique et Toxicologie, INSPECT-LB: Institut National de Santé Publique, Beirut, Lebanon
| | - Muna Barakat
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Sara Mansour
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Pascale Salameh
- Epidémiologie Clinique et Toxicologie, INSPECT-LB: Institut National de Santé Publique, Beirut, Lebanon
- Faculty of Pharmacy, Lebanese University, Hadat, Lebanon
- University of Nicosia Medical School, Nicosia, Cyprus
- School of Medicine, Lebanese American University, Byblos, Lebanon
| | - Hassan Hosseini
- Stroke Unit, Service de Neurologie, CHU Henri Mondor- 94010, Créteil Cedex, France
- UPE-C, Faculté de Santé, Université Paris-Est Créteil, Paris, France
- INSERM U955-E01, IMRB, Créteil, France
| |
Collapse
|
13
|
Awareness of Being at Risk of Stroke and Its Determinant Factors among Hypertensive Patients in Banyumas, Indonesia. Stroke Res Treat 2022; 2022:4891134. [PMID: 35449795 PMCID: PMC9017563 DOI: 10.1155/2022/4891134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 02/25/2022] [Accepted: 03/29/2022] [Indexed: 12/05/2022] Open
Abstract
Background The global burden of stroke is still high, particularly in developing countries, with hypertension serving as the main risk factor. The awareness of stroke among hypertensive patients is crucial for stroke prevention. This study was aimed at identifying the awareness of being at risk of stroke and its determinant factors among hypertensive patients in Banyumas, Indonesia. Methods This was a cross-sectional study conducted in Primary Health Centers (PHCs) in Banyumas Regency, Indonesia, from April to August 2019. A simple random sampling technique was used to select the representatives' PHCs. Hypertensive patients who came regularly to the PHCs were consecutively recruited. Data were collected through a self-reported questionnaire and medical records. The main outcome was the level of participants' awareness of being at risk of stroke. Multivariate logistic regression analysis was performed to measure determinant factors associated with the level of awareness. Results Out of 457 patients investigated, 77.46% had a low level of awareness. Low knowledge of hypertension, low income, and no history of previous stroke were associated with a low-level of awareness (odds ratio (OR) 1.942, 95% CI 1.195-3.158, p 0.007; OR 2.321, 95% CI 1.326-4.064, p 0.003; and OR 6.033, 95% CI 2.450-14.858, p < 0.001, respectively). Conclusion Majority of hypertensive patients were unaware of being at risk of stroke. Knowledge of hypertension, income, and history of previous stroke are factors that may influence the awareness of being at risk of stroke among them. This emphasizes the need to provide better campaigns and education programs to raise the awareness of stroke in a community setting, particularly for the population at risk.
Collapse
|
14
|
Solbakken LM, Nordhaug M, Halvorsen K. Patients’ experiences of involvement, motivation and coping with physiotherapists during subacute stroke rehabilitation – a qualitative study. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2022. [DOI: 10.1080/21679169.2022.2032825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Liss Marita Solbakken
- Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Marita Nordhaug
- Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Kristin Halvorsen
- Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| |
Collapse
|
15
|
Barakat M, A. AlSalamat H, Jirjees F, Al-Obaidi H, k. Hussain Z, El Hadidi S, Mansour S, Malaeb D, Hosseini H. Factors Associated with Knowledge and Awareness of Stroke Among the Jordanian Population: A Cross-Sectional Study. F1000Res 2021; 10:1242. [PMID: 34987775 PMCID: PMC8672222 DOI: 10.12688/f1000research.74492.2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/07/2022] [Indexed: 01/01/2023] Open
Abstract
Background and objective: Stroke is the second leading cause of death in Jordan and over the world. Knowledge and awareness towards stroke play a crucial role in the management and prevention of its complications. This study aims to assess the knowledge and awareness about stroke among the Jordanian population and determine factors associated with stroke awareness. Methods: This cross-sectional study through a web-based anonymous questionnaire that needed 10 minutes to be completed. It examined sociodemographic characteristics and recognition of the risk factors, warning signs, stroke consequences, and early response to stroke symptoms. Logistic regression analysis identified the factors associated with poor knowledge of stroke. Results: A total of 573 Jordanian adults participated in this study. The participant's ability to identify at least one early symptom of stroke and the proper response to the symptoms were significantly correlated with the educational level (OR of 3.4 and 2.5, respectively). At least one consequence of stroke was significantly associated with different demographic factors such as gender, socioeconomic income, females versus males and those with medium income versus low income had significantly higher odds (OR of 6.6 and 4.1, respectively). Conclusion: This study revealed a good knowledge and awareness level about stroke among Jordanians correlated mainly with their educational level. Therefore, new strategies should be considered to decrease the prevalence of stroke in Jordan, including the need for engagement in enhanced awareness campaigns.
