Factors associated with knowledge and awareness of stroke among the Lebanese population: A cross-sectional study

Assessment of knowledge and awareness of stroke among Arabic speaking adults: unveiling the current landscape in seven countries through the first international representative study

Introduction

While several studies have examined stroke public knowledge and awareness in individual countries within the Middle East and North Africa (MENA) region, none have provided a comprehensive cross-country assessment.

Purpose

To assess public stroke knowledge and awareness among Arabic-speaking adults in seven MENA countries and identify associated factors.

Materials and methods

An online cross-sectional survey was self-administered by the public population in Iraq, Lebanon, Sudan, Jordan, United Arab Emirates, Syria, and Saudi Arabia (April 2021-2023). Associations of stroke risk factors, early symptoms, and consequences with socio-demographics and medical history were analyzed using logistic regression models.

Results

Of 4,090 participants (58.3% females), 42.9% identified four out of five correct answers related to general stroke knowledge. Only 25.2% identified all stroke risk factors, 24.7% recognized all symptoms, and 37.5% knew all possible consequences. Results show consistent pattern of high identification for at least one risk factor and consequences across all countries (96.3 to 99.8% and 86.2 to 100%, respectively), with varying levels of early symptom identification (56.8 to 97.9%). Females were more likely to identify a stroke risk factor, symptom, and consequence compared to males (OR = 2.525, 2.474, and 2.302, respectively, p < 0.001). Employed, urban residents, and those with higher education demonstrated better stroke awareness.

Conclusion

The sample showed variable levels of stroke knowledge among the public, underscoring the pressing need for targeted community initiatives, media campaigns, and educational interventions. These efforts are paramount for improving awareness, early detection, and timely response, especially in countries with lower levels of community stroke awareness.

Knowledge, attitude, and practice of stroke and thrombectomy among medical students in Henan, China

To assess knowledge, attitude, and practice (KAP) of stroke and thrombectomy among medical students in Henan, China. A cross-sectional study was conducted on medical students from 5 universities in Henan, China between June and September, 2022, using a self-administered questionnaire. A total of 1105 medical students [697 (62.1%) females] participated. Their mean KAP scores were 11.1 ± 2.90, 35.37 ± 4.94, and 21.48 ± 5.51 out of 14, 44, and 24, respectively. Structural equation modeling revealed that, age (estimate = 0.351, P = .005) and education (estimate = 0.370, P = .024) positively affected knowledge, while major (estimate = -0.128, P = .017), internship experience in neurosurgery or neurology (estimate = -1.321, P < .001), and family history of stroke (estimate = -0.557, P < .001) negatively influenced knowledge. Knowledge (estimate = 0.649, P < .001) and having seniors over the age of 60 at home (estimate = 1.228, P = .001) had positive effects on attitudes, while internship experience in neurosurgery or neurology (estimate = -0.471, P = .090) and family history of stroke (estimate = -0.596, P = .020) had negative impact on attitudes. Moreover, knowledge (estimate = 0.230, P < .001) and attitudes (estimate = 0.628, P < .001) positively influenced practices, whereas sex (estimate = -1.141, P < .001), internship experience in neurosurgery or neurology (estimate = -0.578, P = .025), and family history of stroke (estimate = -0.523, P = .027) negatively influenced practices. Medical students in Henan, China showed adequate knowledge, positive attitude, and proactive practice toward stroke and thrombectomy. Age, sex, education, major, internship experience in neurosurgery or neurology, family history of stroke, having seniors over the age of 60 at home might have impact on their KAP.

A Retrospective Analysis of the Underlying Health Status of Patients Treated for Stroke in the Emergency Department of a Community Hospital Situated in a Health Professional Shortage Area

Background Hypertension, diabetes, and hyperlipidemia are known contributors to the incidence of stroke. These and other risk factors such as smoking can be managed with effective primary care, but living in a medically underserved area and racial background can limit access, thereby deleteriously affecting underlying medical conditions and disproportionately contributing to negative stroke outcomes. Our goal is to learn about the on-admission health of 1,731 stroke patients who presented to the Crouse Hospital emergency department (ED) between January 2019 and January 2021 to better understand the circumstances affecting these patients. Crouse Hospital is a community hospital in Syracuse, New York, and an award-winning comprehensive stroke center in the region. The hospital is located in a health professional shortage area (HPSA) and serves both rural and urban patients of various ethnic backgrounds and socioeconomic statuses. Methodology We retrospectively examined the stroke patient data to determine how access to primary care and race affected smoking status, arrival time following the onset of symptoms, stroke severity, thrombolytic administration, and metrics relating to hypertension, diabetes, hyperlipidemia, and depression. Results We determined that, while most patients stated that they had a primary care provider, stroke incidents were typically associated with high blood pressure and high blood glucose despite the prevalence of prescriptions to treat these conditions and that both conditions affected the underserved and non-White patients (Black, Hispanic, Asian, Indigenous, and Other) more so than the served and White populations. Underserved and non-White patients, were also more likely to be associated with smoking behavior. Conclusions The data indicated the major health factors affecting the patients and highlighted those influenced by limited access to primary care and racial background. As a result, we developed a survey to gauge patients' perspectives on primary care and underlying medical conditions before and after their stroke. This patient-centered approach will help refine our stroke education efforts to improve stroke outcomes in the community.

