Stroke Education Research Articles

Community service: stroke risk detection and primary prevention of stroke education

Stroke is a neurovascular disease that is the second cause of death and the third cause of disease in the world. The prevalence of stroke in Indonesia has increased. The increasing prevalence of stroke can be caused by low stroke prevention. Factors that influence stroke prevention behavior are knowledge and awareness. Efforts to reduce the incidence of stroke are primary preventions. The first activity was detection of stroke risk using the Stroke Risk Scorecard, examination of blood pressure, body weight, measurement of blood glucose and cholesterol levels. The second was providing education. This activity was carried out at Kendangan, Caturharjo, Sleman, Yogyakarta. The stroke risk detection was attended by 67 people. The results of risk factor detection found that people at high risk of stroke were 4 people (6%), and 63 people at low risk of stroke (94%). People with hypertension 31 (46%), hypercholesterolemia 26 (38%), smoking 7 (10%), never exercising 50 (74%), and overweight 7 (10%). Education of stroke was attended by 36 people. The knowledge has increased after being given education (score 15) with an average pre-test score of 59,41 (min-max 20-100) and a post-test of 74.41 (min-max 30-100). Stroke risk detection and primary prevention education is an effort to prevent stroke in an early and continuous manner

Community service: Stroke risk detection and primary prevention of stroke education

Abstract. Stroke is a neurovascular disease and is the second cause of death and the third cause of disease in the world. The prevalence of stroke in Indonesia has increased. The increasing prevalence of stroke can be caused by low stroke prevention. Factors that influence stroke prevention behavior are knowledge and awareness. Efforts to reduce the incidence of stroke are primary prevention. This community service program made 2 basic efforts in stroke prevention. The first activity was detection of stroke risk using the stroke risk scorecard, examination of blood pressure and body weight, and measurement of blood glucose and cholesterol levels. The second one was providing education. This program was carried out at Kendangan, Caturharjo, Sleman, Yogyakarta. Stroke risk detection was attended by 67 people. The results of risk factor detection found that there were 4 people at high risk of stroke (6%), and 63 people were at low risk of stroke (94%). There were also other health issues found; 31 people with hypertension (46%), 26 people with hypercholesterolemia (38%), 7 people smoking (10%), 50 people never exercise (74%), and 7 people with overweight (10%). Education of stroke was attended by 36 people. The knowledge had increased after given education with an average pretest score of 59.41 (with minimum score of 20 and maximum score of 100) and an average post-test score of 74.41 (with minimum score of 30 and maximum score of 100). Stroke risk detection and primary prevention education are efforts to prevent stroke early, so they need to be done continuously.

Value of the stroke 1-2-0 prehospital stroke education system: the experience of a general practitioner team

BackgroundStroke is one of the leading causes of death worldwide, especially in developing countries. In China, there is an urgent need to educate people about stroke awareness and the importance of using emergency medical services (EMS) quickly after a stroke has occurred.ObjectiveWe sought to explore the effects of the Stroke 1-2-0 Prehospital Stroke Education System based on the experience of a general practitioner team.MethodWe prospectively enrolled 119 community general practitioners to be trained in the procedures advocated by the Stroke 1-2-0 Prehospital Stroke Education System. The training content included early detection of ischemic stroke, first aid for stroke, and intravenous thrombolysis; The effects of the training were later evaluated via a before-and-after comparison. The 119 enrolled physicians formed a Stroke 1-2-0 lecturer group and taught stroke knowledge to community residents. The group remained active for 6 months, during which the medical treatment data of stroke patients (i.e., stroke onset time, prehospital delay, whether an ambulance was called, and whether thrombolytic therapy was performed) in each of 5 jurisdictions were recorded for the month before (January 2021) and that after (August 2021) the 6-month community education program. Finally, the effects of the community education program were evaluated.ResultsThe participants’ understanding of intravenous thrombolysis in the treatment of acute ischemic stroke improved significantly after the training as compared with their earlier understanding (96% vs. 78.99%; P < .001), and their understanding of the time window for intravenous thrombolysis increased from 26.05% before to 72% (P < .001) after the training. Most of the participants (90% vs. 67.23%; P < .001) said that they would immediately call the 120 emergency number of China’s emergency phone system if they encountered individuals who appeared to be victims of acute stroke. A total of 82 stroke patients were seen before and 67 after the community education program. As for the use of the emergency call system, more patients with stroke activated that system after the program versus before (21.95% vs. 37.31%; P = .04). The 3-hour arrival rate after the program was nearly three times higher than that before the program (62.69% vs. 19.51%; P < .001). Also, regarding receiving thrombolysis after the occurrence of a stroke, the program triggered a substantial increase compared with the total earlier (19.4% vs. 6.1%; P = .013).ConclusionWe found that the Stroke 1-2-0 Prehospital Stroke Education System significantly improved community residents’ knowledge regarding stroke.

