Stroke education focusing on recognition and response to decrease pre-hospital delay in India: Need of the hour to save hours

Background: Stroke is the second leading cause of death in Korea and the prevalence of acute ischemic stroke among older adults continues to grow, which is known to be related to delayed hospital arrival after the onset of symptoms. Thus, decreasing the incidence of elderly stroke is a major health promotion objective in Korea, yet little is reported about the factors associated with the delayed medical care seeking behavior among elderly stroke patients in Korea. Purpose: The purpose of this study was to understand factors of delayed medical care seeking among elderly stroke patients in order to develop intervention strategies to improve the health of this population. Methods: A cross-sectional, descriptive study was conducted in a convenience sample of 233 hospitalized elderly patients with acute ischemic stroke using a self-administered survey. Descriptive statistics and chi-square test were used for data analysis. Results: More than half of them were male (60.5%) with age of 61 and older (76.9%), and relied on the opinion of their children or friends when deciding medical care for stroke (58.3%). Regarding the reasons of seeking medical care, there was no statistical significance between individuals who arrived at a hospital within three hours of the onset of symptoms and who arrived after three hours. Reasons for delayed hospital arrival were significantly different between groups (individuals of hospital arrival within three hours vs. individuals with hospital arrival after three hours), which include lack of knowledge about the severity of stroke and unawareness of symptoms (χ2 = 24.1), or inconvenience of a hospital visit, waiting for the effects of alternative medications, and stroke during sleep (χ2 = 55.1) with p <0.001. Conclusions: In conclusion, this study helped identify factors delaying hospital arrival after the onset of symptoms among Korean elderly stroke patients. Interventions should include stroke education focusing on the severity of stroke and related symptoms. The stroke education should target not only elderly stroke patients but their family members and friends. It may result in overall national health by decreasing prevalence of stroke among Korean elderly population.

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Abstract WP164: An Assessment of Stroke Knowledge in the Coulee Region Community

Stroke ◽

10.1161/str.47.suppl_1.wp164 ◽

2016 ◽

Vol 47 (suppl_1) ◽

Author(s):

Mouhammed Kabbani ◽

Katherine Riley ◽

Angela L Smith ◽

Andrew Borgert ◽

John Gabbert ◽

...

Keyword(s):

Delayed Presentation ◽

Gis Technology ◽

Exact Test ◽

Demographic Groups ◽

Level Of Knowledge ◽

Stroke Education ◽

Low Levels ◽

Middle Aged Adults ◽

Stroke Knowledge ◽

Targeted Approach

Introduction: Delayed presentation to the hospital persists as a significant barrier to early intervention of stroke with tPA treatment. Community knowledge about stroke symptoms is moderate at best and not parallel with behavior. Objective: To assess our community’s level of knowledge about stroke to direct the development of targeted educational efforts. Methods: Members of communities in our regional stroke alert locations were asked to complete a 15-item survey that included questions about basic demographics, stroke symptoms, behavior actions and interest in and barriers to attending stroke education. Surveys were collected from local businesses, online and in public venues. Overall scores were calculated by summing the number of correct responses and, with the exception of questions pertaining to the BEFAST mnemonic, subtracting the number of incorrect or unmarked responses. Reported metrics include overall survey scores and demographics of survey respondents. Total scores were compared between demographic groups via the Wilcoxon Rank Sum, while question level comparisons utilized the χ2 or Fisher’s exact test. GIS technology was applied to identify geographic clusters of different knowledge levels. Results: Among 1118 participants, 86% had low levels of stroke knowledge as defined by a survey score of ≤ 70% accuracy (medium = 71-89%; high ≥ 90-100%). Knowledge was low throughout most of our community with isolated pockets of higher knowledge in outlying areas. Awareness was highest (though still low) among females, middle-aged adults (36-55 yo), those with post-high school degrees, and those with previous formal stroke education. In case of stroke, older adults (55+ yo) were least likely to call 9-1-1. Only 21.6% of participants were likely or highly likely to attend stroke education. Conclusions: The level of stroke knowledge in our community is low. People tend to not be interested in attending formal stroke education outside of their regular day. Efforts must be made to raise awareness about stroke symptoms and treatment in order to increase more positive outcomes following stroke. Incorporating stroke education into work and school curriculums will be our targeted approach.

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