Stroke Knowledge Research Articles

Knowledge, attitude, and practice of stroke and thrombectomy among medical students in Henan, China.

To assess knowledge, attitude, and practice (KAP) of stroke and thrombectomy among medical students in Henan, China. A cross-sectional study was conducted on medical students from 5 universities in Henan, China between June and September, 2022, using a self-administered questionnaire. A total of 1105 medical students [697 (62.1%) females] participated. Their mean KAP scores were 11.1 ± 2.90, 35.37 ± 4.94, and 21.48 ± 5.51 out of 14, 44, and 24, respectively. Structural equation modeling revealed that, age (estimate = 0.351, P = .005) and education (estimate = 0.370, P = .024) positively affected knowledge, while major (estimate = -0.128, P = .017), internship experience in neurosurgery or neurology (estimate = -1.321, P < .001), and family history of stroke (estimate = -0.557, P < .001) negatively influenced knowledge. Knowledge (estimate = 0.649, P < .001) and having seniors over the age of 60 at home (estimate = 1.228, P = .001) had positive effects on attitudes, while internship experience in neurosurgery or neurology (estimate = -0.471, P = .090) and family history of stroke (estimate = -0.596, P = .020) had negative impact on attitudes. Moreover, knowledge (estimate = 0.230, P < .001) and attitudes (estimate = 0.628, P < .001) positively influenced practices, whereas sex (estimate = -1.141, P < .001), internship experience in neurosurgery or neurology (estimate = -0.578, P = .025), and family history of stroke (estimate = -0.523, P = .027) negatively influenced practices. Medical students in Henan, China showed adequate knowledge, positive attitude, and proactive practice toward stroke and thrombectomy. Age, sex, education, major, internship experience in neurosurgery or neurology, family history of stroke, having seniors over the age of 60 at home might have impact on their KAP.

Một số yếu tố ảnh hưởng đến thời gian nhập viện ở bệnh nhân nhồi máu não cấp

Object: Some factors affect hospitalization time in patients with acute cerebral infarctionMethod: Cross-sectional, retrospective descriptive study including 150 patients with acute cerebral infarction treated at the Neurology Center and Stroke Center, Bach Mai Hospital from January 2023 to December 2023.Result: The average hospital admission time was 661.5 minutes (11 hours); Only 26 patients were hospitalized early before 4.5 hours, accounting for 17.3%; Factors affecting the early hospitalization time of patients are high educational level (OR: 2.362; 95% CI [1.002-5.565]), daytime onset time (OR: 3.787; 95% CI [ 0.081-0.996]), having a witness at the time of symptom onset (OR: 5.928; 95% CI [1.336-26.308]), using ambulance transportation (OR: 32.445; 95% CI [9,916-106,223]), history of stroke or TIA (OR: 5.9; 95% CI [1.73-20,121]), recognition of symptoms of stroke (OR: 256.82; 95% CI [31] ,69-2081.44]) and knowledge of fibrinolytic drugs (OR: 83.18; 95% CI [16.81-411.69]); Factors affecting the patient's late hospitalization time include: distance to the hospital &gt;15km (OR: 0.33; 95% CI [0.117-0.931]), admission to a front-line medical facility (OR: : 0.165; 95% CI [0.054-0.507]).Conclusion: Factors affecting the patient's early hospitalization time include: high educational level, time of illness onset during the day, presence of witnesses at the time of symptom onset, use of public transport ambulance, history of stroke or TIA, recognition of stroke symptoms and knowledge of thrombolytic drugs.

Impact of Gender and Marital Status on Door-to-Treatment (DTT) Time and Acute Stroke Outcome.

Delays in acute stroke treatment lead to poor outcomes. Women can present with atypical stroke symptoms, are older at the time of stroke, and tend to be living alone, causing delays in pre-hospital diagnosis and seeking care. It is unclear if gender disparities in ED arrival and stroke assessment are compounded by gender differences after ED arrival. Therefore, we sought to identify if gender and marital status were associated with faster door-to-treatment (DTT) time. Our single-center stroke database was queried for adults presenting to ED with acute stroke between January 1, 2018 and January 30, 2023 treated with IV thrombolytics (IVT)+/- endovascular thrombectomy (EVT) and a known DTT time. The primary outcome was DTT (door-to-needle+door-to-puncture) time. Data collected includes the National Institutes of Health Stroke Scale (NIHSS) at presentation and discharge, gender, marital status, age, and intervention (IVT alone or IVT+/- EVT). Among 674 patients identified, 35 patients were excluded due to missing data. Of 639 patients (median age 66y), 25%/18% of patients were married men/women, respectively, and 22%/35% were single men/women. Median DTN time, DTP time, and discharge NIHSS score were 36, 79, and 4mins, respectively. On multivariable analysis, neither DTT time nor NIHSS score at discharge improved among married men relative to any other combination of gender and marital status. Gender differences in the knowledge of stroke warning signs and gender disparities in ED assessment did not translate into faster DTT time. More work is needed to find ways to accelerate stroke care after ED arrival.

