Chang Thashi, Ibrahim Shiyana, Ranasinghe Hasanthika M, Mihirini A H T M, Weerasinghe Dinushi, Vithanage T D P, Banagala Chinthaka, Arambepola Carukshi
Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.
Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.
J Stroke Cerebrovasc Dis. 2020 May;29(5):104760. doi: 10.1016/j.jstrokecerebrovasdis.2020.104760. Epub 2020 Mar 13.
An adequate stroke literacy among the general public and first-contact physicians is an essential prerequisite to ensure timely treatment and prevention of stroke. Knowledge on stroke pathophysiology, warning symptoms, risk factors and treatment, and its determinants was assessed among general public and general practitioners (GPs) in a South Asian population.
A cross-sectional study was conducted among relatives of nonstroke patients admitted to the apex tertiary-care hospital in Sri Lanka. Trained doctors administered pretested, structured, open- and close-ended questionnaires. A postal survey using self-administered questionnaires was conducted among all registered GPs in Sri Lanka.
The sample of general public (51.7% males; mean age = 40.7 years) from 21 of 25 districts of Sri Lanka was 840 (response-rate = 97.4%) while the sample of GPs (77.6% males; mean age = 59.63 years) was 98 (response-rate = 30%). Of the general public, 83.2% were aware of a vascular aetiology of stroke, but only 46.8% were aware that the affected organ was the brain while 67.5% believed that either the heart or limb muscles die as sequalae of stroke. Over 50% correctly identified stroke warning symptoms while 84.7% would seek immediate Western medical treatment. Approximately, 32%-46% were not aware of the major stroke risk factors. Lower education (adj. OR = 1.7; 95% CI = 1.3-2.3), absence of stroke risk factors (2.6; 1.9-3.7) and nonutility of information sources (1.5; 1.0-2.0) determined poor knowledge on risk factors. Only about 1 in 8 GPs accurately defined stroke and TIA while only 43.9% correctly classified stroke subtypes. Only 1 in 10 GPs were aware of the recommended therapeutic window for thrombolysis. Older age (P = 0.01) and longer service (P = 0.04) of GPs were associated with not requesting brain imaging in stroke.
Strategies to educate both the public and first-contact physicians to improve stroke literacy need to be an integral part of programmes that aim to reduce the burden of stroke in any population.
普通公众和首诊医生具备足够的中风知识是确保中风及时治疗和预防的重要前提。在南亚人群中，对普通公众和全科医生（GP）关于中风病理生理学、警示症状、危险因素、治疗及其决定因素的知识进行了评估。
在斯里兰卡顶级三级护理医院收治的非中风患者的亲属中进行了一项横断面研究。经过培训的医生发放经过预测试的、结构化的、开放式和封闭式问卷。对斯里兰卡所有注册全科医生进行了使用自填问卷的邮寄调查。
来自斯里兰卡25个区中21个区的普通公众样本（男性占51.7%；平均年龄=40.7岁）为840人（回复率=97.4%），而全科医生样本（男性占77.6%；平均年龄=59.63岁）为98人（回复率=30%）。在普通公众中，83.2%知道中风的血管病因，但只有46.8%知道受影响的器官是大脑，而67.5%认为中风后遗症是心脏或肢体肌肉坏死。超过50%的人正确识别了中风警示症状，84.7%的人会寻求西医立即治疗。约32%-46%的人不知道主要的中风危险因素。较低的教育程度（调整后比值比=1.7；95%置信区间=1.3-2.3）、不存在中风危险因素（2.6；1.9-3.7）以及信息来源无用（1.5；1.0-2.0）决定了对危险因素的了解不足。每8名全科医生中只有约1人能准确界定中风和短暂性脑缺血发作（TIA），只有43.9%的人能正确分类中风亚型。每10名全科医生中只有1人知道推荐的溶栓治疗时间窗。全科医生年龄较大（P=0.01）和服务年限较长（P=0.04）与中风时不要求进行脑部成像有关。
教育公众和首诊医生以提高中风知识的策略应成为旨在减轻任何人群中风负担的项目的一个组成部分。
