Incidence, lethality, and post-stroke functional status in different Brazilian macro-regions: The SAMBA study (analysis of stroke in multiple Brazilian areas)

Stroke awareness in a Brazilian Northeastern capital city and the burden of the COVID-19 pandemic

BACKGROUND

 The delay in recognizing stroke symptoms is a significant obstacle to receiving acute treatment. Therefore, it is essential to understand the gaps in the knowledge about stroke among the general population and promote campaigns based on these gaps.

OBJECTIVE

 To investigate the general knowledge about stroke in a capital in Northeastern Brazil in a sample of individuals who attended a public hospital and the impacts of the coronavirus disease 2019 (COVID-19) pandemic on the use of emergency services.

METHODS

 We included patients older than 18 years of age and their family members and/or companions. After obtaining consent, the researcher presented a typical case of stroke, and the participants filled out a questionnaire divided into 2 sections: sociodemographic data and 15 questions about stroke detection and seeking health services and treatment.

RESULTS

 We included 154 individuals with a mean age of 44.45 ± 16.21 years. After presenting the case, 60.4% mentioned the acronym AVC (acidente vascular cerebral, or cerebrovascular accident [stroke], in Portuguese) as a possible explanation, and 54.5% reported that they would call the Mobile Emergency Care Service. However, 62.9% provided the incorrect telephone number for the Mobile Emergency Care Service or lacked knowledge of the accurate number. Regarding the risk factors for stroke, 27.9% did not know any of them, 65.5% were unaware of any treatment, and no reference was made to thrombolytic therapy. About their chosen conduct in the same case in the context of the COVID-19 pandemic, 98.1% of the participants would not change their behavior.

CONCLUSION

 These results can assist in the planning of public policies and campaigns emphasizing the issue of risk factors and how to access emergency medical services in the state of Alagoas, Brazil.

Barriers and facilitators to access post-stroke rehabilitation services in the first six months of recovery in Brazil

PURPOSE

To identify barriers and facilitators to accessing post-stroke rehabilitation services six months after discharge from the stroke unit of a Brazilian public hospital.

MATERIALS AND METHODS

This cross-sectional and descriptive study collected sociodemographic and clinical-functional data during hospitalization. Then, barriers and facilitators for accessing the post-stroke rehabilitation services were collected six months after discharge. We considered economic conditions and displacement, the quality and organization of post-stroke rehabilitation services, and personal conditions.

RESULTS

A total of 174 patients were included. Among the 20 aspects analyzed, 17 (85.0%) were reported as facilitators, while three (15.0%) were as barriers. The identified barriers included financial income available for healthcare (49.4%), waiting time to schedule or to be seen (47.0%), and process to scheduling (45.4%). The main facilitators (> 79.0%) were the expectation of the patient with the treatment and assistance from family and friends. Moreover, most patients indicated as facilitators all aspects related to the quality of post-stroke rehabilitation services.

CONCLUSION

Access to post-stroke rehabilitation services presented more facilitators than barriers. Public policies to subsidize health costs, optimize waiting time, and process for scheduling post-stroke rehabilitation services should be considered to reduce barriers. Likewise, human and financial resources must promote the facilitators.