Collapse
Affiliation(s)
- Muna Barakat
- Department of Clinical Pharmacy and therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, 11931, Jordan
| | - Husam A. AlSalamat
- Department of Basic Medical Sciences, Faculty of Medicine, Al-Balqa Applied University, Al-Salt, 19117, Jordan
- Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, University of Jordan, Amman, 11942, Jordan
| | - Feras Jirjees
- College of Pharmacy, University of Sharjah, Sharjah, 27272, United Arab Emirates
| | - Hala Al-Obaidi
- College of pharmacy, Ajman University, Ajman, United Arab Emirates
| | - Zainab k. Hussain
- Department of Biology, College of Science, University of Baghdad, Baghdad, Iraq
| | - Seif El Hadidi
- Faculty of Pharmaceutical Sciences and Pharmaceutical Industries, Future University in Egypt, Cairo, Egypt
| | - Sara Mansour
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Diana Malaeb
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Hassan Hosseini
- Life Sciences and Health Department, Paris-Est University, Paris, France
| |
Collapse
|
16
|
Barakat M, A. AlSalamat H, Jirjees F, Al-Obaidi H, k. Hussain Z, El Hadidi S, Mansour S, Malaeb D, Hosseini H. Factors Associated with Knowledge and Awareness of Stroke Among the Jordanian Population: A Cross-Sectional Study. F1000Res 2021; 10:1242. [PMID: 34987775 PMCID: PMC8672222 DOI: 10.12688/f1000research.74492.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/24/2021] [Indexed: 10/20/2023] Open
Abstract
Background and objective: Stroke is the second leading cause of death in Jordan and over the world. Knowledge and awareness towards stroke play a crucial role in the management and prevention of its complications. This study aims to assess the knowledge and awareness about stroke among the Jordanian population and determine factors associated with stroke awareness. Methods: This cross-sectional study through a web-based anonymous questionnaire that needed 10 minutes to be completed. It examined sociodemographic characteristics and recognition of the risk factors, warning signs, stroke consequences, and early response to stroke symptoms. Logistic regression analysis identified the factors associated with poor knowledge of stroke. Results: A total of 573 Jordanian adults participated in this study. The participant's ability to identify at least one early symptom of stroke and the proper response to the symptoms were significantly correlated with the educational level (OR of 3.4 and 2.5, respectively). At least one consequence of stroke was significantly associated with different demographic factors such as gender, socioeconomic income, females versus males and those with medium income versus low income had significantly higher odds (OR of 6.6 and 4.1, respectively). Conclusion: This study revealed a good knowledge and awareness level about stroke among Jordanians correlated mainly with their educational level. Therefore, new strategies should be considered to decrease the prevalence of stroke in Jordan, including the need for engagement in enhanced awareness campaigns.
Collapse
Affiliation(s)
- Muna Barakat
- Department of Clinical Pharmacy and therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, 11931, Jordan
| | - Husam A. AlSalamat
- Department of Basic Medical Sciences, Faculty of Medicine, Al-Balqa Applied University, Al-Salt, 19117, Jordan
- Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, University of Jordan, Amman, 11942, Jordan
| | - Feras Jirjees
- College of Pharmacy, University of Sharjah, Sharjah, 27272, United Arab Emirates
| | - Hala Al-Obaidi
- College of pharmacy, Ajman University, Ajman, United Arab Emirates
| | - Zainab k. Hussain
- Department of Biology, College of Science, University of Baghdad, Baghdad, Iraq
| | - Seif El Hadidi
- Faculty of Pharmaceutical Sciences and Pharmaceutical Industries, Future University in Egypt, Cairo, Egypt
| | - Sara Mansour
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Diana Malaeb
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Hassan Hosseini
- Life Sciences and Health Department, Paris-Est University, Paris, France
| |
Collapse
|
17
|
Melak AD, Wondimsigegn D, Kifle ZD. Knowledge, Prevention Practice and Associated Factors of Stroke Among Hypertensive and Diabetic Patients - A Systematic Review. Risk Manag Healthc Policy 2021; 14:3295-3310. [PMID: 34408515 PMCID: PMC8364969 DOI: 10.2147/rmhp.s324960] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 08/03/2021] [Indexed: 01/28/2023] Open
Abstract
INTRODUCTION Because of the inadequate level of public awareness of the disease, the incidence of stroke has been sharply rising. Eventually, due to the prehospital delay, many stroke cases could not be eligible for thrombolysis thereby poor rehabilitative outcome has been tremendously increased. Thus, this study aimed to review the level of knowledge, prevention practice, and associated factors of stroke among hypertensive and diabetic patients. METHODS A systematic review of primarily published articles (2010-2020) related to knowledge and prevention practices of stroke was performed by searching online electronic databases like PubMed, Google Scholar, Refseek, Science direct, ResearchGate, and manual Google search by using the keywords and MeSH terms. Studies conducted on knowledge and prevention practices amongst hypertensive and/or diabetic patients were included. RESULTS Out of 531 searched studies, 42 articles were identified to be reviewed. The reported overall knowledge of stroke was ranging from 4.4% to 79%. Knowledge to the signs/symptoms of stroke was 23.6% to 87%. However, 15% to 77% of subjects were also reported that they did not know any sign of stroke. The range of risk factor knowledge was 10.5% to 86.6%. The reported level of stroke prevention practice was 2.4% to 72% but physical activity and weight reduction practice were relatively low. Inadequate level of knowledge and prevention practice of stroke was related to elderly, female gender, uneducated, unmarried, rural residents, economically low, comorbidity and unemployed individuals. CONCLUSION The current finding revealed that the level of knowledge and prevention practice of stroke was inadequate. Hence, the finding highlights health educational programs should be planned as an important avenue to enhance stroke awareness among the high-risk populations.
