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Nik Ramli NN, Genasan D, Rossman NS. Assessing the Awareness on Symptoms and Risk Factors of Stroke amongst Rural Community in Central Region of Malaysia: A Cross-Sectional Survey. Malays J Med Sci 2024; 31:150-160. [PMID: 38456110 PMCID: PMC10917593 DOI: 10.21315/mjms2024.31.1.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 04/06/2023] [Indexed: 03/09/2024] Open
Abstract
Background As the third leading cause of mortality in Malaysia, stroke is recognised as a medical emergency which requires urgent medical attention within a limited timeframe to prevent exacerbation of the brain damage and death in patients. Recent report revealed a high prevalence of pre-hospital delay amongst the stroke patients due to the lack of awareness on symptoms and risk factors of stroke, as well as poor understanding on appropriate action towards stroke. A number of studies had assessed stroke awareness amongst urban population residing in central region of Malaysia but yet amongst rural population. Methods A cross-sectional survey was conducted amongst individuals residing in rural districts of Selangor by using a set of questionnaires assessing the sociodemographic characteristics, as well as the awareness and action towards stroke symptoms and risk factors. Results All 343 respondents were able to recognise at least one modifiable risk factor for stroke. Meanwhile, only 36.44% were able to identify all the stroke symptoms. Despite majority of them were familiar with the stroke term, less than half of the respondents were aware of calling the emergency medical service as the appropriate action towards stroke symptoms. Conclusion The present study indicated a poor level of awareness and action towards stroke symptoms and risk factors amongst rural population residing in Selangor.
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Affiliation(s)
| | - Deviga Genasan
- International Medical School, Management and Science University, Selangor, Malaysia
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Kim G, Jang H, Kwon S, Lee B, Jang SY, Chae W, Jang SI. Engaging social activities prevent stroke and myocardial infraction by raising awareness of warning symptoms: A cross-sectional survey study. Front Public Health 2023; 10:1043875. [PMID: 36726633 PMCID: PMC9885037 DOI: 10.3389/fpubh.2022.1043875] [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: 09/14/2022] [Accepted: 12/28/2022] [Indexed: 01/18/2023] Open
Abstract
Background Stroke and myocardial infarction (MI) are medical emergencies, and early treatment within the golden hour is crucial for good prognosis. Adequate knowledge about the warning symptoms can shorten the onset-to-door time. Various factors affect the level of awareness, including social activity. This study aimed to determine if engaging in social activity is associated with the awareness of the warning symptoms of stroke and MI. Methods This cross-sectional study analyzed 451,793 participants from the 2017 and 2019 Korea Community Health Survey. Based on five questions for each of stroke and MI symptoms, participants were divided into an awareness group (replied "Yes" to all five questions) and unawareness group. Engagement in social activities (i.e., religious, friendship, leisure, and volunteer activity) was evaluated through a questionnaire. Multiple logistic regression analysis was performed to evaluate the relation between social activity and awareness of warning symptoms. Results Overall, 52.6% participants were aware of the warning symptoms of stroke, and 45.8% of MI. Regular engagement in at least one social activity, particularly friendship or volunteer activity, was associated with better awareness of the warning symptoms, both stroke (OR: 1.21, 95% CI: 1.20-1.23) and MI (OR: 1.22, 95% CI: 1.20-1.24). Additionally, more diverse types of social activities were associated with higher levels of awareness. Relationship between social activity and awareness showed positive association with participants older than 60 years, rural residents, or with low socioeconomic status. Conclusion Engagement in social activity was significantly associated with better knowledge about the warning symptoms of stroke and MI. For early hospital treatment after symptom onset, participation in social activities could be beneficial.
