Allied Health and Nursing Students' Knowledge of Stroke Risk Factors and Warning Signs in Older Adults and Young Females

Background: There is limited recent population-based data of trends in acute ischemic stroke (AIS) hospitalization rates among young adults (YA). Rising prevalence of stroke risk factors may increase stroke rates in YA. We hypothesized that 1) stroke hospitalizations and mortality among YA are increasing over time (2000-2011), 2) besides traditional stroke risk factors, non-traditional factors are associated with stroke in YA, 3) stroke hospitalization among YA is associated with higher mortality, length of stay (LOS), and cost. Methods: In the Nationwide Inpatient Sample database (years 2000-2011), adult hospitalizations for AIS and concurrent diagnoses were identified by ICD-9-CM codes; the analytic cohort constituted all AIS hospitalizations. We performed weighted analysis using chi-square, t-test, and Jonckheere trend test. Multivariable survey regression models evaluated interactions between age group (18-45 vs. >45 years) and traditional and non-traditional risk factors, with outcomes including mortality, LOS, and cost. Models were adjusted for race, sex, Charlson’s Comorbidity Index, primary payer, location and teaching status of hospital, and admission day. Results: Among 5220960 AIS hospitalizations, 231858 (4.4%) were YA. On trend analysis, proportion of YA amongst AIS increased from 3.6% in 2000 to 4.7% in 2011 (p<0.0001) but mortality in YA decreased from 3.7% in 2000 to 2.6% in 2011, compared to 7.1% in 2000 to 4.6% in 2011 (p<0.0001) among older adults. Non-traditional, especially behavioral, risk factors were more common among YA, and LOS and cost were higher (Table). Conclusion: There was a trend for higher proportion of YA among AIS hospitalizations, though there was a decreasing mortality trend over 10 years. Behavioral risk factors were more common among YA, and there was an increased length of stay and cost. AIS in YA may require different preventive approaches compared to AIS among older adults.

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Does Socioeconomic Position Affect Knowledge of the Risk Factors and Warning Signs of Stroke in the WHO European Region? A Systematic Literature Review

10.21203/rs.3.rs-22447/v2 ◽

2020 ◽

Author(s):

Katie Stack ◽

Wendy Robertson ◽

Clare Blackburn

Keyword(s):

Risk Factors ◽

Socioeconomic Position ◽

Stroke Risk ◽

Educational Interventions ◽

Warning Signs ◽

European Region ◽

Free Text ◽

Stroke Risk Factors ◽

Mesh Terms ◽

Increasing Knowledge

Abstract Background: Strokes are one of the leading causes of death worldwide. People with a lower socioeconomic position (SEP) (i.e. with regards to education, income and occupation) are at a higher risk of having a stroke and have worse clinical outcomes compared to the general population. Good knowledge levels about stroke risk factors and warning signs are key to prolonging life and reducing health issues caused by stroke. This systematic review examined differences in knowledge of stroke risk factors and warning signs with regards to SEP in the WHO European region. Methods: MEDLINE, Embase, Web of Science, PsycINFO and CINAHL were systematically searched using appropriate Medical Subject Headings (MeSH) terms and free text, combining search terms with Boolean operators. Two independent reviewers selected studies in two stages (title and abstract, and full-text), and screened reference lists of included studies. Only studies in English and based in the WHO European region were included. Results: Screening identified 2,118 records. In the final review, 20 articles were included, with 67,309 study participants between them. Out of 17 studies that looked at stroke risk factors, 11 found increasing knowledge to be associated with higher SEP, four found no difference by SEP, one showed a mixed pattern and one outlier study found increasing knowledge of risk factors to be associated with a lower SEP. Out of 19 studies that looked at stroke warning signs or symptoms, 15 found there to be better knowledge of warning signs with a higher SEP, three found there to be no difference, and the same outlier study found increasing knowledge of warning signs with a lower SEP. Studies that seemed to have a higher quality rating found increasing knowledge of stroke with a higher SEP. A meta-analysis was not possible due to heterogeneity of studies. Conclusions: In the WHO European region, better knowledge of stroke risk factors and warning signs is associated with a higher SEP. Public health campaigns and educational interventions aiming to increase stroke knowledge should be targeted at people with a lower SEP.

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Knowledge of Stroke Risk Factors and Warning Signs in Ireland: Development and Application of the Stroke Awareness Questionnaire (SAQ)

International Journal of Stroke ◽

10.1111/j.1747-4949.2011.00698.x ◽

2011 ◽

Vol 7 (4) ◽

pp. 298-306 ◽

Cited By ~ 40

Author(s):

Anne Hickey ◽

Deirdre Holly ◽

Hannah McGee ◽

Ronan Conroy ◽

Emer Shelley

Keyword(s):

Risk Factors ◽

Stroke Risk ◽

Warning Signs ◽

Stroke Risk Factors ◽

Stroke Awareness

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Knowledge and Perception of Stroke: A Population-Based Survey in Uganda

ISRN Stroke ◽

10.1155/2014/309106 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7 ◽

Cited By ~ 15

Author(s):

Jane Nakibuuka ◽

Martha Sajatovic ◽

Elly Katabira ◽

Edward Ddumba ◽

Jayne Byakika-Tusiime ◽

...