The one-year incidence of stroke in patients with atrial fibrillation in Jordan and its associated factors

Background

An elevated risk of stroke is linked to atrial fibrillation (AF). Effective care and prevention measures for individuals with AF require an understanding of the factors impacting the incidence of stroke in this population. Evidence regarding the incidence of stroke among patients with AF is insufficient in Jordan. This study aimed to determine the incidence of stroke and its associated factors among patients with AF in Jordan.

Methods

The Jordan Atrial Fibrillation Registry JoFib was used to identify a total of 2020 AF patients meeting the study inclusion and exclusion criteria. Demographics, clinical characteristics, and the CHA2DS2-VASc score-based evaluation of stroke risk were extracted from the registry.

Results

This study encompassed 2020 participants diagnosed with AF, with 925 (45.8%) being men and 1,095 (54.2%) women. The one-year stroke incidence among the 2020 AF patients was 3.4%. Notably, stroke incidence significantly increased with age (p = 0.04) and was associated with the history of stroke (7.4% vs. 2.7%), hypertension (3.9% vs. 1.9%), and diabetes (5.1% vs. 2.1%). In the multivariate analysis, diabetes (OR = 2.6, 95% CI: 1.5-4.4, p = 0.001) and history of stroke (OR = 2.6, 95% CI: 1.5-4.6, p = 0.001) were significantly associated with stroke incidence.

Conclusion

This study emphasizes Jordan's high stroke rate among AF patients. Diabetes and prior stroke history are associated with increased odds of stroke, like all stroke patients. These results highlight the necessity for specialized management strategies among AF patients and highlight the significance of thorough risk assessment and focused interventions to reduce stroke risk in AF patients.

Assessment of knowledge and awareness of stroke among the Syrian population: unveiling the current landscape in Syria through the first nationally representative study

Stroke is a global public health concern, contributing to high rates of morbidity and mortality. In Syria, the current conflict and associated challenges have had a profound impact on healthcare infrastructure, including education and awareness programs related to stroke. An essential aspect of preventing stroke is the awareness of individuals. The study aimed to investigate factors associated with knowledge and awareness of stroke among Syrian people. A cross-sectional national representative study was conducted in Syria. The questionnaire was created on Google form and disseminated as a link through online platform social media like Facebook, WhatsApp, and Twitter. The population of the study was divided using proportionate random sampling into the 14 governorates. A random sample was selected from each area. The STROBE reporting guideline for cross-sectional studies was followed. Logistic regression analysis was performed to identify the factors associated with poor knowledge of stroke. A total of 1013 Syrian adults participated in the study. With more than half of them were females (53.5%) and employed (55.6%). Significant associations were found between ability to identify at least one correct risk factor and employability status (p = 0.029), single group (p = 0.036) and smokers (p < 0.001). In addition, significant associations were found between identifying at least one correct stroke symptom and smokers (p < 0.001) and no-obese people (p = 0.048). Furthermore, younger age group (below 30 years) were significantly able to list at least one correct stroke consequence compared to the older age groups (p = 0.025). Moreover, a significantly higher number of smokers compared to non-smokers correctly identified at least one stroke consequence (p = 0.019). The study revealed that there is a relatively weak understanding of the preventable nature of stroke among Syrian population. The overall awareness is still inadequate and varies depending on lifestyle factors and employment status.

Stroke Knowledge and Response Among the General Population in Saudi Arabia: A Population-Based Survey

INTRODUCTION

Stroke, a condition that disrupts brain function and can result in long-lasting clinical symptoms or death, remains a substantial global health concern. General awareness of stroke leads to a proper response to stroke, pursuit of medical treatment, and a better outcome. Our study aims to explore how the general Saudi Arabian population responds to stroke, investigate the relationship between stroke knowledge and appropriate actions, and identify the most relied upon medical information source about stroke among the public. By highlighting these aspects, we aspire to contribute to the development of effective stroke prevention and management strategies in Saudi Arabia.