Mobile Technology-Based Interventions for Stroke Self-Management Support: Scoping Review.

There is growing interest in enhancing stroke self-management support using mobile health (mHealth) technology (eg, smartphones and apps). Despite this growing interest, "self-management support" is inconsistently defined and applied in the poststroke mHealth intervention literature, which limits efforts to synthesize and compare evidence. To address this gap in conceptual clarity, a scoping review was conducted. The objectives were to (1) identify and describe the types of poststroke mHealth interventions evaluated using a randomized controlled trial design, (2) determine whether (and how) such interventions align with well-accepted conceptualizations of self-management support (the theory by Lorig and Holman and the Practical Reviews in Self-Management Support [PRISMS] taxonomy by Pearce and colleagues), and (3) identify the mHealth functions that facilitate self-management. A scoping review was conducted according to the methodology by Arksey and O'Malley and Levac et al. In total, 7 databases were searched. Article screening and data extraction were performed by 2 reviewers. The data were analyzed using descriptive statistics and content analysis. A total of 29 studies (26 interventions) were included. The interventions addressed 7 focal areas (physical exercise, risk factor management, linguistic exercise, activities of daily living training, medication adherence, stroke education, and weight management), 5 types of mobile devices (mobile phones or smartphones, tablets, wearable sensors, wireless monitoring devices, and laptops), and 7 mHealth functions (educating, communicating, goal setting, monitoring, providing feedback, reminding, and motivating). Collectively, the interventions aligned well with the concept of self-management support. However, on an individual basis (per intervention), the alignment was less strong. On the basis of the results, it is recommended that future research on poststroke mHealth interventions be more theoretically driven, more multidisciplinary, and larger in scale.

The Role of Insulin-like Growth Factor I in Mechanisms of Resilience and Vulnerability to Sporadic Alzheimer's Disease.

Despite decades of intense research, disease-modifying therapeutic approaches for Alzheimer's disease (AD) are still very much needed. Apart from the extensively analyzed tau and amyloid pathological cascades, two promising avenues of research that may eventually identify new druggable targets for AD are based on a better understanding of the mechanisms of resilience and vulnerability to this condition. We argue that insulin-like growth factor I (IGF-I) activity in the brain provides a common substrate for the mechanisms of resilience and vulnerability to AD. We postulate that preserved brain IGF-I activity contributes to resilience to AD pathology as this growth factor intervenes in all the major pathological cascades considered to be involved in AD, including metabolic impairment, altered proteostasis, and inflammation, to name the three that are considered to be the most important ones. Conversely, disturbed IGF-I activity is found in many AD risk factors, such as old age, type 2 diabetes, imbalanced diet, sedentary life, sociality, stroke, stress, and low education, whereas the Apolipoprotein (Apo) E4 genotype and traumatic brain injury may also be influenced by brain IGF-I activity. Accordingly, IGF-I activity should be taken into consideration when analyzing these processes, while its preservation will predictably help prevent the progress of AD pathology. Thus, we need to define IGF-I activity in all these conditions and develop a means to preserve it. However, defining brain IGF-I activity cannot be solely based on humoral or tissue levels of this neurotrophic factor, and new functionally based assessments need to be developed.

