Centre for Family and Community Medicine, Karolinska Institutet, Alfred Nobels allé 12, SE-141 83 Huddinge, Sweden.
BMC Fam Pract. 2010 Jun 15;11:47. doi: 10.1186/1471-2296-11-47.
Survivers of stroke or transient ischaemic attacks (TIA) are at risk of new vascular events. Our objective was to study primary health care patients with stroke/TIA regarding their knowledge about risk factors for having a new event of stroke/TIA, possible associations between patient characteristics and patients' knowledge about risk factors, and patients' knowledge about their preventive treatment for stroke/TIA.
A questionnaire was distributed to 240 patients with stroke/TIA diagnoses, and 182 patients (76%) responded. We asked 13 questions about diseases/conditions and lifestyle factors known to be risk factors and four questions regarding other diseases/conditions ("distractors"). The patients were also asked whether they considered each disease/condition to be one of their own. Additional questions concerned the patients' social and functional status and their drug use. The t-test was used for continuous variables, chi-square test for categorical variables, and a regression model with variables influencing patient knowledge was created.
Hypertension, hyperlipidemia and smoking were identified as risk factors by nearly 90% of patients, and atrial fibrillation and diabetes by less than 50%. Few patients considered the distractors as stroke/TIA risk factors (3-6%). Patients with a family history of cardiovascular disease, and patients diagnosed with carotid stenosis, atrial fibrillation or diabetes, knew these were stroke/TIA risk factors to a greater extent than patients without these conditions. Atrial fibrillation or a family history of cardiovascular disease was associated with better knowledge about risk factors, and higher age, cerebral haemorrhage and living alone with poorer knowledge. Only 56% of those taking anticoagulant drugs considered this as intended for prevention, while 48% of those taking platelet aggregation inhibitors thought this was for prevention.
Knowledge about hypertension, hyperlipidemia and smoking as risk factors was good, and patients who suffered from atrial fibrillation or carotid stenosis seemed to be well informed about these conditions as risk factors. However, the knowledge level was low regarding diabetes as a risk factor and regarding the use of anticoagulants and platelet aggregation inhibitors for stroke/TIA prevention. Better teaching strategies for stroke/TIA patients should be developed, with special attention focused on diabetic patients.
中风或短暂性脑缺血发作（TIA）的幸存者有新血管事件的风险。我们的目的是研究有中风/TIA 的初级保健患者，了解他们对中风/TIA 新发病风险因素的认识，患者特征与患者对风险因素的认识之间可能存在的关联，以及患者对中风/TIA 预防治疗的认识。
我们向 240 名中风/TIA 患者发放了问卷，182 名患者（76%）做出了回应。我们询问了 13 个关于已知疾病/状况和生活方式因素的问题，这些因素被认为是风险因素，还有 4 个关于其他疾病/状况（“干扰项”）的问题。还询问了患者是否认为每个疾病/状况都属于自己的疾病/状况。附加问题涉及患者的社会和功能状况以及药物使用情况。连续变量采用 t 检验，分类变量采用卡方检验，创建了一个影响患者知识的回归模型。
近 90%的患者将高血压、高血脂和吸烟识别为风险因素，不到 50%的患者将房颤和糖尿病识别为风险因素。很少有患者认为干扰项是中风/TIA 的风险因素（3-6%）。有心血管疾病家族史的患者和诊断为颈动脉狭窄、房颤或糖尿病的患者，比没有这些疾病的患者更了解这些疾病是中风/TIA 的风险因素。房颤或心血管疾病家族史与更好的风险因素知识相关，而年龄较大、脑出血和独居则与较差的知识相关。只有 56%正在服用抗凝药物的患者认为这是为了预防，而 48%正在服用血小板聚集抑制剂的患者认为这是为了预防。
对高血压、高血脂和吸烟作为风险因素的认识良好，患有房颤或颈动脉狭窄的患者似乎对这些疾病作为风险因素有较好的认识。然而，糖尿病作为风险因素的认识水平较低，以及对用于中风/TIA 预防的抗凝药物和血小板聚集抑制剂的认识水平也较低。应制定针对中风/TIA 患者的更好的教学策略，特别关注糖尿病患者。