Collapse
Affiliation(s)
- Abreham Degu Melak
- University of Gondar, College of Medicine and Health Science, School of Pharmacy, Department of Pharmacology, Gondar, Ethiopia
| | - Dawit Wondimsigegn
- University of Gondar, College of Medicine and Health Science, School of Pharmacy, Department of Pharmaceutics and Social Pharmacy, Gondar, Ethiopia
| | - Zemene Demelash Kifle
- University of Gondar, College of Medicine and Health Science, School of Pharmacy, Department of Pharmacology, Gondar, Ethiopia
| |
Collapse
|
18
|
Lee C, Chow CM, Yan AT, Moe GW, Tu JV, Chu JY. Awareness of Warning Symptoms of Heart Disease and Stroke: Results of a Follow-up Study of the Chinese Canadian Cardiovascular Health Project. CJC Open 2021; 3:741-750. [PMID: 34169253 PMCID: PMC8209403 DOI: 10.1016/j.cjco.2021.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 01/24/2021] [Indexed: 11/17/2022] Open
Abstract
Background Our original pilot study in 2008 demonstrated a poor degree of awareness of heart disease and stroke among Chinese Canadians, warranting an updated survey of their knowledge. We sought to determine the current degree of knowledge of cardiovascular disease, including stroke, among ethnic Chinese residents of Canada. Methods A 35-question online survey was conducted in the fall of 2017 among 1001 Chinese Canadians (aged ≥ 18 years) in the greater Toronto area (n = 501) and Vancouver (n = 500). Knowledge of heart disease and stroke, such as signs and symptoms of stroke and heart attack, health habits, and initial response to a cardiovascular emergency were assessed. Results A total of 52.0% of the respondents were female, and 46.3% were aged <45 years. A total of 40.1% spoke Cantonese, and 23.7% spoke Mandarin; 79.5% were immigrants, and 31% had lived in Canada < 10 years. A total of 85% identified at least one heart attack symptom, and 80% identified at least one stroke symptom; 86.2% indicated that they would call 911 if experiencing a heart attack or stroke. Internet use was positively associated with the ability to identify a greater number of heart attack and stroke symptoms, compared to the number among non–Internet users (P < 0.001). Women were 14% more likely to overlook gender as a risk factor for cardiovascular disease (CVD). Conclusions This study found that in 2017, compared to 2008, awareness of symptoms of heart disease and stroke improved among Chinese Canadians residing in Toronto and Vancouver.
Collapse
Affiliation(s)
- Calvin Lee
- School of Medicine, Royal College of Surgeons Ireland, Dublin, Ireland
| | - Chi-Ming Chow
- Division of Cardiology, St Michael’s Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Andrew T. Yan
- Division of Cardiology, St Michael’s Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Gordon W. Moe
- Division of Cardiology, St Michael’s Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Jack V. Tu
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
| | - Joseph Y. Chu
- Division of Neurology, Toronto Western Hospital-UHN, University of Toronto, Toronto, Ontario, Canada
- Corresponding author: Dr Joseph Y. Chu, Queensway Professional Centre, 312-190 Sherway Drive, Toronto, Ontario M9C 5N2, Canada. Tel.: +1-416-626-0740; fax: +1-416-626-0635.
