Intended for healthcare professionals

Letters

General perception of stroke

BMJ 2002; 325 doi: https://doi.org/10.1136/bmj.325.7360.392/a (Published 17 August 2002) Cite this as: BMJ 2002;325:392

Knowledge of stroke is lacking

  1. Abhaya Gupta, specialist registrar on geriatric medicine (guptaabhaya{at}hotmail.com),
  2. Peter Thomas, consultant physician
  1. Llandough Hospital, Cardiff CF64 2XX
  2. Prince Philip Hospital, Llanelli SA14 8QF
  3. Leeds General Infirmary, Leeds LS1 3EX
  4. James Connolly Memorial Hospital, Blanchardstown, Dublin 15, Republic of Ireland
  5. Adelaide and Meath Hospital, Tallaght, Dublin 24

    EDITOR—Yoon and Byles found that the recognition of symptoms of stroke and risk factors for it was poor.1 Lack of knowledge results in delays in seeking medical care.2 As a result, patients with stroke may fail to gain the benefits of acute treatments—for example, acute thrombolysis—because of the narrow therapeutic window.3

    We conducted a large prospective questionnaire study among elderly patients attending a UK hospital clinic.4 Patients with established risk factors for stroke (atrial fibrillation, diabetes, hypertension, previous stroke, transient ischaemic attack) were interviewed. A total of 410 patients (mean age 78) gave their responses to a semi-structured questionnaire.

    Altogether 336 patients could identify the symptoms of stroke correctly; the remainder were not sure or gave incorrect answers. Forty one thought that stroke is caused by damage to the heart, and 353 correctly correlated stroke with brain damage. On free recall, 267 correctly identified at least one established risk factor for stroke; the rest did not know any. The commonest perceived risk factor was stress (reported by 213) and the second commonest was hypertension (n=197).

    When patients were asked to choose risk factors for stroke (on a questionnaire with closed questions containing both correct and incorrect responses) stress was again identified as the commonest factor (by 254 patients). Many subjects reported other incorrect risk factors—for example, liver disease, cold, no rest. Only 62 patients considered themselves to be at increased risk of stroke because of underlying disease. Few subjects (n=90) had been informed by a health professional that their underlying condition predisposed them to stroke.

    Our results show that understanding about symptoms of stroke, risk factors, perceived risk, and organ affected was incomplete among a population at risk. We agree with Yoon and Byles that educational strategies are needed to correct misconceptions and to enable patients to seek medical help and early treatments for stroke.5 Effective educational programmes could also increase public awareness of stroke.

    References

    Poor knowledge of stroke can be improved by simple measures

    1. D R Collins, specialist registrar in geriatric medicine (collinsronan{at}yahoo.co.uk),
    2. P M E McCormack, consultant physician in geriatric medicine,
    3. D O'Neill, professor of geriatric medicine
    1. Llandough Hospital, Cardiff CF64 2XX
    2. Prince Philip Hospital, Llanelli SA14 8QF
    3. Leeds General Infirmary, Leeds LS1 3EX
    4. James Connolly Memorial Hospital, Blanchardstown, Dublin 15, Republic of Ireland
    5. Adelaide and Meath Hospital, Tallaght, Dublin 24

      EDITOR—Yoon and Byles's paper highlights the need for greater public education regarding recognition of risk factors and symptoms of stroke.1 In an audit of patients' and carers' knowledge of stroke we surveyed 39 patients with recent cerebral infarction without cognitive or language difficulties and 16 carers.2 Only 14 of the patients and 10 of the carers recognised the onset of stroke, and when presented with some common scenarios a third did not recognise half the common presenting symptoms of stroke (hemiparesis, hemisensory loss, dysphasia, homonymous hemianopia, etc).

      When asked about risk factors for cerebral infarction the 55 people interviewed could only name 1.5 risk factors on average; 17 could not name any. After an information booklet on stroke was provided they could name 2.5 risk factors on average, and only nine could not identify any. Thirty six of the participants read the booklet.

      Our audit suggests that most patients and many carers do not recognise the onset of stroke and that knowledge of risk factors is poor. Knowledge improved, however, with the provision of a simple information booklet, which most people read.

      References

      View Abstract