Keyword(s):

Risk Factors ◽

Population Survey ◽

Stroke Risk ◽

Large Population ◽

Population Based ◽

Traditional Healers ◽

Warning Signs ◽

Stroke Event ◽

Stroke Risk Factors ◽

Stroke Knowledge

Purpose. This study, designed to complement a large population survey on prevalence of stroke risk factors, assessed knowledge and perception of stroke and associated factors. Methods. A population survey was conducted in urban Nansana and rural Busukuma, Wakiso district, central Uganda. Adult participants selected by multistage stratified sampling were interviewed about selected aspects of stroke knowledge and perception in a pretested structured questionnaire. Results. There were 1616 participants (71.8% urban; 68.4% female; mean age: 39.6 years ± 15.3). Nearly 3/4 did not know any stroke risk factors and warning signs or recognize the brain as the organ affected. Going to hospital (85.2%) was their most preferred response to a stroke event. Visiting herbalists/traditional healers was preferred by less than 1%. At multivariable logistic regression, good knowledge of stroke warning signs and risk factors was associated with tertiary level of education (OR 4.29, 95% CI 2.13–8.62 and OR 5.96, 95% CI 2.94–12.06), resp.) and self-reported diabetes (OR 1.97, 95% CI 1.18–3.32 and OR 1.84, 95% CI 1.04–3.25), resp.). Conclusion. Knowledge about stroke in Uganda is poor although the planned response to a stroke event was adequate. Educational strategies to increase stroke knowledge are urgently needed as a prelude to developing preventive programmes.

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Knowledge of Stroke Risk Factors and Warning Signs in Patients with Recurrent Stroke or Recurrent Transient Ischaemic Attack in Thailand

Neurology Research International ◽

10.1155/2017/8215726 ◽

2017 ◽

Vol 2017 ◽

pp. 1-7 ◽

Cited By ~ 7

Author(s):

Jittima Saengsuwan ◽

Pathitta Suangpho ◽

Somsak Tiamkao

Keyword(s):

Risk Factors ◽

Transient Ischaemic Attack ◽

Stroke Risk ◽

Recurrent Stroke ◽

Warning Signs ◽

High Risk Population ◽

Cross Sectional ◽

Stroke Risk Factors ◽

Ischaemic Attack ◽

Structured Interventions

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.

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Changes in Knowledge of Stroke Risk Factors and Warning Signs among Michigan Adults

Cerebrovascular Diseases ◽

10.1159/000121338 ◽

2008 ◽

Vol 25 (5) ◽

pp. 385-391 ◽

Cited By ~ 55

Author(s):

Mathew J. Reeves ◽

Ann P. Rafferty ◽

Alison A.R. Aranha ◽

Velma Theisen

Keyword(s):

Risk Factors ◽

Stroke Risk ◽

Warning Signs ◽

Stroke Risk Factors

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A Pharmacist-Led Stroke Education and Screening Program for Community-Dwelling Older Adults

The Senior Care Pharmacist ◽

10.4140/tcp.n.2019.127 ◽

2019 ◽

Vol 34 (2) ◽

pp. 127-142

Author(s):

Marketa Marvanova ◽

Paul Jacob Henkel

Keyword(s):

Risk Factors ◽

Health Status ◽

Stroke Prevention ◽

Stroke Risk ◽

Community Dwelling ◽

Warning Signs ◽

Secondary Stroke Prevention ◽

Stroke Risk Factors ◽

Stroke Knowledge ◽

Study Questionnaire

OBJECTIVES: To deliver a pharmacist-led education and screening for community-dwelling residents, assess the effect of this initiative on knowledge of stroke risk factors and warning signs, and evaluate the stroke-knowledge and risk-assessment questionnaire as a tool to identify stroke-related health status and identify need(s) for specific clinical intervention(s) to decrease risk. DESIGN: The 70-minute-long event comprised: brief introduction/informed consent, baseline assessment of stroke knowledge, completion of study questionnaire, single blood pressure and heart rate readings, presentation, question-and-answer session, postsurvey questionnaire items. SETTING: Four faith-based institutions in the Midwest. PARTICIPANTS: Independent community-dwelling adults 18 years of age and older (N = 97), 89.7% 60 years of age and older. INTERVENTIONS: Thirty-minute presentation followed by question-and-answer session on ischemic stroke. Screening for primary and secondary stroke-prevention status using study questionnaire and vital signs. MAIN OUTCOME MEASURE(S): Stroke knowledge regarding modifiable stroke-risk factors and acute stroke-warning signs, individual primary/secondary stroke-prevention status. RESULTS: Postintervention, mean number of modifiable stroke risk factors (2.6 ± 0.8) and warning signs (2.6 ± 0.8) named improved from preintervention (P < 0.001) including for most subgroups (i.e., self-reported hypertension, atrial fibrillation [AF], or high number of personal risk factors). Needs for improved primary/secondary prevention were identified for blood-measure control and antilipidemic therapy. No disparity was observed regarding thrombotic therapy in participants with AF. CONCLUSION: The program was resource-efficient, involved student pharmacists, improved immediate stroke-related knowledge of participants including those with increased risk(s) of stroke, and demonstrated value for evaluating stroke-related health status and identifying need for primary and secondary stroke prevention.