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Affiliation(s)
- Gahyeon Kim
- Medical School, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hyeokjoo Jang
- Medical School, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sebin Kwon
- Medical School, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Bumyeol Lee
- Medical School, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Suk-Yong Jang
- Department of Healthcare Management, Graduate School of Public Health, Yonsei University, Seoul, Republic of Korea,Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Wonjeong Chae
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea,Department of Health Policy and Management, Graduate School of Public Health, Yonsei University, Seoul, Republic of Korea,Wonjeong Chae ✉
| | - Sung-In Jang
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea,Department of Preventive Medicine, Yonsei University, Seoul, Republic of Korea,*Correspondence: Sung-In Jang ✉
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Liu Y, Ma J, Zhang N, Xiao JY, Wang JX, Li XW, Wang J, Zhang Y, Gao MD, Zhang X, Wang Y, Wang JX, Xu SB, Gao J. Latent class cluster analysis of knowledge on acute myocardial infarction in community residents: a cross-sectional study in Tianjin, China. BMJ Open 2022; 12:e051952. [PMID: 35697448 PMCID: PMC9196158 DOI: 10.1136/bmjopen-2021-051952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Public knowledge of early onset symptoms and risk factors (RF) of acute myocardial infarction (AMI) is very important for prevention, recurrence and guide medical seeking behaviours. This study aimed to identify clusters of knowledge on symptoms and RFs of AMI, compare characteristics and the awareness of the need for prompt treatment. DESIGN Multistage stratified sampling was used in this cross-sectional study. Latent GOLD Statistical Package was used to identify and classify the respondent subtypes of the knowledge on AMI symptoms or modifiable RFs. Multivariable logistic regression was performed to identify factors that predicted high knowledge membership. PARTICIPANTS A structured questionnaire was used to interview 4200 community residents aged over 35 in China. 4122 valid questionnaires were recovered. RESULTS For AMI symptoms and RFs, the knowledge levels were classified into two or three distinct clusters, respectively. 62.7% (Symptom High Knowledge Cluster) and 39.5% (RF High Knowledge Cluster) of the respondents were able to identify most of the symptoms and modifiable RFs. Respondents who were highly educated, had higher monthly household income, were insured, had regular physical examinations, had a disease history of AMI RFs, had AMI history in immediate family member or acquaintance or had received public education on AMI were observed to have higher probability of knowledge on symptoms and RFs. There was significant difference in awareness of the prompt treatment in case of AMI occurs among different clusters. 'Calling an ambulance' was the most popular option in response of seeing others presenting symptoms of AMI. CONCLUSIONS A moderate or relatively low knowledge on AMI symptoms and modifiable RFs was observed in our study. Identification of Knowledge Clusters could be a way to detect specific targeted groups with low knowledge of AMI, which may facilitate health education, further reduce the prehospital delay in China and improve patient outcomes.
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Affiliation(s)
- Yin Liu
- Department of Cardiology, Tianjin Chest Hospital, Tianjin, Tianjin, China
- Thoracic Clinical College, Tianjin Medical University, Tianjin, Tianjin, China
| | - Jing Ma
- Tianjin Cardiovascular Institute, Tianjin Chest Hospital, Tianjin, Tianjin, China
| | - Nan Zhang
- Department of Cardiology, Tianjin Chest Hospital, Tianjin, Tianjin, China
| | - Jian-Yong Xiao
- Department of Cardiology, Tianjin Chest Hospital, Tianjin, Tianjin, China
| | - Ji-Xiang Wang
- Department of Cardiology, Tianjin Chest Hospital, Tianjin, Tianjin, China
| | - Xiao-Wei Li
- Department of Cardiology, Tianjin Chest Hospital, Tianjin, Tianjin, China
| | - Jing Wang
- Department of Nursing, Tianjin Chest Hospital, Tianjin, Tianjin, China
| | - Yan Zhang
- Department of Nursing, Tianjin Chest Hospital, Tianjin, Tianjin, China
| | - Ming-Dong Gao
- Department of Cardiology, Tianjin Chest Hospital, Tianjin, Tianjin, China
| | - Xu Zhang
- Tianjin Cardiovascular Institute, Tianjin Chest Hospital, Tianjin, Tianjin, China
| | - Yuan Wang
- Thoracic Clinical College, Tianjin Medical University, Tianjin, Tianjin, China
| | - Jing-Xian Wang
- Thoracic Clinical College, Tianjin Medical University, Tianjin, Tianjin, China
| | - Shi-Bo Xu
- Thoracic Clinical College, Tianjin Medical University, Tianjin, Tianjin, China
| | - Jing Gao
- Thoracic Clinical College, Tianjin Medical University, Tianjin, Tianjin, China
- Tianjin Cardiovascular Institute, Tianjin Chest Hospital, Tianjin, Tianjin, China
- Chest Hospital, Tianjin University, Tianjin, Tianjin, China
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Luo K, Liu X, Li J, Ma Y, Ye Q, Bai J, Liang C, Zou F. Redundant Gaussian dictionary in compressed sensing for ambulatory photoplethysmography monitoring. Biomed Signal Process Control 2021. [DOI: 10.1016/j.bspc.2021.102479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2022]
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Workina A, Kebede S, Fekadu C, Wubetie Snr A. Knowledge of Risk Factors and Warning Signs of Stroke Among Patients with Heart Disease at Tikur Anbessa Specialized Hospital. Open Access Emerg Med 2021; 13:57-66. [PMID: 33623445 PMCID: PMC7896790 DOI: 10.2147/oaem.s291648] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 01/25/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Stroke is a leading cause of mortality and disability worldwide and the economic costs of treatment and post-stroke care are extensive. The inability to identify stroke warning signs accurately is an important cause of delay in seeking medical attention, leading to potential ineligibility for acute intervention and which leads to secondary complications. PURPOSE To identify cardiac patients' knowledge of stroke risk factors and warning signs. PATIENTS AND METHODS The institutional based cross-sectional study design was employed. Participants were selected using systematic random sampling. Close-ended questionnaires were pre-tested and validated for consistency before data collection. Then after data collection, data were checked and entered into Epi-data 4.6. Finally, the cleaned data were exported to SPSS version 25 for analysis. Statistical analysis using binary logistic regression was done and Predictors with a p-value of <0.05 were considered statistically significant. RESULTS A total of 227 patients were included in the study, of which 140 (61.7%) of them identified physical inactivity, followed by hypertension126 (55.5%) as stroke risk factor while 15.4% of them did not know any risk factor of stroke. Amongst the study participants, 45.81% of them had adequate knowledge of stroke risk factors. Regarding stroke warning signs the most identified sign was sudden unilateral weakness 142 (62.6%) while 46 (20.26%) of them did not know at least one warning sign of a stroke. Based on multivariable logistic regression analysis, higher education level AOR 3.05 (95% CI 1.62-5.74) and Urban residence area AOR 2.07 (95% CI 1.05-4.1) were significantly associated with knowledge of stroke risk factors with p-value<0.05. CONCLUSION Study participants had inadequate knowledge of stroke risk factors and warning signs. Educational status and information about stroke are significantly associated with adequate knowledge of stroke risk factors, raising stroke awareness is the mainstay to reduce stroke burden.