Assessing the efficacy of an educational video on stroke knowledge in Lebanon: a single-arm interventional study

ObjectiveThis study aimed to assess the public’s knowledge of stroke before and after viewing an educational video about stroke risk factors, preventive measures, and alarming signs.MethodsA single-arm interventional study was conducted in Lebanon using a 3-minute video-based education about stroke. A pre- and post-structured questionnaire compared the level of knowledge about stroke.ResultsThe study included 685 participants. Knowledge of stroke, risk factors, warning signs, treatment, and preventive measures significantly increased post-educational video sessions. A higher baseline knowledge score was associated with a family history of stroke (Beta = 1.76) and being a healthcare professional (Beta = 3.35). Participants between 25 and 34 years (Beta=-1.39) and those with a high risk of stroke (Beta=-1.03) were significantly associated with a lower knowledge score.ConclusionThis study demonstrated the effectiveness of a video-based educational tool to raise awareness about stroke. Short, targeted audio-visual resources using lay language can convey health education messages and influence behavioral changes. The community can benefit from a large-scale educational campaign that targets different socio-economic statuses to enhance knowledge of stroke and save lives.

Enhancing stroke knowledge among youth: Insights from Stroke Busters

IntroductionCommunity stroke education has shown promising results with sustained stroke knowledge and behavioral changes; however less is known about the effects of targeted education towards youth. We developed an interactive educational program for high school students, Stroke Busters, that focuses on stroke prevention, recognizing warning signs, and the importance of seeking prompt care. MethodsThis is a prospective cohort study where students are offered a stroke education program, ‘Stroke Busters’, through the Yale Pathways to Science Program, a Science, Technology, Engineering and Math (STEM) pipeline program for high school students living near New Haven, Connecticut. Students filled out a stroke knowledge survey before, after, and 8-months-post program. Data from four separate sessions were collected (two 5-day programs and two 1-day programs) and scores were compared. Students who returned to help teach were also evaluated with an additional post-test. ResultsThe average pre-program score was 36.9% and post-program was 62.5% (N=67, p<0.001) across all sessions. Between sessions, scores were not significantly different. 8-month post-program scores (n=5) were not significantly different from immediate post-program scores. Students in the role of teaching-assistant had post-program scores of 85.7%. DiscussionHigh school students who participated in Stroke Busters retained stroke knowledge for up to 8 months. The 1-day program showed similar results to the 5-day program, which suggests providing shorter programs to high school students may represent a more feasible opportunity for community stroke prevention. Additionally, including students in a teaching role is a promising way to increase enthusiasm and stroke knowledge for youth. ConclusionStroke Busters was successfully able to educate high school youth about stroke and programs of both 1 and 5-day are equally effective.

Pre-hospital delay intention and its associated factors in the high-risk population of stroke: A latent profile analysis.

To explore the possible latent classifications of pre-hospital delayed intention at high risk of stroke and to analyze the characteristics of different profiles. A cross-sectional study was conducted in one community in Shanghai, China. 470 individuals at high risk of stroke were recruited, and self-reported questionnaires (including socio-demographic, stroke knowledge, health belief, and pre-hospital delay behavior intention scale) were distributed between April and June 2023. A latent profile analysis was employed to identify the delay intention clusters, and multinomial logistic regression was utilized to ascertain the factors influencing the latent classes of delay intention. 457 high-risk populations with a response rate of 97.23% were finally enrolled in this study. Four distinct classes were identified: High warning signs-Low delay intention (26.3%), Low warning signs-Low delay intention (17.7%), moderate level of delay intention (37.3%), and high level of delay intention (18.7%). The influencing factors included stroke knowledge, health belief, age, education background, the nearest distance to the medical institution, and household income. The pre-hospital delay intention among high-risk populations of stroke was classified into four distinct classes. It is crucial for individuals at high risk to remain vigilant towards stroke symptoms and to take prompt action. Health promotion education may be explored as a strategy to bridge the gap between the recognition of stroke symptoms and the low pre-hospital delay intention.

