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Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 2004 Apr;75(4):567–571. doi: 10.1136/jnnp.2003.018382

Stroke in Devon: knowledge was good, but action was poor

C Carroll 1, J Hobart 1, C Fox 1, L Teare 1, J Gibson 1
PMCID: PMC1739039  PMID: 15026498

Abstract

Background and aim: Effective implementation of early treatment strategies for stroke requires prompt admission to hospital. There are several reasons for delayed admission. Good awareness should facilitate early admission. We identified local targets for education.

Methods: Four groups, each of 40 people, completed questionnaires to determine their knowledge of stroke symptoms and risk factors, and the action they took or would take in the event of a stroke. The groups were: patients with a diagnosis of stroke or TIA (within 48 hrs of admission); patients at risk of stroke; the general population; and nurses.

Results: Forty per cent of stroke patients identified their stroke. Median time from onset of symptoms to seeking medical help was 30 minutes. Medical help was sought by the patient themselves in only 15% of cases. In 80% of cases the GP was called rather than an ambulance. Of the at risk group, 93% were able to list at least one symptom of acute stroke, as were 88% of the general population. An ambulance would be called by 73% of the at risk group in the event of a stroke. Patients with self reported risk factors for stroke were largely unaware of their increased risk. Only 7.5% of at risk patients acquired their stroke information from the medical profession.

Conclusions: Public knowledge about stroke is good. However, stroke patients access acute services poorly. At risk patients have limited awareness of their increased risk. A campaign should target people at risk, reinforcing the diagnosis of stroke and access to medical services.