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Abstract TP203: Reducing Stroke Burden in Uganda

Stroke ◽

10.1161/str.48.suppl_1.tp203 ◽

2017 ◽

Vol 48 (suppl_1) ◽

Author(s):

Mark Kaddumukasa ◽

Jane Nakibuuka ◽

James Kayima ◽

Elly Katabira ◽

Carol Blixen ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Stroke Risk ◽

Growth Patterns ◽

Warning Signs ◽

Clear Understanding ◽

Stroke Risk Factor ◽

Stroke Risk Factors ◽

Study Participants ◽

Stroke Knowledge

Background: Stroke is a neurological condition with rapidly increasing burden in many low- and middle-income countries. Africa is particularly hard-hit due to rapid population growth, patterns of industrialization, adoption of harmful western diets, and increased prevalence of risk factors such as hypertension and obesity. Reducing stroke risk factors and teaching people to respond to stroke warning signs can prevent stroke and reduce burden. However, being able to address gaps in knowledge and improving both preventative and early-response care requires a clear understanding of practical and potentially modifiable topics. Methods: A cross sectional survey was conducted in urban Mukono district in central Uganda. Through a systematic sampling method, data were gathered from 440 adult participants who were interviewed about selected aspects of stroke knowledge, attitudes and perception, using a pretested structured questionnaire. Results: Of the 440 study participants enrolled for this study nearly 52% correctly reported that stroke involves the brain, while 57% reported that stroke is preventable. Majority of the participants 75.7% reported stress as a contributing factor. Only 45.7% of the study participants reported hypertension as a risk factor. Only two (0.5%) study participants identified cigarette smoking as a stroke risk factor. Of the eighty six study participants with hypertension only 39.5% knew hypertension as a risk factor and only 10.7% knew three or more stroke risk factors. Conclusion: Stroke knowledge is poor in urban Uganda. Individuals with hypertension had poor knowledge regarding stroke in spite their high risk for stroke. Stress and hypertension are the leading perceived risk factors in our settings. While stress is highly reported as a stroke risk factor in this study hypertension is likely a more amenable and practical intervention target.

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Abstract 3391: FAST Stroke Educational Program for Middle School Students

Stroke ◽

10.1161/str.43.suppl_1.a3391 ◽

2012 ◽

Vol 43 (suppl_1) ◽

Author(s):

Elaine T Miller ◽

Keith King ◽

Rosemary Miller ◽

Roberta Lee

Keyword(s):

Risk Factors ◽

Middle School ◽

Self Efficacy ◽

Stroke Risk ◽

Warning Signs ◽

Control School ◽

School Students ◽

Stroke Risk Factors ◽

And Control

Significance and Purpose: Given the continuing escalation of obesity and other major modifable stroke risk factors in American children, now more than ever the testing of the efficacy of stroke educational programs remains a priority. The specific aim of this study was to determine if the 9 month FAST Stroke Prevention Educational Program for Middle School Students leads to a significantly greater increase in stroke knowledge (signs/symptoms, risk factors), self-efficacy, treatment seeking behaviors (calling 911), and stroke risk reduction behavior when compared to a control school. A secondary purpose was to obtain comparison data (intervention and control school) regarding blood pressure, waist circumference, and body mass index. Methodology: The study design is quasi-experimental with an intervention and control middle school that each receives the initial program pretest and long-term posttest. Both schools are in the same city and serve primarily African American students ages 10-14. Instruments to measure the key study variables have established reliability, Chronbach alpha of .85 or higher, and content validity. The FAST Program framed within Social Cognitive Theory, spanned 9 months consisting of 6 modules that included active learning experiences, involvement of multiple stakeholders (school, parents, and community), and senior nursing students in the program implementation. Findings: Seventy-seven students (54% male, 46% female) received the FAST Program and 101 students were in the control school (45% male, 55% female). Students who received the FAST Program knew significantly more of the warning signs of stroke than students not receiving the program. No significant difference between the control and intervention school occurred pertaining to knowledge of stroke risk factors at pretest or long-term posttest at 9 months. Compared to pretest scores, students receiving FAST scored significantly higher at posttest and long-term posttest on self-efficacy. Of those in the intervention group who had identified a modifiable stroke risk reduction objective (e.g., increase exercise, eat a more healthy diet, stop smoking), 42% reported achieving their objective; while another 19% reported making progress. Although BMIs and blood pressures improved in students receiving FAST, there were not any significant improvements between the two schools. Conclusions and Practice Implications: The FAST Program improved the convenient sample of African American students’ knowledge of stroke warning signs and self-efficacy. Plus, many students were able to achieve their predetermined modifiable stroke risk factors in the FAST Program. Further program improvements are recommended, but it is clear that active involvement of parents, school and community stakeholders are essential.

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