What do employers need when supporting stroke survivors to return to work?: a mixed-methods study

ABSTRACT Background Employers are key in supporting stroke survivors to return to work (RTW) but do not always have knowledge/skills or guidance to do so. Objectives To explore employers’ needs for provision of post-stroke RTW support. Methods Mixed-methods study. Participants recruited through voluntary response/purposive sampling. Survey of employers investigated stroke knowledge (maximum score: 7), RTW process knowledge (maximum score: 8), and perceived competency for actions supporting RTW (maximum score: 100%). Regression analyses explored relationships between employers’ demographic/contextual characteristics and knowledge and perceived competency scores. Interviews with employers explored factors influencing their post-stroke RTW support. Interview data were analyzed using a framework analysis. Survey/interview findings were synthesized with those from a qualitative systematic review. Results Across the survey (n = 50), interviews (n = 7), and review (25 studies), employers’ support was influenced by stroke survivors’ decisions to disclose stroke-related limitations, employers’ knowledge regarding roles/responsibilities, employers’ communication skills, and information provided by healthcare. Regression analyses: Human resources/occupational health support was positively associated with stroke knowledge (ß = 2.30, 95% CI 0.36–4.41, p = 0.013) and RTW process knowledge (ß = 5.12, 95% CI 1.80–6.87, p = 0.001). Post-stroke RTW experience was positively associated with stroke knowledge (ß = 1.36, 95% CI 0.46–2.26, p = 0.004) and perceived competency (ß = 31.13, 95% CI 18.40–44.76, p = 0.001). Organization size (i.e. working in a larger organization) was positively associated with RTW process knowledge (ß = 2.96, 95% CI 1.52–4.36, p = <.001). Conclusions Employers’ RTW support was influenced by personal and environmental factors; they may benefit from education and guidance on stroke and their roles/responsibilities during the RTW process.

Post-implementation knowledge retention of stroke: the lasting influence of FAST Heroes.

FAST Heroes is a kindergarten-based educational program that teaches young children and their extended families (parents, grandparents), the main stroke symptoms (Face, Arm, and Speech), and the timely and appropriate steps in the event of a suspected stroke (Time). However, post-campaign knowledge retention remains a challenge. The purpose of the current study was to investigate whether and to what extent grandparents' stroke knowledge is maintained 44 months after the initial implementation of the program. Forty-five participants engaged in the present study (35 women, 10 men; 72.8§5.3) and completed an adapted version of the FAST Heroes Stroke Preparedness Questionnaire via phone calls. Compared to immediately post-program implementation, respondents were still able to recall arm weakness (OR = 1.63; p = 0.246) and slurred speech (OR = 2.02; p = 0.075) as main stroke symptoms. A decrease was observed in recalling facial drooping (OR = 0.44; p = 0.042). Reporting of the appropriate course of action, was found to be increased (OR = 4.17; p < 0.001). Respondents remembered the emergency number to call, i.e., 112 (OR = 0.97; p = 0.947). The results showed that awareness regarding the common signs of a stroke and the importance of promptly contacting emergency services following a stroke, in the population group mostly affected by stroke, is retained. Exploring knowledge preservation in a greater sample size is warranted.

Stroke knowledge level among patients with ischemic stroke at Universiti Malaya Medical Centre

Background and Objectives: Stroke is a significant public health concern. The rising trend among stroke survivors, middle-aged, and multi-comorbid patients highlights the need for preventive intervention. In Malaysia, stroke survivors had insufficient understanding of stroke, despite being a common illness in the country. Methods: A single-centre prospective study was conducted to determine the level of knowledge of stroke, its warning signs and symptoms, risk factors, and its association among stroke survivors who received treatment at the Universiti Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia. A validated Stroke Knowledge Test (SKT) questionnaire was used to analyse stroke knowledge. Results: The participant’s mean age was 57.79 (± 11.13) years old, with the majority being first-time stroke patients (87.2%), below 60 years of age (55.3%), had multiple comorbidities (93.4%), and male gender (68.1%). Most (71.4%) were non-adherent to their current medications. The study participants scored poorly on identifying warning signs compared to their knowledge of strokes in general and understanding of stroke risk factors. The majority have poor knowledge of smoking (1.8%) and atrial fibrillation (AF) (1.5%) as risk factors. However, there was good knowledge of the purpose of rehabilitation (98.9%). Conclusions: Participants’ knowledge about stroke, warning signs, symptoms, and risk factors were insufficient. Stroke knowledge was significantly associated with education, medication adherence, habitation, and income.