| |
Collapse
|
19
|
Abutaima MK, Almaghrabi A, Alhazzaa R, Alaydaa A, Alshuraymi A, Alzahim M, Ashour S, Alayed M, Alshamrani M, Khalifa AFM. Level of awareness regarding stroke among Riyadh population. J Family Med Prim Care 2021; 10:538-541. [PMID: 34017784 PMCID: PMC8132771 DOI: 10.4103/jfmpc.jfmpc_1304_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 09/05/2020] [Accepted: 10/20/2020] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Stroke is known to be the second leading cause of death and persistent disability worldwide, with 5.5 million deaths each year. Public knowledge regarding risk factors, signs and symptoms and the prevention of stroke is an important factor in reducing the incidence of stroke. OBJECTIVE This study aimed to determine the level of awareness regarding stroke in Riyadh, Saudi Arabia. METHODS This study recruited 150 participants from primary health care (PHC) centres, based on the methodology of a similar cross-sectional study conducted in Riyadh. The study group included adult male and female PHC visitors and excluded visitors with mental illness and medical personnel. Systematic random sampling was used to select participants. Data were collected using a self-administered questionnaire and analysed using SPSS. Microsoft Excel was used to generate tables and charts. Consent was obtained before data collection, with emphasis on each participant's right to withdraw from the study at any time. RESULT A total of 150 respondents were included in this study. We found that the majority of the participants had a high level of awareness regarding the risk factors of stroke (n = 115, 76.66%). More than half of the participants (n = 95, 63.3%) had a moderate level of awareness of the signs and symptoms of stroke. The study also revealed that there was no statistically significant relationship between education level and level of awareness regarding risk factors of stroke (p = 0.334). CONCLUSION This study found that the majority of participants had a high level of awareness regarding stroke. Regarding the education level of the participants, we found that the majority of participants with primary school-level education had a high level of awareness regarding stroke risk factors. Furthermore, we found that the level of awareness about prevention of stroke was moderate among participants. Thus, further studies should explore how to improve levels of awareness regarding the prevention of stroke.
Collapse
Affiliation(s)
| | - Ammar Almaghrabi
- Medical Students, AlMaarefa University, Ad Diriyah, Saudi Arabia
| | - Rashed Alhazzaa
- Medical Students, AlMaarefa University, Ad Diriyah, Saudi Arabia
| | - Abdullah Alaydaa
- Medical Students, AlMaarefa University, Ad Diriyah, Saudi Arabia
| | | | - Meshari Alzahim
- Medical Students, AlMaarefa University, Ad Diriyah, Saudi Arabia
| | - Sohaib Ashour
- Medical Students, AlMaarefa University, Ad Diriyah, Saudi Arabia
| | - Mohammed Alayed
- Medical Students, AlMaarefa University, Ad Diriyah, Saudi Arabia
| | | | | |
Collapse
|
20
|
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.
Collapse
|
21
|
Khalil HM, Lahoud N. Knowledge of Stroke Warning Signs, Risk Factors, and Response to Stroke among Lebanese Older Adults in Beirut. J Stroke Cerebrovasc Dis 2020; 29:104716. [PMID: 32192843 DOI: 10.1016/j.jstrokecerebrovasdis.2020.104716] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 01/27/2020] [Accepted: 01/28/2020] [Indexed: 02/09/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Stroke is a global burden. In Lebanon, recent studies have shown that stroke prevalence may be higher than other developing countries. While older people are particularly vulnerable to stroke, research suggests that they have poor stroke awareness. Since awareness is crucial for early hospital admission, thereby outcome, the main objectives of this study were to assess knowledge of stroke ie, symptoms, risk factors, and intended behavior in case of stroke suspicion. METHODS A community-based survey targeting adults aged 50 and above was conducted at 20 random pharmacies in Beirut from May to October 2018 through face to face interviews utilizing a structured questionnaire composed of open and closed ended questions. Descriptive and multivariable analyses were performed. MAIN RESULTS In total, 390 participants completed the questionnaire. Sixty-eight percent were able to spontaneously recall at least 1 stroke symptom, most frequently headache (29.2%), hemiparesis (25.4%), and dizziness (19.5%). Furthermore, 85.4% spontaneously recalled at least 1 risk factor, most frequently hypertension (48.2%), smoking (20.5%), and stress (43.1%). In case of stroke suspicion 57.69% would call an ambulance. Knowing a stroke patient and educational level were predictors for recall of more symptoms and risk factors for stroke. Adequate response to stroke was positively associated with identification of more stroke symptoms but inversely associated with having diabetes. CONCLUSIONS AND RECOMMENDATIONS There are major gaps in stroke knowledge among Beirut's older population. Culturally tailored awareness campaigns should be implemented at multiple levels using different media methods to target vulnerable populations at higher risk for stroke and their families. These campaigns should focus on improving stroke symptoms awareness and actions to take when suspecting stroke.