Two stroke education programs designed for older adults

Stroke is an important public health problem worldwide and in Korea causing death and serious long-term disability. This study tested the feasibility, acceptability, and preliminary efficacy of two stroke education programs. The pictogram-based education program was administered to 118 participants, and the PowerPoint-based education program was administered to 108 participants. Stroke knowledge (stroke definition, risk factors, warning signs) and first action knowledge in the event of stroke were assessed among all participants prior to and following completion of their respective programs. Both stroke education programs showed similar, significant improvements in stroke knowledge and first action knowledge from baseline to posttest. Also, feasibility (81–88 % participation and 96 % completion) and acceptability (86–97 % satisfaction) of both stroke education programs were supported. These findings indicate that healthcare professionals can use either of the education programs to improve stroke knowledge and first action knowledge among older adults who are at high risk for stroke.

Large‐Vessel Occlusion Stroke Knowledge and Training for Stroke Severity Assessment Among Emergency Medical Services Personnel in the United States

BACKGROUND Prehospital identification of large‐vessel occlusion (LVO) stroke facilitates the development of a regional triage protocol that could lead to an improvement in intrahospital and interhospital workflows. This requires stroke education of emergency medical services (EMS) personnel to improve stroke recognition, severity assessment, and prenotification. However, the current state of EMS personnel's knowledge of LVO stroke, their training for stroke severity assessment, and their preferences for educational methods are unknown. We conducted a nationwide EMS survey across the United States to glean insights that can inform and customize future EMS educational efforts. METHODS The Society of Vascular and Interventional Neurology, in collaboration with EMS World , created an online questionnaire for EMS personnel. It included 12 multiple‐choice and free‐response questions designed to test participants’ clinical knowledge of LVO, knowledge of stroke center certification levels, prior LVO educational experiences, preferences for educational content delivery, and perspectives on prehospital hurdles to stroke care. All subscribers of EMS World received a survey link via email. RESULTS Of the 38 486 subscribers of EMS World , the survey email was opened by 1830, of whom 1107 completed the survey across all states in the United States, with a response rate of 2.9%. Most of the respondents identified themselves as paramedics/emergency medical technicians (91%). The number of patients with stroke that survey participants transported in the past year was &lt;10 for 618 (56%). Only 285 (26%) participants answered both LVO knowledge questions correctly, and only 128 (12%) respondents correctly identified all types of stroke centers with thrombectomy capability. A total of 362 EMS personnel (33%) denied receiving training to perform LVO severity assessment. Respondents who received training to perform an LVO scale demonstrated nearly twice the prevalence of LVO knowledge (30.6% versus 15.7%; prevalence ratio, 1.94 [95% CI, 1.50–2.53]) than respondents who did not receive training. The top hurdle to prehospital LVO education was identified as the lack of standardized LVO training by 535 (48%) respondents. CONCLUSIONS EMS providers in the United States reported inadequate LVO training and demonstrated gaps in knowledge of LVO, stroke severity scales, and stroke center levels. Systematic efforts to enhance and standardize the educational content and delivery of LVO education are needed.

Abstract 272: Effect of Level of Education on Outcomes of Mechanical Thrombectomy

Introduction Multiple epidemiological studies have investigated the association between stroke clinical outcomes and education level. However, the relationship between the level of education in patients who underwent mechanical thrombectomy (MT) is limited. We aim to assess if the level of education is associated with poor functional outcome, defined as a modified Rankin Scale (mRS) score of ≥3, in patients following MT. Methods We reviewed 257 patients with large vessel occlusion (LVO) who underwent MT between 2018 and June 2023, education levels were available on 106 patients. Education level was defined as “less than high school” (n=15, 14.2%), “high school” (n=54, 50.9%), and “college or higher” (n=36, 34%), 1 of these with “other” education level was excluded from the analysis. Chi‐square and Kruskal Wallis tests were used to examine potential differences in education level and outcomes. All analyses were conducted in IBM SPSS Statistics version 29. Results Compared to those with a college or higher education, those with a less than high school education were more likely to have a poor functional outcome (mRS ≥3) at 90 days. (p=0.03). Black patients were more likely to have a less than high school education than white patients (30.0% vs 4.8%) p&lt;0.001. There were no significant differences in mortality, length of hospitalization, comorbid conditions, Alberta stroke program early CT score (ASPECTS), or initial National Institutes of Health Stroke Scale (NIHSS). Conclusion In our cohort, patients with less than a high school education are more likely to have poorer functional outcomes 90 days post‐MT compared with patients with a college education or higher. Interestingly, there was no significant statistical difference noted in initial NIHSS, ASPECTS, and length of hospitalization between these cohorts. Larger post‐thrombectomy cohorts should be used to further investigate these initial results. In addition, it is important to note that education and race are intertwined in this study, though our relatively small sample of post‐thrombectomy patients limited our analyses. Future research should evaluate this relationship further.

