Abstract
Introduction: Despite the advances in the management of stroke, including the option of thrombolysis, few patients consult promptly for several reasons. Among these we can cite the lack of knowledge of onset symptoms and of the therapeutic options available.
Objectives: To assess degree of knowledge about stroke among contacts of persons at risk of a cerebrovascular event.
Materials and methods: A descriptive study was carried out in the city of Manizales, among caregivers of people over 60 years of age with hypertension and /or diabetes; in which they were interviewed in their homes. A form with questions about the spontaneous knowledge of symptoms and risk factors (RF), behavior to adopt towards stroke and TIA, and whether they knew of the existence of a thrombolytic drug.
Results. 218 cohabiting caregivers were interviewed between 17 and 89 years of age (X 50,9 ± 15 years). 68,8% of the sample was female, 46,3% were offspring, 23,4% spouses and 13,7% cohabiting outside the family. 70,7% did not know any alarm symptom and 45,4% no RF. Hypertension was the most cited RF, followed by dyslipidemia and smoking, while the DM was the least remembered. 82,1% mentioned having obtained information about stroke nonmedical sources. Only 1,4% (n = 3) of respondents knew of a thrombolytic drug.
Conclusion. This investigation identified significant flaws in the degree of knowledge that people have about cerebrovascular disease, and not from the condition of patients but cohabiting subjects at risk of a cerebrovascular event, being called to quickly recognize the symptoms and act diligently. It reiterates the urgent need to educate patients, their caregivers and the general public, using various information resources both health professionals and media messages to permit an effective primary and secondary prevention of stroke.
References
BONITA R. Epidemiology of stroke. Lancet. 1992; 339: 342-44.
WARLOW CP. Epidemiology of stroke. Lancet 1998;352: S1-S4
FEIGIN V. Stroke epidemiology in the developing world. Lancet 2005; 365: 2160-1
JOHNSTON SC, MENDIS S, MATHERS CD. Global variation in stroke burden and mortality: estimates from monitoring, surveillance, and modelling. Lancet Neurol. 2009; 8: 345-354
FEIGIN VL, LAWES CM, BENNETT DA, BARKER-COLLO SL, PARAG V. Worldwide stroke incidence and early case fatality reported in 56 population-based studies: a systematic review. Lancet Neurol. 2009;8:355-369
KOTHARI R, SAUERBECK L. Patients' Awareness of Stroke Signs, Symptoms, and Risk Factors. Stroke. 1997;28:1871-1875
REEVES MJ, HOGAN JG, RAFFERTY AP. Knowledge of stroke risk factors and warning signs among Michigan adults. Neurology. 2002;59:1547- 1552.
YOON SS, HELLER RF, LEVI C, WIGGERS J, FITZGERALD PE. Knowledge of Stroke Risk Factors, Warning Symptoms, and Treatment Among an Australian Urban Population Stroke 2001;32;1926- 1930.
SEGURA T, VEGA G, LÓPEZ S, RUBIO F, CASTILLO J. Public perception of stroke in Spain. Cerebrovascular Dis 2003; 16: 21-26.
PÉREZ-LÁZARO C, IÑÍGUEZ-MARTÍNEZ C, SANTOS-LASAOSA S, ALBERTI-GONZÁLEZ O, MARTÍNEZ-MARTÍNEZ L, TEJERO-JUSTE C, MOSTACERO-MIGUEL E. Estudio sobre el conocimiento de la población acerca del ictus y de los factores de riesgo vascular. Rev Neurol 2009; 49: 113- 118.
ORÓ M, SANAHUJA-MONTESINOS J, HERNÁNDEZ L, SETÓ E, PURROY F. Grado de conocimiento del ictus entre población de área rural en la provincia de Lleida. Rev neurol 2009; 48: 515-519.
JONES SP, JENKINSON AJ, LEATHLEY MJ, WATKINS CL. Stroke knowledge and awareness: an integrative review of the evidence. Age Ageing. 2010; 39:11-22.