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Affiliation(s)
- Abdata Workina
- School of Nursing, Jimma University, Jimma, Oromia, Ethiopia
| | - Sofia Kebede
- Department of Emergency Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | - Chala Fekadu
- Department of Internal Medicine, Addis Ababa University, Addis Ababa, Ethiopia
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Ahmed AAA, Al-Shami AM, Jamshed S, Zawiah M, Elnaem MH, Mohamed Ibrahim MI. Awareness of the Risk Factors for Heart Attack Among the General Public in Pahang, Malaysia: A Cross-Sectional Study. Risk Manag Healthc Policy 2021; 13:3089-3102. [PMID: 33380849 PMCID: PMC7767710 DOI: 10.2147/rmhp.s281285] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 12/03/2020] [Indexed: 11/23/2022] Open
Abstract
Background Cardiovascular disease is a leading nationwide cause of morbidity and mortality. Public awareness of risk factors for heart attacks is thought to impact the burden of disease, prevention, and timely management. The objective of this study was to assess the awareness of risk factors for heart attack and to identify the factors associated with the awareness of all modifiable risk factors for heart attack in the general population. Methods This is a cross-sectional study conducted among 393 adult individuals in Kuantan, Pahang, Malaysia. Data collection was conducted through face-to-face interviews among the lay public members who were 18–64 years old, excluding healthcare professionals in clinical settings and academic settings. Statistical analysis was performed using chi-square test and logistic regression analysis. Results The majority of the individuals identified smoking as a risk factor for heart attack, followed by atrial fibrillation (57.7%), heart disease (54.1%), and obesity (53.8%). However, diabetes (26%) was the risk factor that was least recognized by the participants. A total of 90.6% of participants identified at least one risk factor for heart attack, while 9.8% of the participants did not identify any risk factors for heart attack, whereas 5.6% identified all modifiable heart attack risk factors. Furthermore, participants aged 46–64 years old, married respondents, and Chinese participants, those with higher educational levels, and received prior information demonstrated great awareness of eight modifiable risk factors for heart attack. Multivariable logistic regression presented that participants with aged 55–64, those with family history of heart attack and individuals with dyslipidemia were factors independently related to excellent awareness (p=0.04, OR=6.21, 95% CL= 1.081–35.641), (p=0.049, OR=2.11, 95% CL=0.721–6.230) and (p=0.009, OR= 4.08, 95% CL= 1.427–11.685), respectively. Conclusion Awareness of risk factors for heart attack appears to be poor, where most of the respondents recognized only one modifiable risk factor. According to these findings, programs and strategies to raise awareness of modifiable risk factors for HA are urgently needed to protect the lay public from HA.
