Stroke knowledge among middle and high school students

Translation and validation of the Chinese version of the stroke knowledge test for the hypertension patient

The measurement of hypertensive patients' stroke knowledge is an important stroke prevention indicator of health care service quality. The aim of this study was to develop a Chinese version of the Stroke Knowledge Test and examine its psychometric properties, reliability, and validity for hypertensive patients. A sample of 200 hypertensive patients completed the Chinese version of the Stroke Knowledge Test, and 30 of the participants were retested after 2 weeks. The final Chinese version of the Stroke Knowledge Test included 20 items with acceptable content validity (I-CVI = 0.88 ~ 1.00, S-CVI/Ave = 0.97). These items showed satisfactory internal reliability consistency (Kuder Richardson-20 = 0.62) and test-retest reliability was 0.77. The 40% of the difficulty index was in the acceptable range, and 25% was in the difficult range, as well as the 90% items overall values for discrimination were ranged from 0.2 to > 0.4. Known-group validity testing was performed based on the education level, and the result exhibited significant difference (F = 21.21, p < 0.001). The Chinese version of the Stroke Knowledge Test demonstrated acceptable psychometric properties, thus providing a new tool for the future care of hypertensive patients in Taiwan. It also could be as a reference for healthcare providers to educate hypertensive patients on stroke prevention.

Al Meslamani A. Assessment of Knowledge and attitude towards Stroke among the UAE population during the COVID-19 pandemic: A cross-sectional study

Background: Despite significant advancements in healthcare, the burden of stroke continues to rise in the developed world, especially during the COVID-19 pandemic. Association between COVID-19 infection and stroke is well established. Factors identified for the delay in presentation and management include a lack of awareness regarding stroke. We aimed to assess the general public knowledge and attitudes on stroke and stroke risk factors in the United Arab Emirates during the COVID-19 pandemic. Methods: A cross-sectional study was conducted between September 2021 and January 2022 among adults≥ 18 years old. Participants completed a self-administered questionnaire on sociodemographic characteristics and stroke knowledge and attitudes. Knowledge and attitude scores were calculated based on the number of correct responses. Linear regression analysis was performed to determine the factors related to knowledge and attitude towards stroke. Results: Of the 500 respondents, 69.4% were females, 53.4% were aged between 18 and 25, and nearly half were students (48.4%). The mean knowledge score was 13.66 (range 2-24). Hypertension (69%), smoking (63.2%), stress (56.4%) obesity/overweight (54.4%), and heart disease (53.6%) were identified as risk factors. Overall, the knowledge of signs/symptoms was suboptimal. The mean attitude score was 4.41 (range, 1-6); 70.2% would call an ambulance if someone were having a stroke. A monthly income of 11,000-50,000 AED and being a student were associated with positive knowledge. Being a non-health worker and lacking access to electronic media sources were associated with worse attitudes. Conclusion: Overall, we identified poor knowledge and suboptimal attitudes toward stroke. These findings reflect the need for effective public health approaches to improve stroke awareness, knowledge, and attitudes for effective prevention in the community. Presently, this is of utmost necessity, given the increased occurrence of stroke and its severity among COVID-19 patients.

Effect of an educational intervention to increase stroke awareness among Italian high school students: A prospective study in Tuscany

INTRODUCTION

Stroke in young people shares traditional modifiable risk factors with older groups, and greatly affects quality of life. However, evidence on the effectiveness of educational interventions in young populations, aiming at spreading stroke knowledge and enhancing prevention, is still scarce. We evaluated baseline knowledge of stroke and possible improvements after an educational intervention among Italian high school students, also considering differences related to sex and type of school.

SUBJECTS AND METHODS

Using a mixed educational strategy, a prospective evaluation of stroke knowledge was performed in five humanities and sciences (lyceums) and five vocational high schools of Tuscany (students of the 12th and 13th grade). A baseline assessment with a structured questionnaire (21 questions) was followed by a standardized oral presentation, using audiovisual materials. After 3 months, the same questionnaire was re-administered to evaluate the long-term impact of the educational intervention.

RESULTS

Overall, 573 students (50.8% males; age range, 17-19 years) were enrolled; 288 (50.3%) were from lyceums and 285 (49.7%) from vocational schools. Follow-up participation was 97.2%. Baseline performances were comparable between groups for most variables examined. At 3 months, all groups showed a significant improvement from baseline regarding reaction to a stroke event, identification of stroke risk factors, such as smoking (from 62.9% to 83.7%; p < 0.001) and alcohol abuse (from 49.6% to 67.2%; p < 0.001), and symptoms. Knowledge of the existence of stroke units and thrombolysis increased from 25.4% to 60.7% (p < 0.001) and from 35.8% to 84.0% (p < 0.001), respectively.