DÍAZ R., RUANO M I. Conocimiento de síntomas y factores de riesgo de enfermedad cerebro vascular en una población urbana colombiana. Acta Neurol Colomb 2011;27:195-204
HACKE W, KASTE M, BLUHMKI E, ECASS INVESTIGATORS, ET AL. Thrombolysis with alteplase 3 to 4.5 hours after acute ischemic stroke. N Engl J Med 359. (13): 1317-1329.2008
WILLIAMS LS, BRUNO A, ROUCH D, MARRIOTT DJ. Stroke patients' knowledge of stroke. Influence on time to presentation. Stroke 1997; 28: 912-915.
KIM YS, PARK SS, BAE HJ, CHO AH, CHO YJ, MOON-KU H, ET AL. Stroke awareness decreases prehospital delay after acute ischemic stroke in korea. BMC Neurology 2011, 11:2-8.
LAVADOS PM, HENNIS AJ, FERNANDES JG, MEDINA MT, LEGETIC B, HOPPE A, SACKS C, JADUE L, SALINAS R. Stroke epidemiology, prevention, and management strategies at a regional level: Latin America and the Caribbean. Lancet Neurol. 2007;6:362-372.
STROEBELE N, MÜ LLER-RIEMENSCHNEIDER F, NOLTE CH, MÜ LLER-NORDHORN J, BOCKELBRINK A, WILLICH SN. Knowledge of risk factors, and warning signs of stroke: a systematic review from a gender perspective. Intern J Stroke. 2011;6:60-66
MAASLAND L, BROUWER-GOOSSENSEN D, DEN HERTOG HM, KOUDSTAAL PJ, DIPPEL D. Health education in patients with a recent stroke or transient ischaemic attack: a comprehensive review. Intern J Stroke 2011; 6: 67-74
HUX K, ROGERS T, MONGAR K. Common perceptions about strokes. J Community Health. 2000;25:47- 65
PANCIOLI AM, BRODERICK J, KOTHARI R, BROTT J, TUCHFARBER A, MILLER R, KHOURY J, JAUCH E. Public perception of stroke warning signs and knowledge of potential risk factors. JAMA. 1998;279:1288 -1292.
MÜLLER-NORDHORN J, NOLTE CH, ROSSNAGEL K, ET AL. Knowledge about risk factors for stroke. A population-based survey with 28 090 participants. Stroke 2006; 37:946-50.
MILLER JE. Knowledge of stroke risk factors, symptoms, and treatment among New Jersey adults. N JMed 2001; 98:47-53
WELTERMANN BM, DRIOUACH-BLECKMANN Y, REINDERS S, BERNDT P, GESENHUES S. Stroke knowledge among diabetics: a cross-sectional study on the influence of age, gender, education, and migration status. BMC Neurol. 2013; 13: 202.
ASDRUBAL FALAVIGNA, ALISSON ROBERTO TELES, VIVIANE MARIA VEDANA, FABRÍCIO DINIZ KLEBER, GABRIELA MOSENA, MAÍRA CRISTINA VELHO, THAÍS MAZZOCCHIN, ROBERTA CASTILHOS DA SILVA, ET AL. Awareness of stroke risk factors and warning signs in southern Brazil Arq. Neuro-Psiquiatr. 2009;67(4)
JEYARAJ DP, ASHISH J, SUKHBINDER SD, GUNEET K, SHIVALI S, DOUGLAS JL, GEORGE A. Public Awareness of Warning Symptoms, Risk Factors, and Treatment of Stroke in Northwest India. Stroke. 2005;36:644-648.
WELTERMANN BM, ROGALEWSKI A, HOMANN J, ET AL. Knowledge about stroke among the German population. Dtsch Med Wochenschr. 2000;125:416-20.
PONTES-NETO OM, SILVA GS, FEITOSA MR, DE FIGUEIREDO NL, FIOROT JA JR, ROCHA TN, ET AL. Stroke awareness in Brazil: alarming results in a community-based study. Stroke 2008;39:292-296.
KLEINDORFER D, KHOURY J, BRODERICK JP, RADEMACHER E, WOO D, FLAHERTY ML, ET AL. Public knowledge of stroke treatment, warning signs and risk factors during the last decade. Stroke. 2007;38:531-532.
ANDERSON BE, RAFFERTY AP, LYON-CALLO S, FUSSMAN C, REEVES MJ. Knowledge of tissue plasminogen activator for acute stroke among Michigan adults. Stroke 2009; 40:2564-2567.
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.