Knowledge, Attitude and Practice of Primary Care Physicians in Dealing with Acute Stroke in Indonesia
Abstract
Objective: There are still many things that interfere with the practice of effective acute stroke management, with one of them being the failure of health workers providing appropriate management. Hence, this study was conducted to evaluate the level of knowledge, attitude and practices of primary care physicians (PCPs) in acute stroke management in Indonesia.
Material and Methods: This cross-sectional face-to-face survey was conducted among all PCPs, from 63 primary health care centres; from October, 2019 to January, 2020 in Surabaya, Indonesia. A self-designed questionnaire, consisting of 25 questions, based on several guidelines, was used as the instrument of this survey.
Results: In total, 134 PCPs participated. The majority of their level of knowledge obtained was in the moderate category (51.5%), while the majority of their attitude and practices towards stroke were in the good category (67.9% and 75.2%). Nearly 75.0% of PCPs also knew about thrombolytic therapy, but only <50.0% knew the ‘golden period’ of thrombolytic therapy. A significant correlation was found between PCPs knowledge-attitude (p-value<0.001), knowledge-practices (p-value=0.002) and attitude-practices (p-value<0.001). There was also a significant difference in the level of stroke knowledge between PCPs, with different clinical practice experience (p-value=0.015). Better stroke knowledge tended to be obtained by PCPs with younger clinical practice experience.
Conclusion: The level of knowledge, attitude and practices of PCPs in acute stroke management in Indonesia is good, but should still be improved; especially knowledge about the use of thrombolytic therapy and its ‘golden period.’
Keywords
Full Text:
PDFReferences
Pandian JD, Jaison A, Deepak SS, Kalra G, Shamsher S, Lincoln DJ, et al. Public awareness of warning symptoms, risk factors, and treatment of stroke in Northwest India. Stroke 2005;36: 644-8.
Pontes-Neto OM, Silva GS, Feitosa MR, de Figueiredo NL, Fiorot JA, Rocha TN, et al. Stroke awareness in Brazil. Stroke 2008;39:292-6.
Thrift AG, Thayabaranathan T, Howard G, Howard VJ, Rothwell PM, Feigin VL, et al. Global stroke statistics. Int J Stroke 2016;12: 13-32.
Venketasubramanian N, Yoon BW, Pandian JD, Navarro JC. Stroke epidemiology in South, East, and South-East Asia: a review. J Stroke 2018;20:142
Johnson W, Onuma O, Owolabi M, Sachdev S. Stroke: a global response is needed. Bulletin of the World Health Organization 2016;94:634-634A.
Ministry of Health, Indonesia. Basic Health Reseaech (Riskesdas) in Indonesia 2018. Jakarta: Ministry of Health, Indonesia; 2018.
Ministry of Health, Indonesia. Basic Health Reseaech (Riskesdas) in Indonesia 2007. Jakarta: Ministry of Health, Indonesia; 2007.
Schwamm LH, Pancioli A, Acker JE, Goldstein LB, Zorowitz RD, Shephard TJ, et al. Recommendations for the establishment of stroke systems of care. Stroke 2005;36:690-703.
Baatiema L, de-Graft Aikins A, Sav A, Mnatzaganian G, Chan CKY, Somerset S. Barriers to evidence-based acute stroke care in Ghana: a qualitative study on the perspectives of stroke care professionals. BMJ Open 2017;7:e015385.
Mellon L, Hasan H, Lee S, Williams D, Hickey A. Knowledge of thrombolytic therapy amongst hospital staff. Stroke 2015; 46:3551-3.
Ministry of Health, Indonesia. Indonesian clinical practice guidelines for doctors in the first level health service facilities 2015. Jakarta: Ministry of Health, Indonesia; 2015.
Powers WJ, Rabinstein AA, Ackerson T, Adeoye OM, Bambakidis NC, Becker K, et al. 2018 guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/ American Stroke Association. Stroke 2018;49:e46-99.
Bustamante A, López-Cancio E, Pich S, Penalba A, Giralt D, García-Berrocoso T, et al. Blood biomarkers for the early diagnosis of stroke. Stroke 2017;48:2419-25.
Akinyemi RO, Ogah OS, Ogundipe RF, Oyesola OA, Oyadoke AA, Ogunlana MO, et al. Knowledge and perception of stroke amongst hospital workers in an African community. Eur J Neurol 2009;16:998-1003.
Madae’en SS, Bulatova NR, Al-Qhewii TA, Sakran LH, El-Zayyat HH, Kamar MKA, et al. Stroke awareness in the general population: a study from Jordan. Trop J Pharm Res 2013;12: 1071-6.
Müller-Nordhorn J, Nolte CH, Rossnagel K, Jungehülsing GJ, Reich A, Roll S, et al. Knowledge about risk factors for stroke. Stroke 2006;37:946-50.
Saengsuwan J, Suangpho P, Tiamkao S. Knowledge of stroke risk factors and warning signs in patients with recurrent stroke or recurrent transient ischaemic attack in Thailand. Neurol Res Int 2017. doi: 10.1155/2017/8215726.
Yang J, Zhang J, Ou S, Wang N, Wang J. Knowledge of Community general practitioners and nurses on pre-hospital Stroke Prevention and Treatment in Chongqing, China. PLoS One 2015;10. doi: 10.1371/journal.pone.0138476.
Adelman EE, Meurer WJ, Nance DK, Kocan MJ, Maddox KE, Morgenstern LB, et al. Stroke awareness among inpatient nursing staff at an academic medical center. Stroke 2014;45: 271-3.
Kim YS, Park SS, Bae HJ, Heo JH, Kwon SU, Lee BC, et al. Public awareness of stroke in Korea. Stroke 2012;43:1146-9.
Roebers S, Wagner M, Ritter MA, Dornbach F, Wahle K, Heuschmann PU. Attitude and current practice of primary care Physicians in Acute Stroke Management. Stroke 2007; 38:1298-303.
Adusumilli D, Syed S. Community stroke awareness: knowledge, attitude, and health-seeking behavior of adults in an urban slum of Hyderabad, India. Int J Med Sci Public Health 2018;7: 848-53.
Refbacks
- There are currently no refbacks.
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.