CONCLUSIONS

Our educational intervention improved stroke awareness in high school students. The effects persisted after 3 months. Improved knowledge in young populations may reduce stroke burden in adult life, increase timely access to therapies, and spread knowledge across families.

Al-Rawi M. Evaluation of knowledge of risk factors and warning signs of stroke - An observational study among future health care professionals

Background and objective

The role of healthcare professionals in society is unique since they are providers of health information and medication counseling to patients. Hence, this study aimed to evaluate Knowledge of Risk Factors and Warning Signs of Stroke among undergraduate health care Students (UHCS) at King Saud University (KSU), Riyadh, Saudi Arabia.

Methodology

An online cross-sectional study was conducted among UHCS at KSU, Riyadh, Saudi Arabia from September to November 2022, using self-administered 34-item questionnaires divided into five sections to assess participants' knowledge of stroke risk factors, warning signs, and management and source of information about the stroke. The Statistical Package for the Social Sciences version 26 was used to analyze the data (SPSS).

Results

Of the 300 questionnaires distributed, 205 students completed the questionnaires, giving a response rate of 68.3%. Of whom 63 (30.7%) were pharmacy, 81 (39.5%) were nursing and 61 (29.8%) were emergency medical services (EMS) Students. One hundred and eighty-two (88.8%) of the students agreed that stroke affects bodily movement. With regards to risk factors, students identified high blood pressure 182 (88.8%), followed by heart disease 175 (85.4%), advanced age 164 (80%), previous Stroke history 158(77.1%), and lack of physical activity 156 (76.1%). Difficulty in speaking or slurred speech 164 (80%), dizziness, and loss of balance 163 (79.5%) were identified as the warning signs of stroke. In this study, 41.3 % of the pharmacy students reported a good level of knowledge than nursing and EMS students. However, 32.2% (N = 66) of the healthcare undergraduates reported good knowledge. The knowledge score was significantly associated with the year of study, and educational degree (p = 0.0001). Furthermore, there were no differences between parents working in healthcare settings (p = 0.99).

Conclusion

In conclusion, the knowledge of stroke among healthcare students at King Saud University varied. The reported knowledge gap mostly relates to stroke risk factors and warning signs. Therefore, increasing public awareness of potential risk factors and stroke warning signs needs to receive more attention.

Effect of the Preparatory School FAST Stroke Educational Program

ABSTRACT

BACKGROUND: The aim of this study was to assess the effectiveness of FAST stroke educational program among all preparatory school students in the state of Qatar. METHODS: The pretest-posttest experimental research design was used to evaluate the effectiveness of the FAST educational program in Qatar. A 30-minute audiovisual presentation was given to improve knowledge of stroke. We included grade 7 to 9 students during the academic year 2018-2019. The FAST program consisted of a pretest, an educational intervention, and immediate and long-term posttests at 2 months. RESULTS: A sample of 1244 students completed presurvey and immediate postsurvey, with an average age of 13.5 (1.12) years (range, 11-18 years) and 655 (53%) females. Students had significantly ( P < .01) greater knowledge of stroke signs, symptoms, and risk factors at intermediate posttest (5.9 [2.6] and 6.2 [2.4]) and at 2 months posttest (5.6 [2.8] and 5.6 [2.7]) compared with pretest (4.8 [2.6] and 4.9 [2.6], respectively). Students also had a higher self-efficacy to seek assistance, which was sustained from pretest to long-term posttest. CONCLUSION: The FAST program improved stroke knowledge that was retained at 2 months.

Awareness towards stroke among high school students in Brazil: a cross-sectional study

BACKGROUND

Stroke is one of the main causes of death worldwide. Educational interventions on stroke are potentially effective in reducing the period between the onset of symptoms and the initial emergency medical assistance.

OBJECTIVES

To assess high school students' knowledge of stroke.

DESIGN AND SETTING

Cross-sectional study conducted in high schools in northeastern Brazil.

METHODS

A self-structured questionnaire survey regarding stroke awareness was applied among high school students in northeastern Brazil. Data were collected between 2018 and 2019. The chi-square test and other descriptive statistics were used. Univariate and multivariate analyses were performed using logistic regression.