METHODOLOGY

This descriptive, cross-sectional, web-based study was carried out across multiple regions in Saudi Arabia. Data collection involved a validated online questionnaire (STAT) in Arabic, targeting adults aged 18 and older. Data analysis was performed using SPSS software.

RESULTS

The study included 390 participants. Notable findings emerged regarding the recognition of stroke symptoms and the factors influencing this recognition. A substantial proportion of respondents correctly identified visual disturbances (55.9%), motor impairment (39.5%), cardiac symptoms (56.2%), sensory symptoms (32.8%), chest pain (62.6%), and arm weakness (36.7%) as indicators requiring immediate medical attention. However, there were lower correct response rates for symptoms such as sudden dizziness (22.8%), confusion (16.9%), difficulty understanding (27.9%), and urinary symptoms (26.9%). Older individuals and retirees generally scored higher in correctly identifying these symptoms.

CONCLUSION

Our study highlights a commendable level of awareness of certain stroke symptoms, such as visual disturbances and chest pain, among the general population of Saudi Arabia. Nonetheless, notable gaps remain in recognizing other symptoms, such as sudden dizziness and confusion. This identification gap presents a clear opportunity for targeted educational initiatives that are essential to improving public recognition of these symptoms. By addressing these gaps, we aim to enhance the response to stroke incidents, potentially improving outcomes and reducing morbidity rates.

Evaluating the influence of a 3-min online video on the community knowledge of stroke in four Arab countries

Introduction

Studies from developed and developing countries showed that the knowledge levels of stroke need improvement. Educational campaigns varied and were of limited influence predominantly because of their short duration and the need for financial support. The study aims to test the impact of a 3-min online video on the knowledge of stroke and factors influencing the knowledge score in four Arab countries.

Methods

A cross-sectional web-based pre-post study was conducted in Egypt, Jordan, Lebanon, and the United Arab Emirates. The data were collected using the snowball technique. Participants were adults aged 18 years and above. The questionnaire sequence was conducting a pretest, followed by the educational video explaining stroke occurrence, types, risks, warning signs, preventive measures, and treatment, and finally, a posttest to evaluate the differences in knowledge from baseline. Statistical analysis included paired t-tests comparing pre-post-education stroke knowledge scores, while repeated measures ANOVA, adjusting for covariates, assessed mean changes.

Results

The total number of participants was 2,721, mainly younger than 55 years. The majority had a university degree and were not healthcare professionals. A significant improvement was noted in the total knowledge score in all countries from a mean average (Mpretest = 21.11; Mposttest = 23.70) with p < 0.001. Identification of the stroke risks (Mpretest = 7.40; Mposttest = 8.75) and warning signs (Mpretest = 4.19; Mposttest = 4.94), understanding the preventive measures (Mpretest = 5.27; Mposttest = 5.39) and the importance of acting fast (Mpretest = 0.82; Mposttest = 0.85) improved from baseline with (p < 0.001) for all score components.

Conclusion

The educational tool successfully enhanced public understanding of stroke risks, the identification of stroke signs, and the critical need for emergency action. The advantages of this video include its short length, free online access, use of evidence-based content in lay language, and reflective images. The ultimate goal remains the long-term improvement of sustainability by mandating full-scale trials.

Stroke awareness and knowledge in Sudan: a cross-sectional analysis of public perceptions and understanding

Introduction

Stroke, a leading cause of morbidity and mortality globally, demands heightened awareness and knowledge for effective preventive strategies and tailored response. Sudan is classified as a low income country with a low rate of literacy, lack of knowledge, and awareness about diseases. Thus, this study aimed to assess stroke awareness and knowledge among Sudanese population, and identify the associated factors influencing awareness.

Methods

A cross-sectional study conducted between October and November 2022 through a self-administered online survey distributed via various social media platforms. The study involved adults aged 18 years and above through snow-ball sampling technique. The survey covered general awareness and knowledge concerning stroke risk factors, consequences, and the appropriate responses taken during acute stroke attacks.

Results

A total of 410 participants were enrolled in the study, majority (93.4%) were from urban area and had university degree (92.4%). Furthermore, 92.2% were aware about stroke and 74.9% were able to recognize the symptoms of stroke. Only 40.2% identified all correct answers, 96.3, 92.3, and 95.1% recognized at least one risk factor, early symptom, and consequences, respectively. Females were significantly more than males able to identify at least one risk factor. Almost all participants (99.5%) perceived stroke as a serious disease (99.5%). Notably, 86.3% would promptly transport a suspected stroke patient to the hospital. The multivariable analysis showed that females versus males and patients with depression versus without depression had significantly higher odds to identify at least one risk factor (OR of 14.716 [95% CI 1.901; 113.908] and 0.241 [95% CI 0.059; 0.984], respectively).

