Stroke Knowledge and Health Anxiety among Stroke Patients in A Rehabilitation Clinic, Tertiary Hospital
DOI:
https://doi.org/10.31674/mjn.2024.v15i03.014Abstract
Background: Stroke generally results in life-altering changes, and the significance of stroke knowledge and health anxiety has become a global priority. Aim: This study aims to determine the level of stroke knowledge and health anxiety among stroke patients in the rehabilitation clinic at the University Malaya Medical Centre and to determine the association of stroke knowledge and health anxiety with socio-demographic data. Methods: This study employed cross-sectional surveys conducted using a convenience sampling technique. The data was gathered from April to October 2021, and approximately 150 stroke patients were required to respond to a set of validated questionnaires (the Stroke Knowledge Test and the Health Anxiety). The data were analyzed with descriptive and inferential statistics. Results: The finding shows that on average, the age of respondents was 51 years (SD=13.12), and the majority of them were male (n=83, 55.3%), married (n=130, 86.7%), had a secondary level of education (n=81, 54.0%) and categorized under B40 (n=89, 59.3%). Most of them reported having good stroke knowledge (n=103, 68.7%), and experienced anxiety (mean=29.96, SD=8.72). There was no association between stroke knowledge and socio-demographic data (p > 0.05). For the health anxiety, age, marital status, and education level were found to be associated with the anxiety (p<0.05). Those who aged less than 30 years experienced more anxiety as compared to the seniors’ group (r=-0.607, p<0.001). Furthermore, married respondents showed lower levels of anxiety than single respondents [t (148) = 0.266, p = 0.009]. Patients who had a high level of education were more anxious than those who had a primary level of education [F (2,147) = 16.03, p<0.001]. Conclusion: The organizations should provide ongoing awareness and psychological support to promote the patients and their family members. Nurses, who spend the most time with patients, are expected to reinforce the stroke education program and communicate with the patient's family to minimize their anxiety level.
Keywords:
Anxiety, Knowledge, Stroke, Patient(s)Downloads
References
Addo, J., Ayerbe, L., Mohan, K. M., Crichton, S., Sheldenkar, A., Chen, R., ... & McKevitt, C. (2012). Socioeconomic status and stroke: an updated review. Stroke, 43(4), 1186-1191. https://doi.org/10.1161/STROKEAHA.111.639732
Ahmad, S. A., Supandiman, I., Markam, S., Estiasari, R., & Hankey, G. (2018). The effect of caregiver education program on functional independence and Mortality in first-ever stroke. Malaysian Journal of Medical Research (MJMR), 2(2), 57-67. https://doi.org/10.31674/mjmr.2018.v02i02.00
Andersen, K. K., & Olsen, T. S. (2018). Married, unmarried, divorced, and widowed and the risk of stroke. Acta Neurologica Scandinavica, 138(1), 41-46. https://doi.org/10.1111/ane.12914
Ayasrah, S. M., Ahmad, M. M., & Basheti, I. A. (2018). Post-stroke depression in Jordan: prevalence correlates and predictors. Journal of Stroke and Cerebrovascular Diseases, 27(5), 1134-1142. https://doi.org/10.1016/j.jstrokecerebrovasdis.2017.11.027
Bartlo, P., Irion, G., & Voorhees, J. (2020). Assessment of the knowledge level regarding cardiovascular disease risk factors: comparison across age groups. Journal of Community Health, 45, 1030-1037. https://doi.org/10.1007/s10900-020-00824-w
