Knowledge, Attitude and Practice Regarding Stroke amongst the Close Relatives of Stroke Victims at a Tertiary Care Hospital in Bangladesh

Abstract

Background and Purpose: Stroke is one of the most commonly encountered neurological emergencies in Tertiary Care Hospitals and is one of the leading causes of death in Bangladesh. Poor knowledge of risk factors, symptoms and appropriate response are possible causes of poor outcome. There are no studies from Bangladesh regarding knowledge about warning symptoms and risk factors amongst stroke patients or their families. We aimed to assess the knowledge, attitude and practice regarding stroke amongst close relatives of stroke patients. Methods: We performed a descriptive cross-sectional questionnaire survey amongst close relatives of acute stroke cases who were admitted under various Medicine units in Shaheed Suhrawardy Medical College & Hospital. Stroke knowledge was excellent if a participant knew (1) at least 2 stroke symptoms (good symptom knowledge) and (2) at least 2 stroke risk factors (good risk factor knowledge), as well as knowing (3) that immediate hospital admission is necessary in case of stroke (good action knowledge). Participants who had studied up to elementary school were considered having lower educational qualification and participants who were under graduates or having higher qualification were considered having higher educational qualification. Results: One hundred and eighty six (186) acute stroke cases were admitted during our study period of which 110 cases matched our criteria and were willing to give informed written consent. Of the 110 participants interviewed, 45 (40.9%) were males and 65 (59.1%) were females. Mean age was 35.2 years (S.D 11.5 years). Good risk factor knowledge was seen in 63.6% while 73.6% had good symptom knowledge and 98.2% had good action knowledge. Stroke knowledge was excellent in 52.7% of subjects. The most common identified stroke risk factor was Stress (n=75, 80.6%) and the most common identified symptom was Weakness/paralysis of one side of body (n=67, 76.1%). Higher educational qualification was associated with good risk factor knowledge (P= 0.009) and excellent stroke knowledge (P= 0.020). Eighty-one (73.6%) participants had never heard about the importance of receiving therapy within the first four and half hours (golden hours) after the onset of symptoms of stroke. Stroke knowledge and perception was not significantly related to other variables of age, sex, religion and income (P >0.05). Conclusions: In this study, in general, there is lack of awareness of major risk factors, warning symptoms, organ involvement, treatment options and the importance of the golden hours. However, higher educational status was associated with better risk factor knowledge and excellent stroke knowledge. Educational strategies to increase stroke knowledge are definitely needed as a prelude to developing preventive programs. By using primary health care resources, public media and organizing health camps, it is possible to promote the level of knowledge, practice and attitude regarding stroke in Bangladeshi population.