The effect of educational level on the recurrence rate and number of episodes of stroke in stroke survivors

ObjectivesThis study aimed to assess the influence of educational level on the recurrence rate and number of stroke episodes in stroke survivors. Materials and methodsFor this cross-sectional study, information regarding patient characteristics, medical history, ability to perform activities of daily living, level of disability, number of episodes, and stroke recurrence was collected. Analyses were conducted using the chi-square test, analysis of variance, nonparametric test, Cox regression model, and the Kaplan-Meier method. ResultsOf the 696 stroke survivors enrolled in this study, the average stroke recurrence rate was 20.83 %, and the recurrence rates in patients with primary (or lower), secondary, and university (or higher) education were 26.58, 19.54 and 14.29 %, respectively. Patients with primary (or lower) or secondary education had a higher risk for stroke recurrence than those with a university education or higher. We found that the recurrence rate 10 years after an initial stroke was higher than that after 5 years. Moreover, there was a statistically significant difference in the cumulative recurrence rate among the three groups (χ2 = 9.36, P < 0.05). Lastly, the proportions of the number of stroke episodes differed between the various education level groups (P < 0.05). ConclusionsA lower educational level was shown to be a risk factor for stroke recurrence and education levels have an impact on the number of stroke episodes. Our results suggest that is necessary to strengthen post-stroke management and rehabilitation interventions for patients with low educational levels.

EDUKASI PENDERITA STROKE DI PUSKESMAS NOGOSARI BOYOLALI

This study focuses on the implementation of stroke education at Nogosari Boyolali Community Health Center, with an emphasis on the pivotal role of physiotherapy in the educational process. Stroke education is a crucial aspect of post-stroke care, aiming to empower patients with knowledge and skills for effective self-management. This research explores the integrated approach of physiotherapy within the educational framework, highlighting its significance in enhancing patients' physical and cognitive functions. Through a comprehensive review of educational materials and interactive sessions, patients are equipped with tailored strategies for daily living and stroke prevention. The study also evaluates the impact of this holistic education on patients' independence and overall prognosis. The findings underscore the indispensable role of physiotherapists in stroke education, emphasizing their contributions to the multidisciplinary care team. This research provides valuable insights for optimizing stroke education programs in community health settings, ultimately improving the quality of life for stroke survivors.

Racial Disparities in Utilization of Emergency Medical Services and Related Impact on Poststroke Disability.

Prompt seeking of emergency medical services (EMS) assistance at stroke onset is critical to minimize poststroke disability. The aim was to study how racial differences in EMS decision-relevant factors and EMS use impact stroke care and disability outcomes. A prospective observational study. A total of 1168 acute ischemic stroke patients discharged from April 2016 to October 2017 at a safety net hospital were included; 108 patients were surveyed before discharge. (1) Prehospital delay: EMS use, timely hospital arrival; (2) Stroke care: alteplase receipt and inpatient rehab; (3) Outcomes: Functional improvement at discharge (admission minus discharge scores on National Institutes of Health Stroke Scale), 90-day modified Rankin Scale; (4) EMS decision-relevant factors: Stroke symptom knowledge, source of knowledge, unfavorable past EMS/care experiences, and financial barriers to EMS use. Despite more Black patients using EMS than Whites/Asians (56% vs. 48%, P =0.003), their timely hospital arrival was 30% less likely. Adjusted for stroke severity, receipt of alteplase, and inpatient rehab were similar, but Black patients fared worse on functional improvement at discharge (among severe strokes, 2.4 National Institutes of Health Stroke Scale points less improvement, P <0.01), and on functional normalcy at 90 days (modified Rankin Scale score 0-1 being 60% less likely across severity categories) ( P <0.01). Fewer Black patients knew any stroke symptoms before the stroke (72% vs. 87%, P =0.03), and fewer learned about stroke from providers ( P =0.01). Financial barriers and provider mistrust were similar. Black patients had less knowledge of stroke symptoms, more care-seeking delay, and poorer outcomes. Including stroke education as a standard of chronic disease care may mitigate stroke outcome disparities.

