Knowledge of Stroke Warning Symptoms and Risk Factors: Variations by Rural and Urban Categories

Abstract

Stroke continues to have a devastating disabling effect on Americans while remaining the third leading cause of death in the United States. Most Americans do not recognize the symptoms of stroke causing delay in receiving emergency treatment.

The purpose of this research was to assess the knowledge of stroke symptoms and risk factors in a general public Midwest sample. Secondarily, similarities and differences in stroke knowledge between rural and urban groups were identified. The self administered Stroke Recognition Questionnaire (SRQ) directed at stroke knowledge assessment was developed.

This descriptive, correlational study used a non-experimental quantitative design. An East Central Illinois community-based sample of 400 rural and 400 urban residents was randomly selected from telephone directories and stratified by residence zip code. Dillman's (2000) Tailored Design Method for mail surveys was implemented. Response rate for this mail survey was 566 (70.5%) returned completed questionnaires. The final sample consisted of 328 (58%) males and 236 (42%) females, ranged in age from 20 to 97 years, and was evenly split at 283 (50%) rural and urban respondents.

The stroke symptom knowledge in this sample is better than that reported in other studies, while the knowledge of stroke risk factors is somewhat better or comparable to the findings in those same studies. The stroke symptom subscale revealed higher scores for rural respondents and those less than 64 years of age. The most frequently identified stroke symptoms were slurred or garbled speech, numbness of one side of face, weakness of one side of body, and confusion. Women were more likely to recognize symptoms of confusion and double vision. The stroke symptoms least often identified were double vision and sudden severe headache.

The stroke risk factor knowledge subscale revealed no significant differences in recognition by residence location and gender. Younger respondents more often recognized high blood pressure, smoking cigarettes, diabetes and alcohol use. The most frequently identified stroke risk factors were high blood pressure, high blood cholesterol, smoking cigarettes, and more than 20 pounds overweight. The stroke risk factors least often identified were alcohol use, irregular heartbeat, diabetes, and history of having had a heart attack.