Assessment of Stroke Awareness and Knowledge of Risk Factors among Patients, Relatives, and Caregivers in a Tertiary Care Center in India: A Cross-Sectional Study

Assessment of Stroke Awareness and Knowledge of Risk Factors among Patients, Relatives, and Caregivers in a Tertiary Care Center in India: A Cross-Sectional Study

Effectiveness of the Stroke e-Learning Module on Malaysian Doctors' Knowledge of Acute Ischaemic Stroke Management.

The Stroke e-Learning Module (SEM) is a nationwide initiative to improve stroke care in Malaysia. This study aimed to assess the module's effectiveness in improving knowledge on acute ischaemic stroke (AIS) management among Malaysian doctors. This was a pre-post study design. Medical officers, specialists and general practitioners from various disciplines who work in healthcare facilities in Malaysia were recruited virtually from those who registered for the SEM on the Docquity platform between 1 February 2021 and 31 January 2022. The Acute Stroke Management Questionnaire (ASMaQ), an existing validated questionnaire, was used to measure the doctors' knowledge of AIS management before and after the SEM. The ASMaQ had three domains: i) general stroke knowledge (GSK), ii) hyperacute stroke management (HSM) and iii) advanced stroke management (ASM). The paired t- and the McNemar-tests were used to evaluate the effectiveness of the module. One hundred and seventy-one participants voluntarily responded to the pre- and post-module questionnaires. The paired t-test revealed statistically significant improvement for the ASM knowledge scores (mean difference = 2.5; 95% CI: 1.8, 3.2; P < 0.001). The baseline proportion of participants with good knowledge of GSK, HSM and ASM were 92.4%, 64.9%, and 76%, respectively. The McNemar test showed that approximately 14% of the participants had significant improvement in ASM knowledge (P < 0.001). However, no significant changes were noted for GSK (-0.6%) and HSM (4.1%). The SEM has been shown to increase Malaysian doctors' knowledge on ASM. However, greater effort should be made to improve GSK and HSM knowledge, particularly in areas related to stroke thrombolysis.

Stroke knowledge and health-promoting behaviors: Mediating effect of patient self-esteem

ObjectiveTo investigate the levels of and associations between stroke knowledge, self-esteem, and health-promoting behavior (HPB) among stroke patients, and examine the mediating effect of self-esteem in the stroke knowledge–HPB relationship. MethodsThis descriptive correlational study involved a total of 150 stroke patients. We collected data through questionnaires during outpatient visits at two Korean secondary hospitals, inquiring about general and disease-related characteristics, stroke knowledge, self-esteem, and HPB. Correlation and mediation analyses were performed. ResultsStroke knowledge significantly increased patients’ self-esteem (β = .53, p = .001) and HPB (β = 1.64, p < .001). Self-esteem mediated the relationship between stroke knowledge and HPB, with the mediating effect coefficient determined to be 1.68 [95 % CI (0.56,−2.46)]. ConclusionEducation and intervention programs that increase both self-esteem and stroke knowledge need to be developed and evaluated such that stroke patients are motivated to engage in HPB. Practice implicationsStroke patients are often physically and mentally impaired, and low self-esteem can be a barrier to engaging in HPB after diagnosis, negatively affecting their health outcomes. Nursing interventions focused on enhancing self-esteem can empower these patients to effectively engage in HPB. Healthcare professionals should adequately communicate and impart disease-related knowledge to patients with poor disease-related knowledge or education.

Global, regional, and national burden of stroke attributable to diet high in sodium from 1990 to 2019: a systematic analysis from the global burden of disease study 2019.

