Mohamed Mustafa Risq Atiqah Munirah, Abd Aziz Noor Azah, Ali Mohd Fairuz
Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, MYS.
Cureus. 2025 Jun 21;17(6):e86484. doi: 10.7759/cureus.86484. eCollection 2025 Jun.
Background Early identification of stroke warning signs and risk factors may expedite intervention, thus improving the clinical outcome, which is especially important in individuals who already have risk factors. The main objective of this study is to assess awareness of stroke risk factors, warning signs, and health-seeking behavior related to stroke among adults with cardio-metabolic risk factors attending primary care. Methods This cross-sectional study was conducted in a primary care clinic in Malacca, Malaysia, focusing on adults with cardio-metabolic risk factors. A standardized questionnaire, piloted prior to the study, that focused on the domains of warning signs of stroke and risk factors was used, whereas the health-seeking behavior domain was adapted from the Malay version of the Attitudes and Beliefs about Cardiovascular Disease risk (ABCD-M) questionnaire. Descriptive analysis and binary logistic regression were done to analyze the factors using SPSS version 29 (IBM Corp., Armonk, NY). Results Out of 230 recruited patients, only 21.3% were able to identify all five stroke warning signs, with the most commonly known sign being sudden numbness or weakness on one side of the body (88.3%), comprising 203 patients, whereas only 23.9% were able to answer all 12 risk factors contributing to stroke. The mean number of warning signs known was 3.2 ± 1.4, and the mean number of risk factors known was 9.2 ± 2.8. There is a huge gap between the health-seeking behavior among this population, with the lowest mark of 8 and the highest mark of 72. The factors that contributed to health-seeking behavior related to stroke were age group (adjusted odds ratio (AOR): -0.293, 95% confidence interval (CI): 0.123-0.696), presence of heart disease (AOR: -0.237, 95% CI: 0.062-0.900), and total number of risk factors of stroke known (AOR: 1.131, 95% CI: 1.024-1.248). Conclusion Awareness of stroke warning signs and risk factors was still poor among the targeted population at risk of stroke. A huge gap in health-seeking behavior within this group warrants a better stroke prevention practice among this group of patients, which can be promoted by the primary healthcare provider.
背景 早期识别中风预警信号和风险因素可能会加快干预，从而改善临床结果，这对于已经存在风险因素的个体尤为重要。本研究的主要目的是评估在初级保健机构就诊的患有心脏代谢风险因素的成年人对中风风险因素、预警信号以及与中风相关的就医行为的认知情况。
方法 这项横断面研究在马来西亚马六甲的一家初级保健诊所进行，重点关注患有心脏代谢风险因素的成年人。使用了一份在研究前进行过预试验的标准化问卷，该问卷聚焦于中风预警信号和风险因素领域，而就医行为领域则改编自马来语版的心血管疾病风险态度和信念问卷（ABCD-M）。使用SPSS 29版（IBM公司，纽约州阿蒙克）进行描述性分析和二元逻辑回归以分析相关因素。
结果 在招募的230名患者中，只有21.3%的人能够识别所有五个中风预警信号，最常见的信号是身体一侧突然麻木或无力（88.3%，共203名患者），而只有23.9%的人能够回答所有12个导致中风的风险因素。已知预警信号的平均数量为3.2±1.4，已知风险因素的平均数量为9.2±2.8。该人群的就医行为存在巨大差距，最低分为8分，最高分为72分。与中风相关的就医行为的影响因素包括年龄组（调整后的优势比（AOR）：-0.293，95%置信区间（CI）：0.123 - 0.696）、心脏病的存在（AOR：-0.237，95% CI：0.062 - 0.900）以及已知的中风风险因素总数（AOR：1.131，95% CI：1.024 - 1.248）。
结论 在有中风风险的目标人群中，对中风预警信号和风险因素的认知仍然较差。该群体在就医行为方面的巨大差距需要在这组患者中开展更好的中风预防实践，这可以由初级医疗保健提供者加以推广。