Current Status of Stroke Center Certification Accreditation Recommendations for Comprehensive Stroke Centers Certification: A Consensus Statement from the Stroke Associated Korean Societies

Stroke is the leading cause of death in Korea. The demand for a multidisciplinary approach and transfer of patients between hospitals to receive higher-level treatment is increasing. However, there are many obstacles in selecting optimal hospitals for paramedics or stroke patients. This has led to a need for comprehensive stroke centers (CSC) capable of providing advanced and multidisciplinary care. Articles with information about guidelines, and other relevant clinical and research reports were investigated to establish the concept of certification for a CSC. Experts recommended by stroke-related societies gathered to form a consensus through public hearings, several meetings, and academic conferences. Herein, we aimed to write the policy statement for CSC certification. We described key elements of CSC in Korea. These areas include healthcare personnel with specific expertise in a number of specializations for stroke care, specific infrastructures and advanced diagnostic techniques including neuroimaging capabilities, surgical and endovascular techniques and neurocritical care for complex stroke care, and programmatic elements such as a stroke registry, education, and quality improvement activities. CSCs should have a comprehensive team that includes neurologists, neurosurgeons, vascular surgeons, neurointensivists, neuroradiologists, rehabilitation specialists who perform cutting edge diagnosis and treatment for two or more complex acute stroke patients simultaneously in an all-in-shop model without additional transfer to other hospitals.

Description and Evaluation of a Stroke Education Capacity Building Initiative for Vietnamese Speaking Pharmacists

Description and Evaluation of a Stroke Education Capacity Building Initiative for Vietnamese Speaking Pharmacists

Qualitative feasibility study of the mobile app Destroke for clinical stroke monitoring based on the NIH stroke scale

BackgroundStroke is a leading cause of severe disability in the United States, but there is no effective method for patients to accurately detect the signs of stroke at home. We developed a mobile app, Destroke, that allows remote performance of a modified NIH stroke scale (NIHSS) by patients. AimsTo assess the feasibility of a mobile app for stroke monitoring and education by patients with a history of stroke. Materials and methodsWe enrolled 25 patients with a history of stroke in a prospective open-label study to evaluate the feasibility of the Destroke app in patients with stroke. Nineteen patients completed all study assessments, with a median time from stroke onset to enrollment of 5.6 years (range 0.1–12 years). We designed a modified NIHSS that assessed 12 out of 16 tasks on the NIHSS. Patients completed this test eight times over a 28-day period. We conducted pre-study surveys that assessed demographic information, stroke and cardiovascular history, baseline NIHSS, and experience using mobile technologies, and mid- and post-study surveys that assessed patient satisfaction on app usage and confidence in stroke detection. ResultsTen men and nine women participated in this study (median age of 64 (33–76)), representing ten US states and Washington D.C. Median baseline NIHSS was 0 (0–4). 15 patients reported using health apps. On a 5-point Likert scale, patients rated the app as 4.2 on being able to understand and use the app and 4.3 on using the app when instructed by their doctor. For eight patients with poor confidence in detecting the signs of a stroke before the study, six showed higher confidence after the study. ConclusionsThe use of an at-home stroke monitoring app is feasible by patients with a history of stroke and improves confidence in detecting the signs of stroke.

Assessment of onset-to-door time in acute ischemic stroke and factors associated with delay at a tertiary care center in South India.