Given the increasing occurrence of stroke and high-sodium diets (DHIS) over the past 30 years, it is crucial to assess the global, national, and regional impact of DHIS on the burden of stroke. The Global Burden of Diseases Study 2019 provided the study's data. We used the Bayesian meta-regression tool DisMod-MR 2.1 to evaluate the burden of stroke attributable to DHIS. Age-standardized disability-adjusted life years (ASDR) and age-standardized mortality rate (ASMR) were used to quantify the burden. We perform correlation analysis utilizing the Spearman rank-order correlation method, and we calculate the estimated annual percentage change (EAPC) to evaluate temporal trends. Globally, DHIS accounts for 17,673.33 thousand disability-adjusted life years (DALYs) and 700.98 thousand deaths of stroke in 2019. The burden of stroke attributable to DHIS has declined between 1990 and 2019 globally and in the majority of regions, with the largest declines seen in regions with high sociodemographic indexes (SDI). Both ASMR and ASDR were higher regionally in regions with moderate SDI than those in developed regions. Furthermore, the absolute values of EAPC, reflecting the rate of decrease, were notably lower in these regions compared to developed nations. High-income North America, categorized within the SDI regions, notably witnessed the smallest decline in ASDR over the last three decades. Additionally, from 1990 to 2019, males consistently bore a larger burden of stroke attributable to DHIS. The burden of stroke attributable to DHIS remained a major concern despite advancements in public knowledge of stroke and their utilization of emergency medical services. Over the past 30 years, more burden has been placed on males and regions with moderate SDI values; in males, higher EAPC values for both ASMR and ASDR have been found. This underscores the urgent need for effective interventions to alleviate the burden of stroke associated with DHIS.

Development of an Acute Stroke Care Seeking Framework.

BACKGROUND: A multitude of variables influence an individual's decision to seek care in emergency situations. By recognizing these variables and their impact on the timeline of an individual seeking care for a stroke, nurses have an opportunity to positively affect the outcomes of stroke within the community. The purpose of this narrative review was to develop a research framework describing the variables involved in care seeking during an acute stroke. METHODS: Using a theory synthesis methodology that included variable identification and the establishment of relationships between variables based on existing literature, a framework describing variables relevant to acute stroke care seeking behavior was developed. RESULTS: Fourteen recently published studies reported significant variables related to seeking emergency medical care during the hyperacute phase of a stroke. Eight variables were identified and characterized as either promoters or distractors. Promoters led an individual to seek acute stroke care earlier, such as perceived symptom severity, stroke knowledge, and the presence of others. Distractors led an individual to delay seeking acute stroke care and resulted in later hospital arrival times, such as a lack of social network or resources, comorbid conditions, and incongruity with the local health system. CONCLUSION: Although individual decision making is exceedingly complex and varies by individual and situation, the developed acute stroke care seeking framework may provide a basis on which to develop stroke awareness programs and interventions targeted at individuals at risk for delayed acute stroke care.

Effects of world stroke campaign on stroke literacy and knowledge in Taiwan

ABSTRACT Objectives Stroke is a leading cause of death in Taiwan. Poor public knowledge of stroke may lead to delays in prehospital arrival, resulting in unfavorable prognoses. Studies have investigated public knowledge of stroke and highlighted the importance of stroke education, however, few such studies have been conducted in Taiwan. This study assessed the changes in public knowledge of stroke between 2012 and 2020 by conducting a survey during two World Stroke Day events. Furthermore, this study identified areas where educational efforts may have been insufficient. Materials & Methods Questionnaires were distributed to the participants of 2012 and 2020 World Stroke Day events in Taiwan. In total, 328 and 336 questionnaires were completed, respectively. Stroke literacy and knowledge were analyzed between 2012 and 2020. Data were analyzed using the chi-square test or independent t-test. p < 0.05 indicates statistical significance. Results Hypertension was the most recognized risk factor for stroke in both years (p < 0.001), and recognition of most of the given risk factors significantly increased. In addition, recognition of more than half of the stroke warning signs significantly increased, awareness of the correct acute stroke response also increased (p < 0.001), and overall stroke literacy in Taiwan increased (p = 0.001). Conclusion Stroke literacy and knowledge in Taiwan have improved significantly between 2012 and 2020, but many people still lack adequate stroke knowledge and awareness. Government health department must take this sort of intervention continually (campaigns) and novel approaches (e.g. board game…) to improve stroke literacy and knowledge in public health. Registration ID N202109072, approved by the Joint Institutional Review Board of Taipei Medical University on 2021/11/02

Personalized Video-Based Educational Platform to Improve Stroke Knowledge: A Randomized Clinical Trial.