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Affiliation(s)
- Abdullah Abdulmajid Abdo Ahmed
- Department of Pharmacy Practice, Kulliyyah of Pharmacy, International Islamic University Malaysia, Kuantan, Pahang, Malaysia
| | - Abdulkareem Mohammed Al-Shami
- Department of Pharmacy Practice, Kulliyyah of Pharmacy, International Islamic University Malaysia, Kuantan, Pahang, Malaysia.,Quality Use of Medicines Research Group, Kulliyyah of Pharmacy, International Islamic University Malaysia, Kuantan, Pahang, Malaysia
| | - Shazia Jamshed
- Department of Pharmacy Practice, Kulliyyah of Pharmacy, International Islamic University Malaysia, Kuantan, Pahang, Malaysia.,Quality Use of Medicines Research Group, Kulliyyah of Pharmacy, International Islamic University Malaysia, Kuantan, Pahang, Malaysia.,Department of Clinical Pharmacy and Practice, Faculty of Pharmacy, UniSZA, Kuala Terengganu 22000, Malaysia
| | - Mohammed Zawiah
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia.,Department of Pharmacy Practice, Faculty of Clinical Pharmacy, Al Hodeidah University, Al Hudaydah, Yemen
| | - Mohamed Hassan Elnaem
- Department of Pharmacy Practice, Kulliyyah of Pharmacy, International Islamic University Malaysia, Kuantan, Pahang, Malaysia.,Quality Use of Medicines Research Group, Kulliyyah of Pharmacy, International Islamic University Malaysia, Kuantan, Pahang, Malaysia
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Birnbach B, Höpner J, Mikolajczyk R. Cardiac symptom attribution and knowledge of the symptoms of acute myocardial infarction: a systematic review. BMC Cardiovasc Disord 2020; 20:445. [PMID: 33054718 PMCID: PMC7557019 DOI: 10.1186/s12872-020-01714-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 09/24/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Since the knowledge of the symptoms of acute myocardial infarction (AMI) may reduce the decision time for patients to seek help in case of an AMI, we aimed to summarize evidence on the knowledge of the AMI symptoms and the symptom attribution in case of an acute coronary syndrome (ACS). METHODS Therefore, we systematically searched the databases PubMed, CINAHL, Embase, and Cochrane Library for relevant studies published between January 1, 2008 and 2019 (last search August 1, 2019). RESULTS A total of 86 studies were included, with a composite sample size of 354,497 participants. The weighted mean of the knowledge scores for the symptoms of AMI of 14,420 participants from the general population, was 42.1% (when maximum score was considered 100%) and 69.5% for 7642 cardiac patients. There was a substantially better level of knowledge for six symptoms ('chest pain or discomfort', 'shortness of breath', 'pain or discomfort in arms or shoulders', 'feeling weak, lightheaded, or faint', 'pain or discomfort in the jaw, neck, or back', and 'sweating') (49.8-88.5%) compared to the four less obvious/atypical symptoms 'stomach or abdominal discomfort', 'nausea or vomiting', 'headache', and 'feeling of anxiety' (8.7-36.7%). Only 45.1% of 14,843 patients, who experienced ACS, have correctly attributed their symptoms to a cardiac cause. CONCLUSION In conclusion, we found a moderate to good knowledge of "classic" and insufficient knowledge of less obvious symptoms of AMI. This might suggest that increasing knowledge about less obvious symptoms of AMI could be beneficial. It appears also important to address cardiac attribution of symptoms.
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Affiliation(s)
- Benedikt Birnbach
- Institute of Medical Epidemiology, Biometrics and Informatics, Interdisciplinary Center for Health Sciences, Martin-Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Jens Höpner
- Institute of Medical Epidemiology, Biometrics and Informatics, Interdisciplinary Center for Health Sciences, Martin-Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Rafael Mikolajczyk
- Institute of Medical Epidemiology, Biometrics and Informatics, Interdisciplinary Center for Health Sciences, Martin-Luther University Halle-Wittenberg, Halle (Saale), Germany.
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Park KS. Factors affecting awareness of myocardial infarction symptoms among the general public in Korea. Epidemiol Health 2020; 42:e2020032. [PMID: 32512667 PMCID: PMC7340619 DOI: 10.4178/epih.e2020032] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 04/23/2020] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES We aimed to determine the level of awareness of myocardial infarction (MI) symptoms among the general public in Korea and identify factors affecting awareness of MI symptoms using data from the 2017 Korea Community Health Survey (KCHS). METHODS This is a cross-sectional study using KCHS data. Based on five questions about MI symptoms, participants were divided into an awareness group (replied ‘yes’ to all five questions) and an unawareness group (replied ‘no’ or ‘not sure’ to at least one of five questions) for analysis. RESULTS Of a total of 228,281 participants, 42.4% were aware of MI symptoms. There was a high level of awareness of chest pain and shortness of breath, but a low level of awareness of gastrointestinal symptoms and pain in the arm, shoulder, jaw, neck, and back. While women had a higher level of overall awareness relative to men, they showed a lower level of awareness regarding chest pain and discomfort. The factors affecting awareness of MI symptoms were gender, age, education level, occupation, smoking, drinking, physical inactivity, and cardiovascular disease risk factors. CONCLUSIONS In order to enhance awareness of MI symptoms among the general population, appropriate education and promotion efforts must be implemented based on gender, age, education level, and occupation. Moreover, active efforts by the government, educational institutions, and medical institutions are necessary to improve awareness of both typical and atypical MI symptoms. Furthermore, health policies to promote reduced smoking and drinking and increased physical activity, as well as continuous monitoring and management of individuals with cardiovascular disease risk factors, are required.