RESULTS

A total of 1,788 students were analyzed. Eighty percent (n = 1430) of them did not have the minimum knowledge on how to act in a stroke situation. Only 10% (n = 179) presented the ideal knowledge on how to act. Males presented lower levels of knowledge on risk factors (odds ratio, OR: 0.62%; 95% confidence interval, CI: 0.49-0.79) and signs and symptoms of stroke (OR: 0.63%; 95% CI: 0.52-0.77). Students with ≥ 10 years of schooling (OR: 1.64%; 95% CI: 1.30-2.07) demonstrated greater knowledge of signs and symptoms of stroke. Students aged 18 years (OR: 1.70%; 95% CI: 1.14-2.52) demonstrated greater knowledge than other ages regarding the telephone number of the emergency medical services.

CONCLUSIONS

There was a knowledge deficit with regard to recognizing stroke and activating the emergency medical services. The findings apply to the sample investigated and suggest that there is a need for stroke educational interventions, starting in high school.

The lack of knowledge on acute stroke in Brazil: A cross-sectional study with children, adolescents, and adults from public schools

OBJECTIVE

Stroke is an important cause of disability and death in adults worldwide. However, it is preventable in most cases and treatable as long as patients recognize it and reach capable medical facilities in time. This community-based study investigated students' stroke knowledge, Emergency Medical Services (EMS) activation, associated risk factors, warning signs and symptoms, and prior experience from different educational levels in the KIDS SAVE LIVES BRAZIL project.

METHODS

The authors conducted the survey with a structured questionnaire in 2019‒2020.

RESULTS

Students from the elementary-school (n = 1187, ∼13 y.o., prior experience: 14%, 51% women), high-school (n = 806, ∼17 y.o., prior experience: 13%, 47% women) and University (n = 1961, ∼22 y.o., prior experience: 9%, 66% women) completed the survey. Among the students, the awareness of stroke general knowledge, associated risk factors, and warning signs and symptoms varied between 42%‒66%. When stimulated, less than 52% of the students associated stroke with hypercholesterolemia, smoking, diabetes, and hypertension. When stimulated, 62%‒65% of students recognized arm weakness, facial drooping, and speech difficulty; only fewer identified acute headache (43%). Interestingly, 67% knew the EMS number; 81% wanted to have stroke education at school, and ∼75% wanted it mandatory. Women, higher education, and prior experience were associated with higher scores of knowing risk factors (OR = 1.28, 95% CI: 1.10‒1.48; OR = 2.12, 95% CI: 1.87‒2.40; OR = 1.46, 95% CI: 1.16‒1.83; respectively), and warning signs- symptoms (OR = 2.22, 95% CI: 1.89‒2.60; OR = 3.30, 95% CI: 2.81‒3.87; OR = 2.04, 95% CI: 1.58‒2.63; respectively).

CONCLUSION

Having higher education, prior experience, and being a woman increases stroke-associated risk factors, and warning signs and symptoms identification. Schoolchildren and adolescents should be the main target population for stroke awareness.

Knowledge and Response to Stroke Among Lebanese Adults: A Population-Based Survey

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.

Detection to Hospital Door: Gender Differences of Patients With Acute Stroke Symptoms

Although prehospital stroke management is challenging, it is a crucial part of the acute stroke chain to enable equal access to highly specialised stroke care. It involves a critical understanding of players usually not specialized in acute stroke treatments. There is contradictory information about gender inequity in prehospital stroke detection, dispatch, and delivery to hospital stroke centers. The aim of this narrative review is to summarize the knowledge of gender differences in the first three stages of acute stroke management. Information on the detection of acute stroke symptoms by patients, their relatives, and bystanders is discussed. Women seem to have a better overall knowledge about stroke, although general understanding needs to be improved. However, older age and different social situations of women could be identified as reasons for reduced and delayed help-seeking. Dispatch and delivery lie within the responsibility of the emergency medical service. Differences in clinical presentation with symptoms mainly affecting general conditions could be identified as a crucial challenge leading to gender inequity in these stages. Improvement of stroke education has to be applied to tackle this inequal management. However, specifically designed projects and analyses are needed to understand more details of sex differences in prehospital stroke management, which is a necessary first step for the potential development of substantially improving strategies.

Understanding the importance of recognising, treating and preventing stroke

Stroke is a medical emergency, resulting in a significant number of annual deaths in the UK and representing a major cause of disability. Early recognition of the signs and symptoms of stroke is vital to ensure effective and potentially lifesaving treatment. It is important that nurses are able to recognise the risk factors for stroke, as well as being aware of the potential treatment modalities. This article details the signs and symptoms, and risk factors for stroke, as well as outlining the treatment options. The author also explains the important role of nurses in stroke prevention and the long-term care of people who have experienced a stroke and their family members.