Intravenous thrombolysis is an effective treatment of acute ischemic stroke but has a narrow therapeutic time window of 3-4.5 h. Pre-hospital delay is a major barrier to patients becoming eligible for thrombolysis. This single-center study assessed the factors causing longer onset-to-door (OTD) time to identify measures that will help decrease the delay. Patients with acute ischemic stroke presenting to the emergency department from August to October 2022 were included in the study. The data were collected using a structured questionnaire and was completed by interviewing the patient or the caregivers. Patients were classified as early and late arrivers with the cutoff being 3.5 h. We then analyzed the relationship between early arrival and demographic factors, clinical factors, patient response factors, and logistic factors. Our study consisted of 153 patients. The average OTD time was 674.33 ± 812.713 min (median: 300; interquartile range: 151-885). The pre-hospital delay was present in 66% of patients. 16.9% of patients came beyond 24 h. In the multivariate analysis, the odds of early arrival were higher among patients who perceived their symptoms as serious (odds ratio [OR]: 18.801; confidence interval [CI]: 3.728-94.803) and lower among patients who experienced a delay in reaching due to traffic (OR: 0.085; CI: 0.008-0.873). Lack of knowledge about stroke centers among both patients and health professionals also contributed to longer OTD times. Out of 52 early arrivers, 24 received thrombolytic therapy after excluding wake-up strokes and contraindications. Pre-hospital delay continues to stand in the way of patients receiving thrombolysis. Comprehensive stroke education, increasing awareness regarding stroke centers, and promoting ambulance services are some of the interventions which could help tackle the issue.

Strategies for specialty training of healthcare professionals in low-resource settings: a systematic review on evidence from stroke care

BackgroundThe greatest mortality and disability from stroke occurs in low- and middle-income countries. A significant barrier to implementation of best stroke care practices in these settings is limited availability of specialized healthcare training. We conducted a systematic review to determine the most effective methods for the provision of speciality stroke care education for hospital-based healthcare professionals in low-resource settings.MethodsWe followed the PRISMA guidelines for systematic reviews and searched PubMed, Web of Science and Scopus for original clinical research articles that described or evaluated stroke care education for hospital-based healthcare professionals in low-resource settings. Two reviewers screened titles/abstracts and then full text articles. Three reviewers critically appraised the articles selected for inclusion.ResultsA total of 1,182 articles were identified and eight were eligible for inclusion in this review; three were randomized controlled trials, four were non-randomized studies, and one was a descriptive study. Most studies used several approaches to education. A “train-the-trainer” approach to education was found to have the most positive clinical outcomes (lower overall complications, lengths of stay in hospital, and clinical vascular events). When used for quality improvement, the “train-the-trainer” approach increased patient reception of eligible performance measures. When technology was used to provide stroke education there was an increased frequency in diagnosis of stroke and use of antithrombotic treatment, reduced door-to-needle times, and increased support for decision making in medication prescription was reported. Task-shifting workshops for non-neurologists improved knowledge of stroke and patient care. Multidimensional education demonstrated an overall care quality improvement and increased prescriptions for evidence-based therapies, although, there were no significant differences in secondary prevention efforts, stroke reoccurrence or mortality rates.ConclusionsThe “train the trainer” approach is likely the most effective strategy for specialist stroke education, while technology is also useful if resources are available to support its development and use. If resources are limited, basic knowledge education should be considered at a minimum and multidimensional training may not be as beneficial. Research into communities of practice, led by those in similar settings, may be helpful to develop educational initiatives with relevance to local contexts.

Stroke nurse navigator utilization reduces unplanned 30-day readmission in stroke patients treated with thrombolysis.