Collapse
Affiliation(s)
| | - Nathalie Lahoud
- Faculty of Pharmacy, Lebanese University, Hadat, Lebanon; Faculty of Public Health, Lebanese University, Fanar, Lebanon; CERIPH, Center for Research in Public Health, Pharmacoepidemiology Surveillance Unit, Faculty of Public Health, Lebanese University, Fanar, Lebanon; INSPECT-LB, Institut National de Santé Publique, Epidémiologie Clinique et Toxicologie, Faculty of Public Health, Lebanese University, Fanar, Lebanon
| |
Collapse
|
22
|
Krishnamurthi RV, Barker-Collo S, Barber PA, Tippett LJ, Dalrymple-Alford JC, Tunnage B, Mahon S, Parmar PG, Moylan M, Feigin VL. Community Knowledge and Awareness of Stroke in New Zealand. J Stroke Cerebrovasc Dis 2019; 29:104589. [PMID: 31879136 DOI: 10.1016/j.jstrokecerebrovasdis.2019.104589] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 11/27/2019] [Accepted: 12/01/2019] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION Community knowledge and stroke awareness is crucial for primary prevention of stroke and timely access to stroke treatments including acute reperfusion therapies. We conducted a national telephone survey to quantify the level of community stroke awareness. METHODS A random sample of 400 adults in New Zealand (NZ), stratified by the 4 main ethnic groups, was surveyed. Eligible participants answered stroke awareness questions using both unprompted (open-ended) and prompted questions (using a list). Proportional odds logistic regression models were used to identify factors associated with stroke awareness. RESULTS Only 1.5% of participants named stroke as a major cause of death. The stroke signs and symptoms most frequently identified from a list were sudden speech difficulty (94%) and sudden 1-sided weakness (92%). Without prompting, 78% of participants correctly identified at least 1 risk factor, 62% identified at least 2, and 35% identified 3 or more. When prompted with the list, scores increased 10-fold compared with unprompted responses. Ethnic disparities were observed, with Pacific peoples having the lowest level of awareness among the 4 ethnic groups. Higher education level, higher income, and personal experience of stroke were predictive of greater awareness (P ≤ .05). CONCLUSIONS Stroke was not recognized as a major cause of death. Although identification of stroke risk factors was high with prompting, awareness was low without prompting, particularly among those with lower education and income. Nationwide, culturally tailored public awareness campaigns are necessary to improve knowledge of stroke risk factors, recognition of stroke in the community and appropriate actions to take in cases of suspected stroke.
Collapse
Affiliation(s)
- Rita V Krishnamurthi
- National Institute for Stroke and Applied Neurosciences, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand.
| | | | - Peter Alan Barber
- Centre for Brain Research, University of Auckland, Auckland, New Zealand; Department of Medicine, University of Auckland, Auckland, New Zealand
| | - Lynette J Tippett
- School of Psychology, The University of Auckland, Auckland, New Zealand; Centre for Brain Research, University of Auckland, Auckland, New Zealand
| | - John C Dalrymple-Alford
- Department of Psychology, University of Canterbury, Christchurch, New Zealand; New Zealand Brain Research Institute, Christchurch, New Zealand
| | - Bronwyn Tunnage
- National Institute for Stroke and Applied Neurosciences, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand; Department of Paramedicine, Auckland University of Technology, Auckland, New Zealand
| | - Susan Mahon
- National Institute for Stroke and Applied Neurosciences, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Priyakumari G Parmar
- National Institute for Stroke and Applied Neurosciences, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Melanie Moylan
- Department of Biostatistics and Epidemiology, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Valery L Feigin
- National Institute for Stroke and Applied Neurosciences, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
| |
Collapse
|
23
|
Niklasson A, Herlitz J, Jood K. Socioeconomic disparities in prehospital stroke care. Scand J Trauma Resusc Emerg Med 2019; 27:53. [PMID: 31046804 PMCID: PMC6498576 DOI: 10.1186/s13049-019-0630-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Accepted: 04/17/2019] [Indexed: 12/14/2022] Open
Abstract
Background and purpose Recent studies have revealed socioeconomic disparities in stroke outcomes. Here, we investigated whether prehospital stroke care differs with respect to socioeconomic status (SES). Methods Consecutive stroke and TIA patients (n = 3006) admitted to stroke units at Sahlgrenska University Hospital, Gothenburg, Sweden, from 1 November 2014 to 31 July 2016, were included. Data on prehospital care were obtained from a local stroke register. Socioeconomic status was classified according to the average level of income and education within each patient’s neighbourhood (postcode area). Results The median system delay from calling the emergency medical communication centre (EMCC) to start of brain computed tomography on hospital arrival was 3 h 47 min (95% confidence interval (CI) 3 h 30 min to 4 h 05 min) for patients within the lowest SES tertile and 3 h 17 min (95% CI 3 h 00 min to 3 h 37 min) for the highest tertile (p < 0.05). Patients with a lower SES were less likely to receive the highest priority in the ambulance (p < 0.05) and had lower rates of prehospital recognition of stroke/TIA (p < 0.05) than those with a high SES. No inequities were found concerning EMCC prioritisation or the probability of ambulance transport. Conclusions We found socioeconomic inequities in prehospital stroke care which could affect the efficacy of acute stroke treatment. The ambulance nurses’ ability to recognise stroke/TIA may partly explain the observed inequities.