Bašić Kes, V., Jurašić, M. J., Zavoreo, I., Lisak, M., Jeleč, V., & Zadro Matovina, L. (2016). Age and gender differences in acute stroke hospital patients. Acta Clinica Croatica, 55(1), 69-77. https://doi.org/10.20471/acc.2016.55.01.11
Beauchamp, J. E. S., Montiel, T. C., Cai, C., Tallavajhula, S., Hinojosa, E., Okpala, M. N., ... & Sharrief, A. Z. (2020). A retrospective study to identify novel factors associated with post-stroke anxiety. Journal of Stroke and Cerebrovascular Diseases, 29(2), 104582. https://doi.org/10.1016/j.jstrokecerebrovasdis.2019.104582
Broomfield, N. M., Quinn, T. J., Abdul-Rahim, A. H., Walters, M. R., & Evans, J. J. (2014). Depression and anxiety symptoms post-stroke/TIA: prevalence and associations in cross-sectional data from a regional stroke registry. BMC Neurology, 14, 1-9. https://doi.org/10.1186/s12883-014-0198-8
Bushnell, C. D., Chaturvedi, S., Gage, K. R., Herson, P. S., Hurn, P. D., Jimenez, M. C., ... & Rundek, T. (2018). Sex differences in stroke: challenges and opportunities. Journal of Cerebral Blood Flow & Metabolism, 38(12), 2179-2191. https://doi.org/10.1177/0271678X18793324
Centers for Disease Control and Prevention [CDC]. (2022, November 2). About Stroke. https://www.cdc.gov/stroke/about.htm#:~:text=A%20stroke%2C%20sometimes%20call%20a,artery%20or%20a%20ruptured%20artery.&text=A%20stroke%2C%20sometimes%20called%20a,vessel%20in%20the%20brain%20bursts, Accessed on 22nd February, 2023
Chun, H. Y. Y., Whiteley, W. N., Dennis, M. S., Mead, G. E., & Carson, A. J. (2018). Anxiety after stroke: the importance of subtyping. Stroke, 49(3), 556-564. https://doi.org/10.1161/STROKEAHA.117.020078
Das, S., Hazra, A., Ray, B. K., Ghosal, M., Banerjee, T. K., Roy, T., ... & Das, S. K. (2010). Burden among stroke caregivers: results of a community-based study from Kolkata, India. Stroke, 41(12), 2965-2968. https://doi.org/10.1161/STROKEAHA.110.589598
Johnson, W., Onuma, O., Owolabi, M., & Sachdev, S. (2016). Stroke: a global response is needed. Bulletin of the World Health Organization, 94(9), 634. https://doi.org/10.2471/BLT.16.181636
Jones, M. P., Howitt, S. C., Jusabani, A., Gray, W. K., Aris, E., Mugusi, F., ... & Walker, R. W. (2012). Anxiety and depression in incident stroke survivors and their carers in rural Tanzania: a case-control follow-up study over five years. Neurology, Psychiatry and Brain Research, 18(3), 122-128. https://doi.org/10.1016/j.npbr.2012.01.003
Karakus, K., Kunt, R., Memis, C. O., Kunt, D. A., Dogan, B., Ozdemiroglu, F., & Sevincok, L. (2017). The factors related to early‐onset depression after first stroke. Psychogeriatrics, 17(6), 414-422. https://doi.org/10.1111/psyg.12266
Knapp, P., Burton, C. A. C., Holmes, J., Murray, J., Gillespie, D., Lightbody, C. E., ... & Lewis, S. R. (2017). Interventions for treating anxiety after stroke. Cochrane Database of Systematic Reviews, (5). https://doi.org/10.1002/14651858.CD008860.pub3.www.cochranelibrary.com
Krzystanek, E., Krzak-Kubica, A., Świat, M., Galus, W., & Gawryluk, J. (2020). Adequate knowledge of stroke symptoms, risk factors, and necessary actions in the general population of Southern Poland. Brain Sciences, 10(12), 1009. https://doi.org/10.3390/brainsci10121009
Liang, C., Van Laar Veth, A. J., Li, Q., Zheng, D., & Hackett, M. L. (2022). Effect of mood on long-term disability in younger stroke survivors: results from the Psychosocial Outcomes In StrokE (POISE) study. Topics in Stroke Rehabilitation, 29(4), 286-294. https://doi.org/10.1080/10749357.2021.1922802
