Knowledge of Stroke among Hypertensive Patients in Dhulikhel

Abstract

Background More than 50% of patients with stroke have hypertension, a common modifiable risk factor for stroke. Studies reported that 90% of diagnosed hypertensive patients do not seek for treatment in Nepal and the reason for this remains unexplored. There is a possibility that lack of knowledge of stroke and its potential causes may be the reason.
 Objective To assess the knowledge of stroke in a group of patients with hypertension in suburban Nepal.
 Method Hypertensive patients visiting a tertiary care hospital in Nepal were approached and were included if they were 18 years or older. We used the Nepali version of ‘Awareness of Stroke, Risk Factors, and Treatment’ questionnaire to assess the knowledge of stroke. Descriptive statistics were used to analyze the results.
 Result A total of 273 patients were included with the mean age of 56 years. Almost half (48%) of the patients were uneducated. We found that only 24% of the patients identified brain as an organ affected by stroke, only 32% were aware about more than one warning signs of stroke, 64% reported that they were unaware of the treatment options for stroke and only 5% reported control of blood pressure as a part of stroke management. The commonest reported identifiable risk factor for hypertension was high blood pressure (44%).
 Conclusion There are significant knowledge gaps regarding stroke in hypertensive patients. Although most patients recognized hypertension as a risk factor for stroke, they were unaware of treatment options. Increasing awareness of hypertension as a risk factor for stroke may help to prevent the stroke burden in Nepal.

Nurses’ practices in stroke-related dysphagia in low- and middle-income countries

“…The lack of knowledge related to silent aspiration was identified as an important factor in patient mortality (Nepal & Sherpa 2019). Knowledge of identification of OPD, specifically nurses' knowledge on OPD complications, was scored low in one study (Knight et al 2020) and moderate in two studies (Nepal & Sherpa 2019;Rhoda & Pickel-Voight 2015).…”

“…Informal swallowing assessments such as observation were performed in four studies, to identify symptoms of OPD following acute stroke (Knight et (Pierpoint & Pillay 2020). In three studies relating to OPD identification, nurses recognised coughing as an indication of dysphagia and possible aspiration; however, they were unaware of and did not record the risk for silent aspiration (Knight et al 2020;Nepal & Sherpa 2019;Rhoda & Pickel-Voight 2015). The lack of knowledge related to silent aspiration was identified as an important factor in patient mortality (Nepal & Sherpa 2019).…”

“…In three studies relating to OPD identification, nurses recognised coughing as an indication of dysphagia and possible aspiration; however, they were unaware of and did not record the risk for silent aspiration (Knight et al 2020;Nepal & Sherpa 2019;Rhoda & Pickel-Voight 2015). The lack of knowledge related to silent aspiration was identified as an important factor in patient mortality (Nepal & Sherpa 2019). Knowledge of identification of OPD, specifically nurses' knowledge on OPD complications, was scored low in one study (Knight et al 2020) and moderate in two studies (Nepal & Sherpa 2019;Rhoda & Pickel-Voight 2015).…”

“…Treatment of patients with stroke-related OPD was described in six studies. Knowledge regarding management of stroke-related OPD varied and was described as moderate in one study (Nepal & Sherpa 2019) and poor in another study (Rhoda & Pickel-Voight 2015). Management of patients with stroke-related OPD included the recommendation of enteral or parenteral feeds in one study (Pierpoint & Pillay 2020), use of compensatory swallowing strategies or optimal positioning during meals in two studies (Huang et al 2006;Pierpoint & Pillay 2020), rehabilitation and swallowing exercises in two studies (Huang et al 2006;Pierpoint & Pillay 2020) and appropriate referral to SLTs in two studies (Liu et al 2016;Pierpoint & Pillay 2020).…”

Hemodynamic signal changes and functional connectivity in acute stroke patients with dysphagia during volitional swallowing: a pilot study

“…Dysphagia is one of the most widespread post-stroke sequelae, with an incidence of 37-78% in stroke survivors. 1 Patients with swallowing disorders often suffer from drooling,choking and aspiration during feeding, 2 which may lead to malnutrition, aspiration pneumonia and other serious complications, and even death. [3][4][5] However, swallowing generally returns to a safe level in most patients within a few weeks.…”