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G. Nepal1, P. Chand1, K. Poudel1
1Kathmandu University School of Medical Sciences, Department of Physiotherapy, Dhulikhel, Nepal
Background: More than 50% of patients with stroke have hypertension, a common risk factor for stroke. Although hypertension is a modifiable risk factor which can be managed with medications, very few patients seek treatment for hypertension in Nepal with a data suggesting 90% of diagnosed hypertension being not treated. It is not clear why patients do not seek treatment for hypertension, but a possible reason might be due to the lack of knowledge on stroke and its potential causes.
Purpose: The primary objective of the study was to assess the knowledge of stroke in a group of patients with hypertension in suburban Nepal. Identification of the knowledge of warning signs of stroke and its risk factors were the secondary objectives of this study.
Methods: We conducted a cross-sectional study from May 2019 to September 2019. Patients visiting a tertiary care hospital in Nepal were approached to participate. Patients were screened at the cardiovascular unit and were included in the study if they had hypertension, were aged 18 years and over, were not health professionals and were not pregnant. We used the ‘Awareness of Stroke, Risk Factors, and Treatment’ questionnaire to assess the knowledge of stroke. The questionnaire consists of 18 questions, and tested knowledge on general information, risk factors, warning signs, treatment options and interest in knowing more about stroke. Prior to use of questionnaire, we translated the questionnaire to Nepali according to recommended guidelines for translation and cross-cultural adaptation. Descriptive statistics were used to analyse the results.
Results: Of 309 patients who were approached, 273 patients (55% male and 45% female) agreed to participate in the study. Mean age of patients was 56 years (SD 13; Range 22 to 86 years). Almost half of patients (48%) were uneducated. Knowledge of stroke was poor, with only 25% of patients identifying the brain as an organ affected by stroke, 64% reporting that they were unaware of treatment options for stroke and 5% opting to control blood pressure as part of stroke management. Although more than half of patients (60%) were aware that hypertension was a risk factor for stroke, only a third (31%) reported that their doctors had educated them on it. It was however encouraging that most patients (84%) wanted to know more about stroke and its management.
Conclusion(s): There are significant knowledge gaps regarding stroke in patients with hypertension in suburban Nepal. Although most patients recognised hypertension as a risk factor for stroke, most were unaware of treatment options and thus, few actively sought treatment for hypertension. Increasing awareness of stroke, causes and treatment options may help to improve uptake of treatments for patients with hypertension in Nepal.
Implications: To prevent/reduce occurrence of strokes, we may need to consider addressing knowledge gaps in patients with hypertension. Identifying the knowledge gaps is a first step to developing targeted interventions for the prevention and management of stroke. Future studies may also explore the barriers faced by doctors in recommending treatments for hypertension in this group of patients who are at high risk of stroke.
Funding, acknowledgements: None
Keywords: Hypertension, Knowledge, Stroke
Topic: Non-communicable diseases (NCDs) & risk factors
Did this work require ethics approval? Yes
Institution: Kathmandu University
Committee: Institutional Review Committee of Kathmandu University School of Medical Sciences
Ethics number: 149/19
All authors, affiliations and abstracts have been published as submitted.