Collapse
Affiliation(s)
- Amanda Niklasson
- Institute of Neuroscience and Physiology, Department of Clinical Neuroscience, The Sahlgrenska Academy, University of Gothenburg, Blå Stråket 7, plan 3, SE-413 45, Gothenburg, Sweden.
| | - Johan Herlitz
- PreHospen - Centre for Prehospital Research, Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
| | - Katarina Jood
- Institute of Neuroscience and Physiology, Department of Clinical Neuroscience, The Sahlgrenska Academy, University of Gothenburg, Blå Stråket 7, plan 3, SE-413 45, Gothenburg, Sweden
| |
Collapse
|
24
|
Knowledge of Stroke Risk Factors and Warning Signs in Patients with Recurrent Stroke or Recurrent Transient Ischaemic Attack in Thailand. Neurol Res Int 2017; 2017:8215726. [PMID: 29130000 PMCID: PMC5654286 DOI: 10.1155/2017/8215726] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2017] [Revised: 08/11/2017] [Accepted: 09/06/2017] [Indexed: 11/17/2022] Open
Abstract
Stroke is a global burden. It is not known whether patients who are most at risk of stroke (recurrent stroke or recurrent transient ischaemic attack) have enough knowledge of stroke risk factors and warning signs. The aim of this study was to assess the knowledge of stroke risk factors and warning signs in this high-risk population. We performed a cross-sectional questionnaire-based study of patients with recurrent stroke or recurrent TIA admitted to Srinagarind Hospital and Khon Kaen Hospital, Thailand. A total of 140 patients were included in the study (age 65.6 ± 11.3 years [mean ± SD], 62 females). Using an open-ended questionnaire, nearly one-third of patients (31.4%) could not name any risk factors for stroke. The most commonly recognized risk factors were hypertension (35%), dyslipidemia (28.6%), and diabetes (22.9%). Regarding stroke warning signs, the most commonly recognized warning signs were sudden unilateral weakness (61.4%), sudden trouble with speaking (25.7%), and sudden trouble with walking, loss of balance, or dizziness (21.4%). Nineteen patients (13.6%) could not identify any warning signs. The results showed that knowledge of stroke obtained from open-ended questionnaires is still unsatisfactory. The healthcare provider should provide structured interventions to increase knowledge and awareness of stroke in these patients.
Collapse
|
25
|
Knowledge of Stroke Risk Factors among Stroke Survivors in Nigeria. Stroke Res Treat 2016; 2016:1902151. [PMID: 27882262 PMCID: PMC5108853 DOI: 10.1155/2016/1902151] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2016] [Accepted: 10/12/2016] [Indexed: 01/12/2023] Open
Abstract
Background. Knowledge of stroke risk factors is expected to reduce the incidence of stroke—whether first-ever or recurrent. This study examined knowledge of stroke risk factors and its determinants among stroke survivors. Methods. A cross-sectional survey of consenting stroke survivors at two physiotherapy facilities in Nigeria was carried out. Sociodemographic and clinical data were obtained and knowledge of stroke risk factors (defined as the ability to mention at least one correct risk factor) was assessed using open-ended questionnaire. Data were treated with descriptive statistics and logistic regression analysis. Results. Sixty-nine stroke survivors (male = 72.5%; mean ± SD age = 49.7 ± 10.6 years) participated in the study. Thirty-four (49.4%) participants had knowledge of stroke risk factors. Only educational level was significantly associated with knowledge and participants with tertiary educational qualification were about 48 times (odds ratio = 48.5; CI = 7.6–309.8; P < 0.0001) more likely to be knowledgeable than those with no education. Conclusion. Less than half of the participants had knowledge of stroke risk factors. Participants with tertiary education were significantly more knowledgeable than those with lower educational qualifications. Effective means of educating stroke survivors on stroke risk factors should be identified and adopted.
Collapse
|
26
|
Masztalewicz M, Nowacki P, Kotlęga D, Bajer-Czajkowska A. Early Emergency Medical Service Calls for Stroke: Was the Long-Term Education Program Based on the Experience of West Pomerania Successful? J Stroke Cerebrovasc Dis 2015; 25:254-8. [PMID: 26706444 DOI: 10.1016/j.jstrokecerebrovasdis.2015.09.025] [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] [Received: 04/19/2015] [Revised: 09/16/2015] [Accepted: 09/21/2015] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Our objectives are to investigate whether the percentage of early emergency calls for stroke had increased and to assess current factors determining the time of deciding to seek medical help in the event of early stroke symptoms. MATERIALS AND METHODS We analyzed data concerning the decision to call for medical help in relation to observed stroke symptoms. Group I comprised 287 people who made the decision to call emergency medical service (EMS) in the first 10 minutes after observing stroke symptoms. Group II included 275 people who called EMS after that time. Data from the current database (2013-2014) were compared with relevant data from the period 2003-2005. RESULTS In 2013-2014, awareness of stroke signs was 2.5 times greater than in 2003-2005. Among the groups of early and delayed EMS calls during 2003-2005 and 2013-2014, there were no significant differences in the number of people who suspected stroke. Advanced patient age, young caller age, hemiparesis, facial weakness, and the severity of neurological deficit were independent factors that correlated strongly with an early EMS call, whereas feelings of numbness and dizziness correlated significantly with delayed EMS calls. CONCLUSIONS In the West Pomeranian community, general knowledge of stroke is not a significant factor when making appropriate decisions at the onset of stroke symptoms. The education campaign regarding the initial symptoms of stroke and the possible fatal consequences appears to have been ineffective.
