Effect of a comprehensive health education program on pre-hospital delay intentions in high-risk stroke population and caregivers
- 570 Downloads
Many factors influence pre-hospital delays in the event of stroke. This study aimed to develop and evaluate a comprehensive educational program for decreasing pre-hospital delays in high-risk stroke population.
We enrolled 220 high-risk stroke population and caregivers from six urban communities in Harbin from May 2013 to May 2015, and randomly divided them into intervention and control groups. We implemented a comprehensive educational program (intervention group), comprising public lectures, instructional brochures, case videos, simulations, and role-playing from May 2013 to May 2015. We delivered conventional oral education in the control group. We compared stroke pre-hospital delay behavioral intention (SPDBI), pre-hospital stroke symptom coping test (PSSCT), and stroke pre-symptoms alert test (SPSAT) results between the groups before and 6, 12, and 18 months after health intervention.
There were significant differences between before and after intervention (P < 0.01). SPDBI, PSSCT, and SPSAT scores were significantly different between the groups (P < 0.01). The interaction between time and intervention method was significant (P < 0.01). According to multivariate repeated measures analysis of variance, SPDBI, PSSCT, and SPSAT scores were significantly different at each time after intervention (P < 0.05).
The comprehensive educational program was significantly effective in decreasing SPDBI, improving knowledge, enhancing stroke pre-symptoms alert, and reducing the possibility of pre-hospital delays.
KeywordsStroke High-risk stroke population Pre-hospital delay Health education
The co-authors would like to thank all community service personnel who helped with the study, and the participants of the study. We also thank Jiangping Ma who give us lots of help in revising the article about statistical analysis. Moreover, the National Natural Science Foundation of China (No. 81273194) funded this project.
This project was supported by the National Natural Science Foundation of China (No. 81273194).
Compliance with ethical standards
Conflict of interest
The authors declare that they have no competing interests.
- 1.WHO. (2004). WHO publishes definitive atlas on global heart disease and stroke epidemic. Indian Journal of Medical Sciences, 58(9), 405–406.Google Scholar
- 3.Feigin, V. L., Forouzanfar, M. H., Krishnamurthi, R., Mensah, G. A., Connor, M., Bennett, D. A., Moran, A. E., Sacco, R. L., Anderson, L., Truelsen, T., et al. (2014). Global and regional burden of stroke during 1990–2010: Findings from the global burden of disease study 2010. Lancet, 383(9913), 245–254.CrossRefPubMedPubMedCentralGoogle Scholar
- 5.Effect of intravenous recombinant tissue plasminogen activator on ischemic stroke lesion size measured by computed tomography (2000). NINDS; The National Institute of Neurological Disorders and Stroke (NINDS) rt-PA Stroke Study Group. Stroke; A Journal of Cerebral Circulation, 31(12), 2912–2919.Google Scholar
- 16.DeLemos, C. D., Atkinson, R. P., Croopnick, S. L., Wentworth, D. A., & Akins, P. T. (2003). How effective are “community” stroke screening programs at improving stroke knowledge and prevention practices? Results of a 3-month follow-up study. Stroke; A Journal of Cerebral Circulation, 34(12), e247–e249.CrossRefGoogle Scholar
- 21.Zhao, Q., Yang, L., Zuo, Q., Zhu, X., Zhang, X., Wu, Y., Yang, L., Gao, W., & Li, M. (2014). Instrument development and validation of the stroke pre-hospital delay behavior intention scale in a Chinese urban population. Health Qual Life Outcomes, 12(1), 70.Google Scholar
- 23.Zhang Xiao, Z. Q., Zuo Qingqing, C. S., Ma Jiangping, L. S., & Yanqiu, W. (2015). The development, valitidy and reliability of Stroke Premonitory Symptoms Alert Questionnaire. Chinese Nursing Management, 15(4), 416–419.Google Scholar
- 25.Mullen, C. K., Juhl, M. J., Gonzales, N. R., Maddox, K. E., Pary, J. K., Brown, D. L., Moye, L. A., Espinosa, N., Grotta, J. C., & Morgenstern, L. B. (2010). Kids Identifying and Defeating Stroke (KIDS): development and implementation of a multiethnic health education intervention to increase stroke awareness among middle school students and their parents. Health Promotion Practice, 11(1), 95–103.CrossRefGoogle Scholar
- 26.Lundelin, K., Graciani, A., Garcia-Puig, J., Guallar-Castillon, P., Taboada, J. M., Rodriguez-Artalejo, F., & Banegas, J. R. (2012). Knowledge of stroke warning symptoms and intended action in response to stroke in Spain: A nationwide population-based study. Cerebrovascular diseases (Basel, Switzerland), 34(2), 161–168.CrossRefGoogle Scholar
- 28.Ebinger, M., Rozanski, M., Waldschmidt, C., Weber, J., Wendt, M., Winter, B., Kellner, P., Baumann, A. M., Malzahn, U., Heuschmann, P. U., et al. (2012). PHANTOM-S: The prehospital acute neurological therapy and optimization of medical care in stroke patients—study. International Journal of Stroke, 7(4), 348–353.CrossRefPubMedGoogle Scholar
- 29.Baldereschi, M., Piccardi, B., Di, C. A., Lucente, G., Guidetti, D., Consoli, D., Provinciali, L., Toni, D., Sacchetti, M. L., Polizzi, B. M., et al. (2012). Relevance of prehospital stroke code activation for acute treatment measures in stroke care: A review. Cerebrovascular Diseases (Basel, Switzerland), 34(3), 182–190.CrossRefGoogle Scholar
- 30.Komolafe, M. A., Obembe, A. O., Olaogun, M. O., Adebiyi, A. M., Ugalahi, T., Dada, O., Kanu, A., Adebiyi, O. C., Akilo, F., Ogunkoya, B., et al. (2015). Awareness of stroke risk factors and warning signs in Nigerian adolescents compared with adults. Journal of Stroke and Cerebrovascular Diseases, 24(3), 687–693.CrossRefPubMedGoogle Scholar
- 32.Hickey, A., O’Hanlon, A., McGee, H., Donnellan, C., Shelley, E., Horgan, F., & O’Neill, D. (2009). Stroke awareness in the general population: Knowledge of stroke risk factors and warning signs in older adults. BMC Geriatrics, 9(1), 35.Google Scholar
- 33.Falavigna, A., Teles, A. R., Vedana, V. M., Kleber, F. D., Mosena, G., Velho, M. C., Mazzocchin, T., Silva, R. C., Lucena, L. F., Santin, J. T., et al. (2009). Awareness of stroke risk factors and warning signs in southern Brazil. Arquivos de Neuro-Psiquiatria, 67(4), 1076–1081.CrossRefPubMedGoogle Scholar
- 34.Gutierrez-Jimenez, E., Gongora-Rivera, F., Martinez, H. R., Escamilla-Garza, J. M., & Villarreal, H. J. (2011). Knowledge of ischemic stroke risk factors and warning signs after a health education program by medical students. Stroke; A Journal of Cerebral Circulation, 42(4), 897–901.CrossRefGoogle Scholar