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Liu Q, Huang YJ, Zhao L, Wang W, Liu S, He GP, Liao L, Zeng Y. Association between knowledge and risk for cardiovascular disease among older adults: A cross-sectional study in China. Int J Nurs Sci 2020; 7:184-190. [PMID: 32685615 PMCID: PMC7355188 DOI: 10.1016/j.ijnss.2020.03.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 02/16/2020] [Accepted: 03/25/2020] [Indexed: 12/19/2022] Open
Abstract
Objectives This study aimed to describe cardiovascular risk and cardiovascular disease (CVD) knowledge among older adults, and further explore the association between knowledge and risk. Methods In this cross-sectional study, we enrolled 1120 older adults who received physical examination in health centers. The participants were interviewed to obtain their behavioral risk factors related to CVD and clinical characteristics. A risk prediction chart was used to predict participants’ cardiovascular risk based on clinical characteristics and behavioral risk factors. Participants’ CVD knowledge was collected with a pretested knowledge questionnaire. Results Among the 1120 participants, 240 (21.4%) had low cardiovascular risk, 353 (31.5%) had moderate cardiovascular risk, 527 (47%) had high and very high cardiovascular risk. The knowledge level about CVD among 0.8% of the 1120 participants was good while that of 56.9% was poor. Lower CVD knowledge level, older age, lower income, and lower educational level were the independent factors of higher cardiovascular risk level. Conclusions This study highlights the need to reduce the cardiovascular risk among older adults. CVD knowledge should be considered when developing health interventions.
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Affiliation(s)
- Qi Liu
- School of Nursing, University of South China, Hengyang, Hunan, China
| | - Yan-Jin Huang
- School of Nursing, University of South China, Hengyang, Hunan, China
| | - Ling Zhao
- School of Nursing, University of South China, Hengyang, Hunan, China
| | - Wen Wang
- School of Nursing, University of South China, Hengyang, Hunan, China
| | - Shan Liu
- School of Nursing, University of South China, Hengyang, Hunan, China
| | - Guo-Ping He
- School of Nursing, University of South China, Hengyang, Hunan, China
| | - Li Liao
- School of Nursing, University of South China, Hengyang, Hunan, China
| | - Ying Zeng
- School of Nursing, University of South China, Hengyang, Hunan, China
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10
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Ahmed AAA, Al-Shami AM, Jamshed S, Fata Nahas AR. Development of questionnaire on awareness and action towards symptoms and risk factors of heart attack and stroke among a Malaysian population. BMC Public Health 2019; 19:1300. [PMID: 31619202 PMCID: PMC6796340 DOI: 10.1186/s12889-019-7596-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 09/05/2019] [Indexed: 02/08/2023] Open
Abstract
Background The awareness of symptoms and action towards heart attack and stroke is important to reduce the morbidity and mortality in both developed and developing countries. The aim of this study was to develop a questionnaire on awareness and action towards symptoms and risk factors of heart attack and stroke among lay public in Malaysia. The questionnaire was developed in both English and Bahasa Melayu. Methods Primarily the questions were generated in English. Face and content validity were performed by five experts in Pharmacy Practice and Medicine. A translation as per guidelines into Malay language was performed; followed by face-to-face interview of 96 lay public in Kuantan, Pahang, Malaysia. For internal consistency, reliability was assessed utilizing Cronbach’s alpha. Results The mean ± SD of the awareness and action towards heart attack symptoms and risk factors was 65.52 ± 6.3, with a good internal consistency (Cronbach’s alpha = 0.75), whereas the mean of the awareness and action towards stroke symptoms and risk factors was 61.93 ± 7.11, with an accepted internal consistency (Cronbach’s alpha = 0.86). Conclusion The current validation research showed that the developed questionnaire is valid and reliable for assessing the awareness and action towards symptoms and risk factors of heart attack and stroke among lay public in Malaysia.
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Affiliation(s)
- Abdullah Abdulmajid Abdo Ahmed
- Department of Pharmacy Practice, Kulliyyah of Pharmacy, International Islamic University Malaysia, 25200, Kuantan, Pahang, Malaysia
| | - Abdulkareem Mohammed Al-Shami
- Department of Pharmacy Practice, Kulliyyah of Pharmacy, International Islamic University Malaysia, 25200, Kuantan, Pahang, Malaysia.