Unplanned 30-day hospital readmissions following a stroke is a serious quality and safety issue in the United States. The transition period between the hospital discharge and ambulatory follow-up is viewed as a vulnerable period in which medication errors and loss of follow-up plans can potentially occur. We sought to determine whether unplanned 30-day readmission in stroke patients treated with thrombolysis can be reduced with the utilization of a stroke nurse navigator team during the transition period. We included 447 consecutive stroke patients treated with thrombolysis from an institutional stroke registry between January 2018 and December 2021. The control group consisted of 287 patients before the stroke nurse navigator team implementation between January 2018 and August 2020. The intervention group consisted of 160 patients after the implementation between September 2020 and December 2021. The stroke nurse navigator interventions included medication reviews, hospitalization course review, stroke education, and review of outpatient follow-ups within 3 days following the hospital discharge. Overall, baseline patient characteristics (age, gender, index admission NIHSS, and pre-admission mRS), stroke risk factors, medication usage, and length of hospital stay were similar in control vs. intervention groups (P > 0.05). Differences included higher mechanical thrombectomy utilization (35.6 vs. 24.7%, P = 0.016), lower pre-admission oral anticoagulant use (1.3 vs. 5.6%, P = 0.025), and less frequent history of stroke/TIA (14.4 vs. 27.5%, P = 0.001) in the implementation group. Based on an unadjusted Kaplan-Meier analysis, 30-day unplanned readmission rates were lower during the implementation period (log-rank P = 0.029). After adjustment for pertinent confounders including age, gender, pre-admission mRS, oral anticoagulant use, and COVID-19 diagnosis, the nurse navigator implementation remained independently associated with lower hazards of unplanned 30-day readmission (adjusted HR 0.48, 95% CI 0.23-0.99, P = 0.046). The utilization of a stroke nurse navigator team reduced unplanned 30-day readmissions in stroke patients treated with thrombolysis. Further studies are warranted to determine the extent of the results of stroke patients not treated with thrombolysis and to better understand the relationship between resource utilization during the transition period from discharge and quality outcomes in stroke.

Effect of stroke education with video on stroke prevention behavior in hypertension elderly in Cipayung health center area east Jakarta

Stroke is a cerebrovascular disease and is a worldwide problem. Stroke is the third leading cause of death. The purpose of this study was to determine the effect of stroke education with video on stroke prevention behavior in elderly hypertensives. This research method uses a quasi-experimental pre-post test only design. The population in this study were hypertensive elderly who visited the Elderly Posyandu. The sampling technique in this study used purposive sampling, with a total sample of 31 respondents. Methods of data collection by pre-post test and blood pressure examination. Analysis of research data using univariate analysis, and bivariate analysis using the dependent t.test statistic, while multivariate analysis using logistic regression tests. The results of the study showed that there was an effect of stroke education through video on knowledge of stroke prevention in elderly with hypertension (p = 0.002). There was no effect of stroke education through video on stroke prevention attitudes in elderly hypertension (p = 0.86). There is an effect of stroke education through video on stroke prevention skills in elderly with hypertension (p = 0.003). There is an effect of stroke education through video on systolic blood pressure in elderly with hypertension (p = 0.000).

Exploring the self-efficacy and self-care-based stroke care model for risk factor modification in mild-to-moderate stroke patients.

The worldwide burden of stroke is projected to grow unless proper stroke education is implemented. Information alone cannot promote patient self-efficacy and self-care and reduce risk factors. This trial aimed to test self-efficacy and self-care-based stroke education (SSE) on changes in self-efficacy, self-care, and risk factor modification. This study is a single-center, double-blinded, interventional, two-arm randomized controlled trial with a 1- and 3-month follow-up in Indonesia. Between January 2022 and October 2022, 120 patients were prospectively enrolled from Cipto Mangunkusumo National Hospital, Indonesia. Participants were assigned using a computer-generated random number list. SSE was given before discharge from the hospital. Self-care, self-efficacy, and stroke risk score was measured 1 month and 3 months after discharge. Modified Rankin Scale, Barthel Index, and blood viscosity was measured at 1 month and 3 months after discharge. A total of 120 patients (intervention n = 60; standard care n = 60) were randomized. In the 1st month, the intervention group showed a more significant change in self-care (4.56 [95% CI: 0.57, 8.56]), self-efficacy (4.95 [95% CI: 0.84, 9.06]), and stroke risk (-2.33 [95% CI:-3.19, -1.47]) compared to the controlled group. In the 3rd month, the intervention group also showed a more significant change in self-care (19.28 [95% CI: 16.01, 22.56]), self-efficacy (19.95 [95% CI: 16.61, 23.28]), and stroke risk (-3.83 [95% CI: -4.65, -3.01]) compared to the controlled group. SSE may boost self-care and self-efficacy, adjust risk factors, enhance functional outcomes, and decrease blood viscosity. ISRCTN11495822.

Social Media in Stroke Career Development.

Social Media in Stroke Career Development.