Collapse
Affiliation(s)
- Marta Masztalewicz
- Department of Neurology, Pomeranian Medical Unversity in Szczecin, Szczecin, Poland.
| | - Przemysław Nowacki
- Department of Neurology, Pomeranian Medical Unversity in Szczecin, Szczecin, Poland
| | - Dariusz Kotlęga
- Department of Neurology, Pomeranian Medical Unversity in Szczecin, Szczecin, Poland
| | | |
Collapse
|
27
|
Diez-Ascaso O, Martínez-Sánchez P, Fernández-Fournier M, Díez-Tejedor E, Fuentes B. Stroke Patients' Recognition and Knowledge of Their Own Vascular Risk Factors: A Sociocultural Study. J Stroke Cerebrovasc Dis 2015; 24:2839-44. [PMID: 26387042 DOI: 10.1016/j.jstrokecerebrovasdis.2015.08.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Accepted: 08/16/2015] [Indexed: 10/23/2022] Open
Abstract
BACKGROUND We aimed to study the knowledge of vascular risk factors (VRFs) among patients with stroke and the elements influencing this knowledge using analysis tools from the fields of social and health anthropology. METHODS A prospective, cross-sectional and observational study in a cohort of patients who had suffered a stroke within the prior 3-12 months. Semistructured, in-depth interviews were conducted by a social anthropologist to evaluate patients' general knowledge of VRF and specifically of their own VRF. RESULTS Overall, 96 patients were included, 56.3% male, mean age 61.6 years. Nearly all patients (97.9%) had at least 1 VRF. When asked to name their VRFs, 45.8% named stress, 29.2% dyslipidemia, 28.1% hypertension, 28.1% cigarette smoking, and 13.5% diabetes. The VRFs most frequently recognized by patients as their own were stress, hypertension, dyslipidemia, cigarette smoking, and cardiac disease. Only 15.6% acknowledged all their VRFs, while 52.1% acknowledged some of them and 32.3% failed to recognize any. Naming stress as a VRF (odds ratio [OR] = .204; 95% confidence interval [CI]: .076-.553) was associated with a lower likelihood of acknowledging at least 1 VRF, whereas working outside the home (OR = 11.314; 95% CI, 1.277-100.232) and having 2 or more VRFs (OR = 3.191; 95% CI, 1.032-9.875) were associated with a higher probability of correctly recognizing at least one of their own VRF. CONCLUSIONS VRF knowledge is poor in patients with stroke. Stress was the risk factor that patients identified more frequently and it was associated with poorer knowledge of their own VRF.
Collapse
Affiliation(s)
- Olga Diez-Ascaso
- Department of Neurology and Stroke Center, La Paz University Hospital, Autonomous University of Madrid, IdiPAZ Health Research Institute, Madrid, Spain
| | - Patricia Martínez-Sánchez
- Department of Neurology and Stroke Center, La Paz University Hospital, Autonomous University of Madrid, IdiPAZ Health Research Institute, Madrid, Spain
| | - Mireya Fernández-Fournier
- Department of Neurology and Stroke Center, La Paz University Hospital, Autonomous University of Madrid, IdiPAZ Health Research Institute, Madrid, Spain
| | - Exuperio Díez-Tejedor
- Department of Neurology and Stroke Center, La Paz University Hospital, Autonomous University of Madrid, IdiPAZ Health Research Institute, Madrid, Spain.
| | - Blanca Fuentes
- Department of Neurology and Stroke Center, La Paz University Hospital, Autonomous University of Madrid, IdiPAZ Health Research Institute, Madrid, Spain.