| | - Shazia Jamshed
- Department of Pharmacy Practice, Kulliyyah of Pharmacy, International Islamic University Malaysia, 25200, Kuantan, Pahang, Malaysia
| | - Abdul Rahman Fata Nahas
- Department of Pharmacy Practice, Kulliyyah of Pharmacy, International Islamic University Malaysia, 25200, Kuantan, Pahang, Malaysia
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Narcisse MR, Rowland B, Long CR, Felix H, McElfish PA. Heart Attack and Stroke Symptoms Knowledge of Native Hawaiians and Pacific Islanders in the United States: Findings From the National Health Interview Survey. Health Promot Pract 2019; 22:122-131. [PMID: 31018704 DOI: 10.1177/1524839919845669] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Native Hawaiians and other Pacific Islanders (NHPI) suffer disproportionate rates of death from heart attack and stroke; however, little is known about NHPI heart attack and stroke symptoms knowledge. We used multivariable logistic regression to examine associations between heart attack and stroke symptoms knowledge and electronic health (eHealth) use, education, engaging in health risk behaviors, and having an at-risk diagnosis or a past heart attack and/or stroke. The analytic sample included 2,172 NHPI adults responding to the 2014 NHPI-National Health Interview Survey. NHPI reported moderate to high levels of heart attack and stroke symptoms knowledge. NHPI with an at-risk diagnosis were significantly more likely to know three of five heart attack symptoms. Engaging in health risk behaviors increased the odds of knowing one heart attack symptom. Neither a prior heart attack nor a prior stroke increased the likelihood of recognizing most symptoms of heart attack or stroke. eHealth use was associated with increased likelihood for knowing heart attack and stroke symptoms. The findings of this study can be used to inform interventions that support the Healthy People 2020 goals to increase the proportion of adults who are aware of the symptoms of heart attack and stroke and to reduce heart attack and stroke disparities.
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Affiliation(s)
- Marie-Rachelle Narcisse
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA
| | - Brett Rowland
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA
| | - Christopher R Long
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA
| | - Holly Felix
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Pearl A McElfish
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA
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12
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Stroke awareness in Korean high school students. Acta Neurol Belg 2017; 117:455-459. [PMID: 28154990 DOI: 10.1007/s13760-017-0754-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 01/24/2017] [Indexed: 10/20/2022]
Abstract
Public awareness is essential for the early diagnosis, treatment, and prevention of stroke. In particular, young adults represent an important avenue for increasing awareness and precluding the adoption of unhealthy, risk-increasing behaviors. This study was the first to investigate the basic knowledge of Korean adolescents about stroke and evaluate the improvement of this knowledge after an educational lecture. In total, 1269 high school students were instructed on the risk factors, symptoms, diagnosis, and management of stroke. Knowledge was evaluated before education (Pre-E), immediately after the lecture (Post-E1), and during a 2-week follow-up (Post-E2), using a questionnaire. Overall, we found that students' knowledge increased after the educational session. On the questionnaire section pertaining to stroke risk factors, out of nine possible points, the mean scores were 3.97, 5.28, and 5.10, on the Pre-E, Post-E1, and Post-E2 tests, respectively, indicating a significant improvement (p < 0.001). Additionally, students who reported that they paid attention during the lecture performed better, and scored 4.29, 6.32, and 6.40, on the Pre-E, Post-E1, and Post-E2 tests, respectively, again indicating a significant improvement (p < 0.001). Our findings indicate that incorporating a stroke education program into school curriculums will enhance the knowledge of Korean adolescents. Implementing this type of program is critical as it may reduce behavior associated with increased stroke risk, and more effort is needed to develop educational methods for engaging students and increasing their concentration during these programs.
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Boo S, Oh H, Froelicher ES, Suh CH. Knowledge and perception of cardiovascular disease risk among patients with rheumatoid arthritis. PLoS One 2017; 12:e0176291. [PMID: 28437445 PMCID: PMC5402932 DOI: 10.1371/journal.pone.0176291] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 04/07/2017] [Indexed: 11/18/2022] Open
Abstract
Patients with rheumatoid arthritis are at increased risk for cardiovascular disease. The prerequisites for reducing the risk of cardiovascular disease are adequate levels of knowledge and being aware of the risk. In this study, the levels of knowledge about cardiovascular disease among patients with rheumatoid arthritis and the perception were evaluated in relation to their actual 10-year risk of cardiovascular disease. This cross-sectional study of 200 patients with rheumatoid arthritis was conducted in a university-affiliated hospital in South Korea. The patients' actual risk of cardiovascular disease was estimated using the Framingham Risk Score. The most common risk factor was physical inactivity, with 77% of the patients not engaging in regular exercise. The patients lacked knowledge about the effects of physical inactivity and anti-inflammatory medication on the development of cardiovascular disease. Misperceptions about the risk of cardiovascular disease were common, i.e., 19.5% of the patients underestimated their risk and 41% overestimated. Hypertension, diabetes, obesity, and smoking were the most prevalent among the patients who underestimated their risk, and these same patients had the lowest level of knowledge about cardiovascular disease. This study demonstrated the rheumatoid arthritis patients' lack of knowledge about the effects of physical inactivity and anti-inflammatory medications on the development of cardiovascular disease, and their misperception of cardiovascular risk was common. As a preventive measure, educational programs about cardiovascular disease should be tailored specifically for patients with rheumatoid arthritis, and behavioral interventions, including routine exercise, should be made available at the time of diagnosis.