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Selected References

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  1. Becker K., Fruin M., Gooding T., Tirschwell D., Love P., Mankowski T. Community-based education improves stroke knowledge. Cerebrovasc Dis. 2001;11(1):34–43. doi: 10.1159/000047609. [DOI] [PubMed] [Google Scholar]
  2. Cheung R. T., Li L. S., Mak W., Tsang K. L., Lauder I. J., Chan K. H., Fong G. C. Knowledge of stroke in Hong Kong Chinese. Cerebrovasc Dis. 1999 Mar-Apr;9(2):119–123. doi: 10.1159/000015909. [DOI] [PubMed] [Google Scholar]
  3. Collins D. R., McCormack P. M. E., O'Neill D. General perception of stroke. Poor knowledge of stroke can be improved by simple measures. BMJ. 2002 Aug 17;325(7360):392–392. [PubMed] [Google Scholar]
  4. Daley S., Braimah J., Sailor S., Kongable G. L., Barch C., Rapp K., Bratina P., Spilker J., Donnarumma R. Education to improve stroke awareness and emergent response. The NINDS rt-PA Stroke Study Group. J Neurosci Nurs. 1997 Dec;29(6):393–396. doi: 10.1097/01376517-199712000-00009. [DOI] [PubMed] [Google Scholar]
  5. De Keyser J., Sulter G., Langedijk M., Elting J. W., van der Naalt J. Management of acute ischaemic stroke. Acta Clin Belg. 1999 Oct;54(5):302–305. doi: 10.1080/17843286.1999.11754250. [DOI] [PubMed] [Google Scholar]
  6. Fontanarosa P. B., Winker M. A. Timely and appropriate treatment of acute stroke: what's missing from this picture? JAMA. 1998 Apr 22;279(16):1307–1309. doi: 10.1001/jama.279.16.1307. [DOI] [PubMed] [Google Scholar]
  7. Gupta Abhaya, Thomas Peter. General perception of stroke. Knowledge of stroke is lacking. BMJ. 2002 Aug 17;325(7360):392–392. doi: 10.1136/bmj.325.7360.392/a. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Harraf Farzaneh, Sharma Anil K., Brown Martin M., Lees Kennedy R., Vass Richard I., Kalra Lalit. A multicentre observational study of presentation and early assessment of acute stroke. BMJ. 2002 Jul 6;325(7354):17–17. doi: 10.1136/bmj.325.7354.17. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Heros R. C., Camarata P. J., Latchaw R. E. Brain attack. Introduction. Neurosurg Clin N Am. 1997 Apr;8(2):135–144. [PubMed] [Google Scholar]
  10. Hux K., Rogers T., Mongar K. Common perceptions about strokes. J Community Health. 2000 Feb;25(1):47–65. doi: 10.1023/a:1005140918066. [DOI] [PubMed] [Google Scholar]
  11. Jørgensen H. S., Nakayama H., Reith J., Raaschou H. O., Olsen T. S. Factors delaying hospital admission in acute stroke: the Copenhagen Stroke Study. Neurology. 1996 Aug;47(2):383–387. doi: 10.1212/wnl.47.2.383. [DOI] [PubMed] [Google Scholar]
  12. Kothari R., Sauerbeck L., Jauch E., Broderick J., Brott T., Khoury J., Liu T. Patients' awareness of stroke signs, symptoms, and risk factors. Stroke. 1997 Oct;28(10):1871–1875. doi: 10.1161/01.str.28.10.1871. [DOI] [PubMed] [Google Scholar]
  13. Pancioli A. M., Broderick J., Kothari R., Brott T., Tuchfarber A., Miller R., Khoury J., Jauch E. Public perception of stroke warning signs and knowledge of potential risk factors. JAMA. 1998 Apr 22;279(16):1288–1292. doi: 10.1001/jama.279.16.1288. [DOI] [PubMed] [Google Scholar]
  14. Parahoo Kader, Thompson Kate, Cooper Marian, Stringer Maurice, Ennis Edel, McCollam Paddy. Stroke: awareness of the signs, symptoms and risk factors--a population-based survey. Cerebrovasc Dis. 2003;16(2):134–140. doi: 10.1159/000070593. [DOI] [PubMed] [Google Scholar]
  15. Pattenden Jill, Watt Ian, Lewin Robert J. P., Stanford Neil. Decision making processes in people with symptoms of acute myocardial infarction: qualitative study. BMJ. 2002 Apr 27;324(7344):1006–1009. doi: 10.1136/bmj.324.7344.1006. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Pistollato G., Ermani M. Time of hospital presentation after stroke. A multicenter study in north-east Italy. Italian SINV (Società Interdisciplinare Neurovascolare) Study group. Ital J Neurol Sci. 1996 Dec;17(6):401–407. doi: 10.1007/BF01997714. [DOI] [PubMed] [Google Scholar]
  17. Rosamond W. D., Gorton R. A., Hinn A. R., Hohenhaus S. M., Morris D. L. Rapid response to stroke symptoms: the Delay in Accessing Stroke Healthcare (DASH) study. Acad Emerg Med. 1998 Jan;5(1):45–51. doi: 10.1111/j.1553-2712.1998.tb02574.x. [DOI] [PubMed] [Google Scholar]
  18. Samsa G. P., Cohen S. J., Goldstein L. B., Bonito A. J., Duncan P. W., Enarson C., DeFriese G. H., Horner R. D., Matchar D. B. Knowledge of risk among patients at increased risk for stroke. Stroke. 1997 May;28(5):916–921. doi: 10.1161/01.str.28.5.916. [DOI] [PubMed] [Google Scholar]
  19. Stern E. B., Berman M., Thomas J. J., Klassen A. C. Community education for stroke awareness: An efficacy study. Stroke. 1999 Apr;30(4):720–723. doi: 10.1161/01.str.30.4.720. [DOI] [PubMed] [Google Scholar]
  20. Sug Yoon S., Heller R. F., Levi C., Wiggers J., Fitzgerald P. E. Knowledge of stroke risk factors, warning symptoms, and treatment among an Australian urban population. Stroke. 2001 Aug;32(8):1926–1930. doi: 10.1161/01.str.32.8.1926. [DOI] [PubMed] [Google Scholar]
  21. Williams L. S., Bruno A., Rouch D., Marriott D. J. Stroke patients' knowledge of stroke. Influence on time to presentation. Stroke. 1997 May;28(5):912–915. doi: 10.1161/01.str.28.5.912. [DOI] [PubMed] [Google Scholar]
  22. Yoon Sung Sug, Byles Julie. Perceptions of stroke in the general public and patients with stroke: a qualitative study. BMJ. 2002 May 4;324(7345):1065–1068. doi: 10.1136/bmj.324.7345.1065. [DOI] [PMC free article] [PubMed] [Google Scholar]

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