Maalouf, E., Hallit, S., Salameh, P., & Hosseini, H. (2023). Depression, anxiety, insomnia, stress, and the way of coping emotions as risk factors for ischemic stroke and their influence on stroke severity: A case–control study in Lebanon. Frontiers in Psychiatry, 14, 1097873. https://doi.org/10.3389/fpsyt.2023.1097873
Menlove, L., Crayton, E., Kneebone, I., Allen-Crooks, R., Otto, E., & Harder, H. (2015). Predictors of anxiety after stroke: a systematic review of observational studies. Journal of Stroke and Cerebrovascular Diseases, 24(6), 1107-1117. https://doi.org/10.1016/j.jstrokecerebrovasdis.2014.12.036
Mohammed, M., Zainal, H., Tangiisuran, B., Harun, S. N., Ghadzi, S. M., Looi, I., ... & Aziz, Z. A. (2020). Impact of adherence to key performance indicators on mortality among patients managed for ischemic stroke. Pharmacy Practice (Granada), 18(1). https://doi.org/10.18549/PharmPract.2020.1.1760
Morris, J. H., Van Wijck, F., Joice, S., & Donaghy, M. (2013). Predicting health related quality of life 6 months after stroke: the role of anxiety and upper limb dysfunction. Disability and Rehabilitation, 35(4), 291-299. https://doi.org/10.3109/09638288.2012.691942
Murphy, S. J., & Werring, D. J. (2020). Stroke: causes and clinical features. Medicine, 48(9), 561-566. https://doi.org/10.1016/j.mpmed.2020.06.002
Pandian, J. D., Felix, C., Kaur, P., Sharma, D., Julia, L., Toor, G., ... & Lindley, R. (2015). Family-led rehabilitation after stroke in India: the ATTEND pilot study. International Journal of Stroke, 10(4), 609-614. https://doi.org/10.1111/ijs.12475
Patel, A., Fang, J., Gillespie, C., Odom, E., King, S. C., Luncheon, C., & Ayala, C. (2019). Peer Reviewed: Awareness of Stroke Signs and Symptoms and Calling 9-1-1 Among US Adults: National Health Interview Survey, 2009 and 2014. Preventing Chronic Disease, 16. https://doi.org/10.5888/pcd16.180564
Pratiwi, S. H., Sari, E. A., & Hernawaty, T. (2017). Level of anxiety and depression in post-stroke patients at DR. Hasan Sadikin Hospital Bandung. Jurnal Pendidikan Keperawatan Indonesia, 3(2), 139-144. https://doi.org/10.17509/jpki.v3i2.9419
Rafsten, L., Danielsson, A., & Sunnerhagen, K. S. (2018). Anxiety after stroke: a systematic review and meta-analysis. Journal of Rehabilitation Medicine, 50(9), 769-778. https://doi.org/10.2340/16501977-2384
Rohmah, A. I. N., Muslimah, M., Ruhyanudin, F., & Arfianto, M. A. (2023). Factors Affecting Coping Strategies in Post-Stroke Patients: A Literature Study. KnE Medicine, 246-258. https://doi.org/10.18502/kme.v3i3.13511
Ramos-Lima, M. J. M., Brasileiro, I. D. C., Lima, T. L. D., & Braga-Neto, P. (2018). Quality of life after stroke: impact of clinical and sociodemographic factors. Clinics, 73. https://doi.org/10.6061/clinics/2017/e418
Rosmary, M. T., & Handayani, F. (2020). The Relationship between Family Knowledge and Family Behavior in Handling Early Onset of Stroke. Holistic Nursing and Health Science, 3(1), 32-39. https://doi.org/10.14710/hnhs.3.1.2020.32-39
Salkovskis, P. M., Rimes, K. A., Warwick, H. M. C., & Clark, D. (2002). The Health Anxiety Inventory: development and validation of scales for the measurement of health anxiety and hypochondriasis. Psychological Medicine, 32(5), 843-853. https://doi.org/10.1017/S0033291702005822