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Affiliation(s)
- Sunjoo Boo
- Institute of Nursing Science∙College of Nursing, Ajou University, Suwon, Gyeonggi-do, Korea
| | - Hyunjin Oh
- College of Nursing, Gachon University, Incheon, Korea
| | - Erika S. Froelicher
- School of Nursing and Medicine, University of California San Francisco, San Francisco, California, United States of America
| | - Chang-Hee Suh
- Department of Rheumatology, Ajou University School of Medicine, Suwon, Gyeonggi-do, Korea
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Rafiee Alhossaini M, Hassanzadeh A, Feizi A, Sarrafzadegan N. Transition in public knowledge of risk factors of cardiovascular disease in an Iranian general population: A latent transition analysis (LTA) on a longitudinal large community-based educational prevention program. ARYA ATHEROSCLEROSIS 2016; 12:185-191. [PMID: 28149314 PMCID: PMC5266135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Cardiovascular diseases (CVD) are the second leading cause of death, after accidents, in Iran. This study was performed to assess the change in levels of knowledge about 8 risk factors of CVD and its associated determinants the Iranian general population. METHODS The current repeated cross-sectional study included 3014 people in 2004, 3012 in 2005, and 4719 in 2007, aged older than 19 years. Knowledge about 8 risk factors (high blood pressure, nutrition, physical inactivity, smoking, diabetes, heredity, stress, and obesity) as the major causes of CVD was evaluated using latent transition analysis (LTA). RESULTS The most widely known CVD risk factors were nutrition and physical inactivity followed by stress. In addition, old age, low level of education, male gender and low socioeconomic status (SES) level were the significant determinants of low knowledge levels of CVD risk factors. Besides, individuals' knowledge of CVD risk factors increased across the time. CONCLUSION Public knowledge of CVD risk factors has increased; however significant gaps continue to exist, particularly among the elderly, less-educated people, people in low socioeconomic status level and men. Future intensified educational efforts by policymakers are necessary for improving knowledge of CVD, particularly among high-risk groups.
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Affiliation(s)
- Mahsa Rafiee Alhossaini
- PhD Student, Department of Biostatistics, School of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Akbar Hassanzadeh
- Instructor, Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Awat Feizi
- Associate Professor, Department of Biostatistics and Epidemiology AND Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran,Correspondence to: Awat Feizi,
| | - Nizal Sarrafzadegan
- Professor, Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
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Kim HS, Lee H, Kim K, Park HK, Park KS, Kang GW, Shin HY, Kim RB, Oh GJ, Seo JH, Lee YH. The General Public's Awareness of Early Symptoms of and Emergency Responses to Acute Myocardial Infarction and Related Factors in South Korea: A National Public Telephone Survey. J Epidemiol 2016; 26:233-41. [PMID: 26853101 PMCID: PMC4848321 DOI: 10.2188/jea.je20150074] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Prompt treatment affects prognosis and survival after acute myocardial infarction (AMI) onset. This study evaluated the awareness of early symptoms of AMI and knowledge of appropriate responses on symptom occurrence, along with related factors. METHODS Participants' knowledge of the early symptoms of and responses to AMI onset were investigated using a random digit dialing survey. We included 9600 residents of 16 metropolitan cities and provinces in Korea. RESULTS The proportions of respondents who were aware of early symptoms of AMI ranged from 32.9% (arm or shoulder pain) to 79.1% (chest pain and discomfort). Of the respondents, 67.0% would call an ambulance if someone showed signs of AMI, 88.7% knew ≥1 symptom, 10.9% knew all five symptoms, and 3.1% had excellent knowledge (correct identification of all five AMI symptoms, not answering "Yes" to the trap question, and correctly identifying calling an ambulance as the appropriate response when someone is exhibiting AMI symptoms). The odds ratio (OR) for having excellent knowledge was significantly higher for those who graduated college or higher (OR 3.42; 95% confidence interval [CI], 1.09-10.76) than for those with less than a primary school education, as well as for subjects with AMI advertisement exposure (OR 1.49; 95% CI, 1.10-2.02) and with knowledge of AMI (OR 1.63; 95% CI, 1.16-2.27). The 60- to 79-year-old group had significantly lower OR for excellent knowledge than the 20- to 39-year-old group (OR 0.53; 95% CI, 0.28-0.99). CONCLUSIONS Awareness of AMI symptoms and the appropriate action to take after symptom onset in South Korea was poor. Therefore, educational and promotional strategies to increase the overall awareness in the general public, especially in the elderly and those with low education levels, are needed.