Stroke knowledge is critical to treatment adherence and poststroke outcomes. Here, we aimed to quantify the impact of a personalized video-based educational platform to test the hypothesis that it improves patient satisfaction and stroke knowledge. In a single-center pilot randomized trial, all patients with stroke and caregivers received standard stroke education during the hospitalization, but half were randomized to receive access to MyStroke, a personalized educational platform that provided brief videos about their stroke, risk factors, medications, and poststroke lifestyle. Satisfaction, stroke knowledge, and quality of life were assessed 7, 30, and 90 days after discharge. A total of 120 subjects (96 patients and 24 caregivers) were randomized to standard education (n=59) or MyStroke. At 90 days post-stroke, those who received MyStroke were more likely to be satisfied with the stroke education the received (90% versus 73%, P=0.05) and more likely to correctly identify their stroke cause (67% versus 32%, P=0.003). However, MyStroke was not associated with a difference in self-reported quality of life (EuroQol Visual Analogue Scale: 80 versus 75, P=0.06) or general stroke knowledge (total Stroke Patient Education Retention: 5 versus 5, P=0.47). With respect to secondary end points, MyStroke increased risk factor awareness 7 and 30 days poststroke, but this difference was not significant at 90 days. The MyStroke personalized video-based education platform improved patient and caregiver satisfaction while improving some aspects of personalized stroke knowledge without improving general stroke knowledge. A multicenter trial is needed to confirm these results, clarify generalizability, and target clinically relevant metrics such as stroke recurrence or adherence. URL: https://www.clinicaltrials.gov; Unique identifier: NCT05118503.

Stroke Knowledge and Response Among the General Population in Saudi Arabia: A Population-Based Survey.

Stroke, a condition that disrupts brain function and can result in long-lasting clinical symptoms or death, remains a substantial global health concern. General awareness of stroke leads to a proper response to stroke, pursuit of medical treatment, and a better outcome. Our study aims to explore how the general Saudi Arabian population responds to stroke, investigate the relationship between stroke knowledge and appropriate actions, and identify the most relied upon medical information source about stroke among the public. By highlighting these aspects, we aspire to contribute to the development of effective stroke prevention and management strategies in Saudi Arabia. This descriptive, cross-sectional, web-based study was carried out across multiple regions in Saudi Arabia. Data collection involved a validated online questionnaire (STAT) in Arabic,targeting adults aged 18 and older. Data analysis was performed using SPSS software. The study included 390 participants. Notable findings emerged regarding the recognition of stroke symptoms and the factors influencing this recognition. A substantial proportion of respondents correctly identified visual disturbances (55.9%), motor impairment (39.5%), cardiac symptoms (56.2%), sensory symptoms (32.8%), chest pain (62.6%), and arm weakness (36.7%) as indicators requiring immediate medical attention. However, there were lower correct response rates for symptoms such as sudden dizziness (22.8%), confusion (16.9%), difficulty understanding (27.9%), and urinary symptoms (26.9%). Older individuals and retirees generally scored higher in correctly identifying these symptoms. Our study highlights a commendable level of awareness of certain stroke symptoms, such as visual disturbances and chest pain, among the general population of Saudi Arabia. Nonetheless, notable gaps remain in recognizing other symptoms, such as sudden dizziness and confusion. This identification gap presents a clear opportunity for targeted educational initiatives that are essential to improving public recognition of these symptoms. By addressing these gaps, we aim to enhance the response to stroke incidents, potentially improving outcomes and reducing morbidity rates.

Assessment of knowledge and awareness of stroke among the Syrian population: unveiling the current landscape in Syria through the first nationally representative study