Sebestova, M., Lackner, I., Inayat, M., Ademaj, A., & Mikutta, C. (2021). Post stroke depression. Ther. Umschau78, 299-304. https://doi.org/10.1024/0040-5930/a001274
Soto-Cámara, R., González-Bernal, J. J., González-Santos, J., Aguilar-Parra, J. M., Trigueros, R., & López-Liria, R. (2020). Age-related risk factors at the first stroke event. Journal of Clinical Medicine, 9(7), 2233. https://doi.org/10.3390/jcm9072233
Sowtali, S. N. (2017). Trending in Multidisciplinary Research for Stroke Disease Management. https://doi.org/10.23880/nhij-16000125
Sowtali, S. N., Yusoff, D. M., Harith, S., & Mohamed, M. (2016). Translation and validation of the Malay version of the Stroke Knowledge Test. Journal of Arrhythmia, 32(2), 112-118. https://doi.org/10.1016/j.joa.2015.10.003
Sullivan, K., & Dunton, N. J. (2004). Development and validation of the stroke knowledge test. Topics in Stroke Rehabilitation, 11(3), 19-28. https://doi.org/10.1310/RED5-V47T-8MJN-JY9H
Tan, K. S., & Venketasubramanian, N. (2022). Stroke burden in Malaysia. Cerebrovascular Diseases Extra, 12(2), 58-62. https://doi.org/10.1159/000524271
Tang, W. K., Lau, C. G., Mok, V., Ungvari, G. S., & Wong, K. S. (2013). Impact of anxiety on health-related quality of life after stroke: a cross-sectional study. Archives of Physical Medicine and Rehabilitation, 94(12), 2535-2541. https://doi.org/10.1016/j.apmr.2013.07.012
Uy, H. O. (2023). Availability and Burden of Family Caregivers in Caring for a Recurrent Stroke Survivor in the Community During a Pandemic. The Malaysian Journal of Nursing (MJN), 14(3), 76-85. https://doi.org/10.31674/mjn.2023.v14i03.009
Wang, M. D., Wang, Y., Mao, L., Xia, Y. P., He, Q. W., Lu, Z. X., ... & Hu, B. (2018). Acute stroke patients’ knowledge of stroke at discharge in China: a cross‐sectional study. Tropical Medicine & International Health, 23(11), 1200-1206. https://doi.org/10.1111/tmi.13148
Widjaja, K. K., Chulavatnatol, S., Suansanae, T., Wibowo, Y. I., Sani, A. F., Islamiyah, W. R., & Nathisuwan, S. (2021). Knowledge of stroke and medication adherence among patients with recurrent stroke or transient ischemic attack in Indonesia: a multi-center, cross-sectional study. International Journal of Clinical Pharmacy, 43, 666-672. https://doi.org/10.1007/s11096-020-01178-y
Wilhelm, L. O., Gellert, P., White, M., Araujo-Soares, V., Ford, G. A., Mackintosh, J. E., ... & Dombrowski, S. U. (2020). The Recognition-response gap in acute stroke: examining the relationship between stroke recognition and response in a general population survey. Journal of Stroke and Cerebrovascular Diseases, 29(2), 104499. https://doi.org/10.1016/j.jstrokecerebrovasdis.2019.104499
Wright, F., Wu, S., Chun, H. Y. Y., & Mead, G. (2017). Factors associated with poststroke anxiety: a systematic review and meta-analysis. Stroke Research and Treatment, 2017. https://doi.org/10.1155/2017/2124743
Xiao, M., Huang, G., Feng, L., Luan, X., Wang, Q., Ren, W., ... & He, J. (2020). Impact of sleep quality on post‐stroke anxiety in stroke patients. Brain and Behavior, 10(12), e01716. https://doi.org/10.1002/brb3.1716
Xiuyun, W., Qian, W., Minjun, X., Weidong, L., & Lizhen, L. (2020). Education and stroke: evidence from epidemiology and Mendelian randomization study. Scientific Reports, 10(1), 21208. https://doi.org/10.1038/s41598-020-78248-8
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 The Malaysian Journal of Nursing (MJN)
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.