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Affiliation(s)
- Hee-Sook Kim
- Department of Epidemiology, Graduate School of Public Health, Seoul National University
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Bang DW, Manemann SM, Gerber Y, Roger VL, Lohse CM, Rand-Weaver J, Krusemark E, Yawn BP, Juhn YJ. A novel socioeconomic measure using individual housing data in cardiovascular outcome research. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:11597-615. [PMID: 25396769 PMCID: PMC4245632 DOI: 10.3390/ijerph111111597] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2014] [Revised: 09/25/2014] [Accepted: 10/29/2014] [Indexed: 01/09/2023]
Abstract
BACKGROUND To assess whether the individual housing-based socioeconomic status (SES) measure termed HOUSES was associated with post-myocardial infarction (MI) mortality. METHODS The study was designed as a population-based cohort study, which compared post-MI mortality among Olmsted County, Minnesota, USA, residents with different SES as measured by HOUSES using Cox proportional hazards models. Subjects' addresses at index date of MI were geocoded to real property data to formulate HOUSES (a z-score for housing value, square footage, and numbers of bedrooms and bathrooms). Educational levels were used as a comparison for the HOUSES index. RESULTS 637 of the 696 eligible patients with MI (92%) were successfully geocoded to real property data. Post-MI survival rates were 60% (50-72), 78% (71-85), 72% (60-87), and 87% (81-93) at 2 years for patients in the first (the lowest SES), second, third, and fourth quartiles of HOUSES, respectively (p < 0.001). HOUSES was associated with post-MI all-cause mortality, controlling for all variables except age and comorbidity (p = 0.036) but was not significant after adjusting for age and comorbidity (p = 0.24). CONCLUSIONS Although HOUSES is associated with post-MI mortality, the differential mortality rates by HOUSES were primarily accounted for by age and comorbid conditions. HOUSES may be useful for health disparities research concerning cardiovascular outcomes, especially in overcoming the paucity of conventional SES measures in commonly used datasets.
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Affiliation(s)
- Duk Won Bang
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA; E-Mails: (D.W.B.); (J.R.-W.); (E.K.)
- Department of Internal Medicine, Division of Cardiology, Soonchunhyang University Hospital, 22, Daesagwan-gil (657 Hannam-dong), Yongsan-gu, Seoul 140-743, Korea
| | - Sheila M. Manemann
- Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA; E-Mails: (S.M.M.); (Y.G.); (V.L.R.); (C.M.L.)
| | - Yariv Gerber
- Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA; E-Mails: (S.M.M.); (Y.G.); (V.L.R.); (C.M.L.)
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, P.O. Box 39040, Tel Aviv 699780, Israel
| | - Veronique L. Roger
- Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA; E-Mails: (S.M.M.); (Y.G.); (V.L.R.); (C.M.L.)
- Division of Cardiovascular Disease, Department of Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
| | - Christine M. Lohse
- Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA; E-Mails: (S.M.M.); (Y.G.); (V.L.R.); (C.M.L.)
| | - Jennifer Rand-Weaver
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA; E-Mails: (D.W.B.); (J.R.-W.); (E.K.)
| | - Elizabeth Krusemark
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA; E-Mails: (D.W.B.); (J.R.-W.); (E.K.)
| | - Barbara P. Yawn
- Department of Research, Olmsted Medical Center, 210 Ninth Street SE, Rochester, MN 55904, USA; E-Mail:
| | - Young J. Juhn
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA; E-Mails: (D.W.B.); (J.R.-W.); (E.K.)
- Division of Allergic Diseases, Department of Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
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Kim HK, Jeong SH, Kang HC. [Identification of subgroups with lower level of stroke knowledge using decision-tree analysis]. J Korean Acad Nurs 2014; 44:97-107. [PMID: 24637290 DOI: 10.4040/jkan.2014.44.1.97] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
PURPOSE This study was performed to explore levels of stroke knowledge and identify subgroups with lower levels of stroke knowledge among adults in Korea. METHODS A cross-sectional survey was used and data were collected in 2012. A national sample of 990 Koreans aged 20 to 74 years participated in this study. Knowledge of risk factors, warning signs, and first action for stroke were surveyed using face-to-face interviews. Descriptive statistics and decision tree analysis were performed using SPSS WIN 20.0 and Answer Tree 3.1. RESULTS Mean score for stroke risk factor knowledge was 7.7 out of 10. The least recognized risk factor was diabetes and four subgroups with lower levels of knowledge were identified. Score for knowledge of stroke warning signs was 3.6 out of 6. The least recognized warning sign was sudden severe headache and six subgroups with lower levels of knowledge were identified. The first action for stroke was recognized by 65.7 percent of participants and four subgroups with lower levels of knowledge were identified. CONCLUSION Multi-faceted education should be designed to improve stroke knowledge among Korean adults, particularly focusing on subgroups with lower levels of knowledge and less recognition of items in this study.
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Affiliation(s)
- Hyun Kyung Kim
- College of Nursing, Research Institute of Nursing Science, Chonbuk National University, Jeonju, Korea
| | - Seok Hee Jeong
- College of Nursing, Research Institute of Nursing Science, Chonbuk National University, Jeonju, Korea.
| | - Hyun Cheol Kang
- Department of Informational Statistics, Hoseo University, Asan, Korea
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