Stroke is a global public health concern, contributing to high rates of morbidity and mortality. In Syria, the current conflict and associated challenges have had a profound impact on healthcare infrastructure, including education and awareness programs related to stroke. An essential aspect of preventing stroke is the awareness of individuals. The study aimed to investigate factors associated with knowledge and awareness of stroke among Syrian people. A cross-sectional national representative study was conducted in Syria. The questionnaire was created on Google form and disseminated as a link through online platform social media like Facebook, WhatsApp, and Twitter. The population of the study was divided using proportionate random sampling into the 14 governorates. A random sample was selected from each area. The STROBE reporting guideline for cross-sectional studies was followed. Logistic regression analysis was performed to identify the factors associated with poor knowledge of stroke. A total of 1013 Syrian adults participated in the study. With more than half of them were females (53.5%) and employed (55.6%). Significant associations were found between ability to identify at least one correct risk factor and employability status (p = 0.029), single group (p = 0.036) and smokers (p < 0.001). In addition, significant associations were found between identifying at least one correct stroke symptom and smokers (p < 0.001) and no-obese people (p = 0.048). Furthermore, younger age group (below 30 years) were significantly able to list at least one correct stroke consequence compared to the older age groups (p = 0.025). Moreover, a significantly higher number of smokers compared to non-smokers correctly identified at least one stroke consequence (p = 0.019). The study revealed that there is a relatively weak understanding of the preventable nature of stroke among Syrian population. The overall awareness is still inadequate and varies depending on lifestyle factors and employment status.

Mechanical Thrombectomy Workshops Improve Procedural Knowledge and Skills Among Neurointerventional Teams in Low- to Middle-Income Countries.

While mechanical thrombectomy (MT) is proven to be lifesaving and disability sparing, there remains a disparity in its access in low- to middle-income countries. We hypothesized that team-based MT workshops would improve MT knowledge and skills. We designed a 22-hour MT workshop, conducted as 2 identical events: in English (Jamaica, January 2022) and in Spanish (Dominican Republic, May 2022). The workshops included participating neurointerventional teams (practicing neurointerventionalists, neurointerventional nurses, and technicians) focused on acute stroke due to large vessel occlusion. The course faculty led didactic and hands-on components, covering topics from case selection and postoperative management to device technology and MT surgical techniques. Attendees were evaluated on stroke knowledge and MT skills before and after the course using a multiple choice exam and simulated procedures utilizing flow models under fluoroscopy, respectively. Press conferences for public education with invited government officials were included to raise stroke awareness. Twenty-two physicians and their teams from 8 countries across the Caribbean completed the didactic and hands-on training. Overall test scores (n=18) improved from 67% to 85% (P<0.002). Precourse and postcourse hands-on assessments demonstrated reduced time to completion from 36.5 to 21.1 minutes (P<0.001). All teams showed an improvement in measures of good MT techniques, with 39% improvement in complete reperfusion. Eight teams achieved a Thrombolysis in Cerebral Infarction score of 3 on pre-course versus 15 of 18 teams on post-course. There was a significant reduction in total potentially dangerous maneuvers (70% pre versus 20% post; P<0.002). Universally, the workshop was rated as satisfactory and likely to change practice in 93% Dominican Republic and 75% Jamaica. A team-based hands-on simulation approach to MT training is novel, feasible, and effective in improving procedural skills. Participants viewed these workshops as practice-changing and instrumental in creating a pathway for increasing access to MT in low- to middle-income countries.

Evaluating the knowledge of stroke management among Nigerian medical doctors

BackgroundStroke is a leading cause of death and disability in Nigeria. Effective stroke management is essential to reduce morbidity and mortality. Few trained neurologists in Nigeria are mostly concentrated in the cities, making non-specialists the backbone of acute stroke management in Nigeria. Physicians-related factors have been identified as one of the factors leading to sub-optimal stroke care. This study aimed to describe the knowledge of medical doctors in acute stroke care and the factors responsible for the disparity in their skills. MethodsA descriptive cross-sectional survey was conducted among 404 medical doctors across all the six geo-political zones in Nigeria using the Acute Stroke Management Questionnaire (ASMaQ). Data were analysed using descriptive statistics and simple logistics regression to predict the relationship between independent variables and the outcome variable (good knowledge vs poor knowledge). Results67 % (95 % CI =63–72 %) of respondents had good overall knowledge of stroke management. Most respondents [88.6 %, 95 % CI =85–92 %] had good knowledge of General Stroke Knowledge (GSK) followed by Hyperacute Stroke Management (HSM) [52.5 %, 95 % CI=47.3–57.7 %] and Advanced Stroke Management (ASM) [49.5 %, 95 %CI= 49.5–54.4 %]. Working in a primary healthcare center (PHCs) and government hospital were significant predictor of overall poor knowledge of stroke. Physicians at PHCs had 2.29 times the odds of poor knowledge compared to those in tertiary hospital ConclusionsIt is essential to retrain doctors on stroke management regularly, as part of their professional development.