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Low awareness of transient ischemic attacks and risk factors of stroke in a Swiss urban community

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Abstract

Background and purpose

Time delays from stroke onset to arrival at the hospital are the main obstacles for widespread use of thrombolysis. In order to decrease the delays, educational campaigns try to inform the general public how to act optimally in case of stroke. To determine the content of such a campaign, we assessed the stroke knowledge in our population.

Methods

The stroke knowledge was studied by means of a closed-ended questionnaire. 422 randomly chosen inhabitants of Bern, Switzerland, were interviewed.

Results

The knowledge of stroke warning signs (WS) was classified as good in 64.7%. A good knowledge of stroke risk factors (RF) was noted in 6.4%. 4.2% knew both the WS and the RF of stroke indicating a very good global knowledge of stroke. Only 8.3% recognized TIA as symptoms of stroke resolving within 24 hours, and only 2.8% identified TIA as a disease requiring immediate medical help. In multivariate analysis being a woman, advancing age, and having an afflicted relative were associated with a good knowledge of WS (p = 0.048, p < 0.001 and p = 0.043). Good knowledge of RF was related to university education (p < 0.001). The good knowledge of TIA did not depend on age, sex, level of education or having an afflicted relative.

Conclusions

The study brings to light relevant deficits of stroke knowledge in our population. A small number of participants could recognize TIA as stroke related symptoms resolving completely within 24 hours. Only a third of the surveyed persons would seek immediate medical help in case of TIA. The information obtained will be used in the development of future educational campaigns.

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Acknowledgements

The authors thank all the volunteers who helped to survey the kind people of Bern and its surroundings. This study was supported by a grant of the Stroke Division of the Swiss Heart Foundation.

Conflict of Interest: None declared.

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Authors and Affiliations

  1. Department of Neurology, Inselspital, University of Bern, Freiburgstrasse 10, 3010, Bern, Switzerland

    Krassen Nedeltchev, Urs Fischer, Marcel Arnold, Liliane Kappeler & Heinrich P. Mattle MD

Authors
  1. Krassen Nedeltchev
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  2. Urs Fischer
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  3. Marcel Arnold
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  4. Liliane Kappeler
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  5. Heinrich P. Mattle MD
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Corresponding author

Correspondence to Heinrich P. Mattle MD.

Additional information

Received in revised form: 15 March 2006

Appendix

Appendix

The Bernese Survey of Public Knowledge of Stroke

  1. 1.

    Personal data: a) sex (male, female); b) age; c) highest level of education.

  2. 2.

    Which of the following diseases is of utmost importance for you? (AIDS, cancer, stroke, Alzheimer’s dementia, myocardial infarction, diabetes mellitus, depression, rheumatoid arthritis, lung diseases)

  3. 3.

    Have you ever heard about stroke? If yes, quote one of the following sources of information: periodicals, television, radio, lecture, family physician, internet, other.

  4. 4.

    Where is the disease located? (brain, arm and leg, heart, skull, spinal cord)

  5. 5.

    Have you ever heard about “transient ischemic attack (TIA)”? If yes, please specify what does TIA mean: (a heart disease, mild stroke, symptoms of stroke that recover completely within 24 hours.

  6. 6.

    Have you ever heard the term “Streifung”? If yes, what would you use the term Streifung to refer to? (mild stroke, TIA, stroke of whatever severity)

  7. 7.

    I will mention a number of symptoms. Do you know which of them are manifestations or symptoms of stroke (loss of strength or numbness of one half of the body and/or of the face, difficulties in speaking or understanding, sudden unconsciousness, high blood pressure, chest pain, sudden and severe headache, sudden loss of vision, gait disturbances, epileptic seizures).

  8. 8.

    Is stroke in your opinion a severe or a harmless disease?

  9. 9.

    Is stroke in your opinion a treatable disease? If yes, where, respectively who should treat it? (family physician, every hospital, specialized stroke center)

  10. 10.

    How long can be waited until thrombolysis, i.e. clot-busting therapy? (3 weeks, 48 hours, 24 hours, 3 hours)

  11. 11.

    I will mention a number of health care providers, which can be called in the event of symptoms suggesting stroke. Which one would you contact? (family physician, EMS, the nearest hospital, the nearest specialized hospital, I would wait symptoms disappear spontaneously)

  12. 12.

    What would you do if you were confident that the symptoms will disappear spontaneously within 24 hours? ( go to your family physician, call EMS, go to the nearest hospital, the nearest specialized hospital, take no further action)

  13. 13.

    Which one of the following health care providers would you call in the event of symptoms or signs of stroke, if you knew that symptoms will disappear spontaneously within the next 24 hours? (family physician, EMS, the nearest hospital, the nearest specialized hospital, I would wait symptoms to disappear spontaneously).

  14. 14.

    I will mention some diseases and medical conditions. Could you tell me which ones predispose an individual to suffer a stroke, i.e. are risk factors of stroke (high and/or low blood pressure, tobacco, alcohol, low physical activity, overweight, myocardial infarction, cardiac arrhythmia, diabetes mellitus, epilepsy).

  15. 15.

    Is it possible to modify or even to reduce the risk of stroke? If yes, how? (control of overweight, blood pressure, physical activity, healthy nutrition, smoking cessation).

  16. 16.

    Has any of your relatives or acquaintances ever suffered a stroke?

  17. 17.

    Would you like to receive further information on stroke?

  18. 18.

    Remarks.

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Nedeltchev, K., Fischer, U., Arnold, M. et al. Low awareness of transient ischemic attacks and risk factors of stroke in a Swiss urban community. J Neurol 254, 179–184 (2007). https://doi.org/10.1007/s00415-006-0313-x

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