Factors Associated with Knowledge and Awareness of Stroke Among the Jordanian Population: A Cross-Sectional Study

Public Awareness and Attitude Towards Stroke in the Southern Region of Saudi Arabia: A Cross-Sectional Study

Introduction Stroke is a leading cause of morbidity and mortality globally. Recognizing risk factors, identifying warning signs, and seeking timely medical intervention are crucial for preventing stroke and improving outcomes. This study aims to assess stroke awareness and attitudes among residents in southern Saudi Arabia and determine predictors of stroke knowledge. Methods A cross-sectional study was conducted among residents aged ≥18 years in the southern region of Saudi Arabia excluding individuals with a history of stroke and healthcare workers. A sample size of 576 participants was calculated. Data were collected conveniently via a self-administered online Arabic questionnaire that was adopted from the literature. The questionnaire assessed demographic characteristics, stroke knowledge, attitudes, and symptom responses. Data analysis was performed using multiple linear regression to identify predictors of awareness of stroke. Results A total of 510 participants (median age: 29 years, interquartile range: 24, 40) were included, with 288 (56%) being male. Stroke was identified as a brain disease by 287 (56%), and 371 (73%) recognized its preventability. Awareness of stroke symptoms ranged from 332 (65%) for sudden dizziness to 399 (78%) for speech difficulties. The most recognized risk factors were hypertension (443, 87%), smoking (395, 77%), and diabetes mellitus (342, 67%). Better general awareness was associated with being married (β: 0.34, 95% CI: 0.07-0.61), divorced (β: 0.34, 95% CI: 0.07-0.61), or having a family history of stroke (β: 0.46, 95% CI: 0.22-0.70). Higher symptom awareness was linked to a family history of stroke (β: 0.92, 95% CI: 0.38-1.50) and earning 3000-10,000 RAS (β: 0.82, 95% CI: 0.11-1.50). For risk factor awareness, family history of stroke (β: 0.96, 95% CI: 0.32-1.60) and earning 3000-10,000 RAS (β: 0.96, 95% CI: 0.12-1.80) were significant predictors. Awareness of stroke's consequence was higher among older participants (β: 0.02, 95% CI: 0.00-0.04) and those with a family history of stroke (β: 0.45, 95% CI: 0.09-0.81), while males (β: -0.32, 95% CI: -0.61 to -0.03) had lower scores. Conclusion The study highlights significant gaps in stroke awareness, particularly in recognizing symptoms with moderate overall knowledge of stroke risk factors. Targeted educational campaigns and community outreach programs for at-risk populations are essential to improving stroke awareness and ensuring timely medical intervention.

Global Awareness and Response to Early Symptoms of Acute Stroke: A Systematic Literature Review

Stroke is a condition that leaves persistent disability and causes high mortality worldwide. Knowledge of recognizing early symptoms along with awareness of immediate response to acute stroke among the general population has proven insufficient. Pre-attendance delays adversely affect the time window from symptoms onset to needle time, therefore the effect of recanalization treatments. Although 35% of patients are potentially eligible for these treatments such as intravenous thrombolysis only about about 8-10% of them manage to receive. The study aimed to investigate the association between knowledge of early symptoms in the general population and proper response to acute stroke through prompt activation of emergency medical services (EMS) independently of sociodemographic factors. A systematic review was conducted to identify relevant studies that assessed the general population's knowledge of early symptom recognition and awareness of immediate response to acute stroke. Two investigators reviewed articles published in the PubMed database, from December 1, 2023, to February 29, 2024. The search yielded a total of 340 articles. After the 340 articles were screened, 293 reports were excluded due to title and abstract, irrelevant studies, or when the full text was not available. Finally, a total of 10 articles were included in this systematic review. Out of ten studies included in this review, seven studies were conducted in Asia, in one study the origin continent is Oceania, while the remaining two studies come from America. All studies were designed and conducted as cross-sectional studies. The most commonly recognizable early symptoms of a stroke were found to be difficulty in speaking or understanding speech, weakness on one side of the body including the face, plus sudden dizziness. Regarding responding to early stroke symptoms, the EMS call option gathered the most preferences of the respondents by 80%. Enlightenment campaigns are needed to highlight acute stroke symptoms unknown to the general public such as facial asymmetry.

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.

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.

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.

Assessing the Awareness on Symptoms and Risk Factors of Stroke amongst Rural Community in Central Region of Malaysia: A Cross-Sectional Survey

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.

Knowledge and awareness of stroke in the United Arab Emirates: a cross-sectional study of the general population

BACKGROUND

The study aimed to assess stroke knowledge among the general population in the United Arab Emirates (UAE) and determine the factors associated with stroke awareness among people.

METHODS

A cross-sectional study was conducted in the UAE between September and November 2021. The general population has self-administered an online bilingual survey (Arabic and English) distributed via social media platforms. The questionnaire covered general knowledge about stroke risk factors, consequences of stroke, and responding to somebody with acute stroke attack.

RESULTS

A total of 545 surveys were completed, with more than half of the participants being female (58.5%), married (55.4%) and employed (59.4%). The majority were less than 50 years old (90.5%) and had a university degree (71.0%). Many of the participants (70.8%) had a good general knowledge of stroke; however, around 20% of the participants were able to recognize all symptoms and risk factors of stroke. The most common sources of stroke-related information were the internet/social media (53.6%). Females were better able to correctly identify at least one stroke symptom and outcome than males (p=0.008). University education has significantly affected participants' ability to identify early stroke symptoms (p=0.001) correctly. In addition, diabetic people were more likely to recognize at least one stroke outcome than non-diabetic people (p=0.039).

CONCLUSIONS

The knowledge of stroke was good among highly educated people and females. However, the awareness of all stroke risk factors, symptoms, consequences and risk factors was inadequate among the general population of the UAE. Thus, there is still a gap between recognition of the relevant stroke and taking action among people.

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.