Conclusion

The study concluded that stroke knowledge and awareness among Sudanese population is suboptimal. Furthermore, early stroke recognition and intake of the appropriate management strategies are lacking which highlights the need for targeted education and awareness campaigns.

Knowledge of symptoms, risk factors, and treatment centers of stroke among the general population of Al-Ahsa, Saudi Arabia

Background

In Saudi Arabia, stroke is a significant cause of illness and mortality progressively becoming more serious. Studies have indicated that modifiable cardiovascular risk factors are responsible for a significant portion of the burden caused by stroke, which could be targeted through public awareness.

Objective

We evaluated the level of knowledge about stroke among the general population of the Al-Ahsa, Saudi Arabia. Furthermore, association between stroke level of knowledge and sample characteristics was analyzed.

Methods

This was a cross-sectional study conducted from February 22, 2023, to March 22, 2023, using a convenience sampling technique. An electronic Google Forms survey was distributed through social media, to reach the maximum number of participants.

Results

This study included a total of 500 participants from Al-Ahsa, Saudi Arabia. Forty-three percentage of participants were male, while 57% were females. Most participants were of a younger age, where 66.6% were 18-39 years. The most recognized stroke symptom, risk factor, and stroke treatment center were dizziness/vertigo (91%), hypertension (97%), and King Fahad Hospital, respectively. Those with higher education possessed a greater level of stroke-related knowledge than other demographic groupings.

Conclusion

The general public of Al-Ahsa demonstrated a high level of knowledge about stroke symptoms (82.6%), risk factors (90%), and treatment facilities (80%). However, it was evident that the general public failed to recognize the proper course of action in the event of a stroke.

Knowledge and awareness of stroke and associated factors in the Saudi general population: a cross-sectional study

Introduction

Stroke is a major cause of death and disability globally and in Saudi Arabia as well. Prevention and management of stroke depend highly on raising knowledge and awareness about the disease.

Purpose

The purpose of this study was to evaluate Saudi adult's knowledge and awareness about stroke and determine the associated factors.

Materials and methods

A cross-sectional online survey was conducted in May-July 2022 among Saudi citizens. Assessments of stroke knowledge about risk factors, symptoms, and response to stroke symptoms were evaluated. Logistic regression was conducted to assess the association between the socio-demographic characteristics and knowledge.

Results

A total of 389 participants were enrolled with the majority (81.7%) being male participants. Less than half of the study subjects (43.3%) identified four out of five correct answers related to general knowledge about stroke. Almost all the participants were able to identify at least one risk factor associated with stroke. The majority of the participants (81.2%) believed that physical inactivity was the most common risk factor associated with stroke. Approximately three-quarters of participants considered difficulty speaking and understanding speech, followed by the sudden loss of consciousness as the most common stroke manifestation. Participants with a history of hypertension, dyslipidemia, and obesity had significantly higher odds of identifying at least one early stroke symptom (OR 2.271 [95% CI 1.402 3.677], 2.059 [95% CI 1.273 3.328], and 2.665 [95% CI 1.431 4.963], respectively).

Conclusion

Our study revealed that participants have good knowledge about stroke. Nonetheless, further efforts are required to raise awareness and educate the public to optimize and ensure better treatment outcomes.

Factors associated with knowledge and awareness of stroke in the Iraqi population: a cross-sectional study

Introduction

Stroke is a highly prevalent condition with high rates of death and disability in Iraq and around the world. Knowledge of stroke and its associated risk factors is essential for disease prevention and rapid response when confronted with a stroke patient.

Purpose

The purpose of this study is to assess stroke knowledge and identify factors associated with awareness among the Iraqi public.

Material and methods

A questionnaire-based, cross-sectional survey was conducted on the Iraqi population. The self-administered online questionnaire contained three sections. The study got ethical approval from the Research Ethics Committee at the University of Baghdad.

Results

The results showed that 26.8% of the participants reported knowledge regarding identifying all risk factors. In addition, 18.4% and 34.8% of the participants recognized all symptoms and mentioned all possible consequences of stroke, respectively. Previous medical history with chronic diseases had essential relationships with the response when faced with a person having an acute stroke. In addition, there was a significant relationship between gender, smoking history, and identification of early stroke symptoms.

Conclusion

There was a lack of knowledge about risk factors for stroke among the participants. There is a need for an awareness program among the Iraqi people to raise their understanding of stroke that can reduce stroke mortality and morbidity.