| |
Collapse
|
28
|
Kristoffersen DT, Helgeland J, Waage HP, Thalamus J, Clemens D, Lindman AS, Rygh LH, Tjomsland O. Survival curves to support quality improvement in hospitals with excess 30-day mortality after acute myocardial infarction, cerebral stroke and hip fracture: a before-after study. BMJ Open 2015; 5:e006741. [PMID: 25808167 PMCID: PMC4386226 DOI: 10.1136/bmjopen-2014-006741] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES To evaluate survival curves (Kaplan-Meier) as a means of identifying areas in the clinical pathway amenable to quality improvement. DESIGN Observational before-after study. SETTING In Norway, annual public reporting of nationwide 30-day in-and-out-of-hospital mortality (30D) for three medical conditions started in 2011: first time acute myocardial infarction (AMI), stroke and hip fracture; reported for 2009. 12 of 61 hospitals had statistically significant lower/higher mortality compared with the hospital mean. PARTICIPANTS Three hospitals with significantly higher mortality requested detailed analyses for quality improvement purposes: Telemark Hospital Trust Skien (AMI and stroke), Østfold Hospital Trust Fredrikstad (stroke), Innlandet Hospital Trust Gjøvik (hip fracture). OUTCOME MEASURES Survival curves, crude and risk-adjusted 30D before (2008-2009) and after (2012-2013). INTERVENTIONS Unadjusted survival curves for the outlier hospitals were compared to curves based on pooled data from the other hospitals for the 30-day period 2008-2009. For patients admitted with AMI (Skien), stroke (Fredrikstad) and hip fracture (Gjøvik), the curves suggested increased mortality from the initial part of the clinical pathway. For stroke (Skien), increased mortality appeared after about 8 days. The curve profiles were thought to reflect suboptimal care in various phases in the clinical pathway. This informed improvement efforts. RESULTS For 2008-2009, hospital-specific curves differed from other hospitals: borderline significant for AMI (p=0.064), highly significant (p≤0.005) for the remainder. After intervention, no difference was found (p>0.188). Before-after comparison of the curves within each hospital revealed a significant change for Fredrikstad (p=0.006). For the three hospitals, crude 30D declined and they were non-outliers for risk-adjusted 30D for 2013. CONCLUSIONS Survival curves as a supplement to 30D may be useful for identifying suboptimal care in the clinical pathway, and thus informing design of quality improvement projects.
Collapse
Affiliation(s)
| | - Jon Helgeland
- Quality Measurement Unit, Norwegian Knowledge Centre for the Health Services, Oslo, Norway
| | | | | | - Dirk Clemens
- Innlandet Hospital Trust Gjøvik, Brumunddal, Norway
| | - Anja Schou Lindman
- Quality Measurement Unit, Norwegian Knowledge Centre for the Health Services, Oslo, Norway
| | - Liv Helen Rygh
- Quality Measurement Unit, Norwegian Knowledge Centre for the Health Services, Oslo, Norway
| | - Ole Tjomsland
- Quality Measurement Unit, Norwegian Knowledge Centre for the Health Services, Oslo, Norway
- South-Eastern Norway Regional Health Authority, Hamar, Norway
| |
Collapse
|
29
|
Ihle-Hansen H, Hagberg G, Thommessen B, Ihle-Hansen H. Tid er hjerne – også når det bakre kretsløp rammes. TIDSSKRIFT FOR DEN NORSKE LEGEFORENING 2015; 135:926-7. [DOI: 10.4045/tidsskr.15.0422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
|
30
|
Droste DW, Safo J, Metz RJ, Osada N. Stroke awareness in luxemburg: deficit concerning symptoms and risk factors. CLINICAL MEDICINE INSIGHTS-CARDIOLOGY 2014; 8:9-13. [PMID: 25452703 PMCID: PMC4227599 DOI: 10.4137/cmc.s15225] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Revised: 08/21/2014] [Accepted: 08/25/2014] [Indexed: 12/25/2022]
Abstract
BACKGROUND Awareness of stroke risk factors is important for stroke prevention. Knowledge of stroke symptoms and awareness regarding the necessity of seeking urgent stroke treatment are vital to provide rapid admission to a stroke unit. Data on this specific knowledge in Luxemburg are lacking. METHODS We investigated 420 patients from the Department of Neurology and their relatives using a questionnaire. There were 44% men and 56% women; 25% were immigrants and 75% Luxemburgish nationals; 13% already had had a stroke or transient ischemic attack (TIA); and the mean age was 55 years ranging from 18 to 87 years. RESULTS A total of 88% of participants knew that a stroke occurs in the head/brain. In all, 10% of participants did not know any symptom of a stroke. The most frequently quoted symptoms (>15%) were paralysis/weakness (36%), speech disorders (32%), cranial nerve deficit (16%), vertigo (15%), and visual disorders (15%). Sensory deficits were mentioned by only 4% of patients. Known risk factors (>15%) were smoking (40%), hypertension (32%), alcohol (32%), poor nutrition (28%), high cholesterol (26%), stress (23%), and lack of exercise (19%). Age (4%), diabetes (6%), carotid stenosis (2%), and heart disease (1%) were less frequently known. In all, 11% of participants did not know any risk factor of a stroke. A total of 89% of participants would correctly call the 112 (emergency phone number). The following groups were better informed: Luxemburgish nationals, younger people, and participants with higher education level. Stroke/TIA patients were better informed concerning stroke symptoms, but unfortunately not concerning how to react in the case of a stroke. There was no relevant gender difference. DISCUSSION Although most of the participants knew what to do in the case of a stroke, they did not know the relevant stroke symptoms and risk factors. Future campaigns should therefore focus on risk factors and symptoms, and should address immigrants, elderly persons, less-educated persons, and patients who had already suffered a stroke/TIA.
Collapse
Affiliation(s)
- Dirk W Droste
- Department of Neurology, University of Münster, Germany. ; CHL, Luxemburg, Luxemburg
| | | | | | - Nani Osada
- Institute of Medical Mathematics and Biomathematics, University of Münster, Germany
| |
Collapse
|