Given the anticipated increase in the burden of stroke in the coming years, and the limited availability of organized stroke care services in Bangladesh, it is important to assess the awareness among caregivers and design stroke prevention strategies based on social-familial factors. Collaborative action with caregiver engagement can minimize the burden of stroke. This study was conducted based on a conceptual framework to assess the knowledge related to stroke among caregivers of stroke patients. A cross-sectional quantitative study was carried out at Shaheed Suhrawardy Medical College and Hospital, Bangladesh, from 25th April to 24th October 2016. Purposive sampling was conducted, and a sample size of 105 was obtained. Sociodemographic data from stroke patients and information related to awareness about stroke among caregivers were collected using validated forms and questionnaires. Data were analyzed using the SPSS Version 24 software. Among the caregivers, 72.5% knew that stroke is a brain disease. All respondents knew that weakness on one side is a clinical manifestation and that hypertension is a primary risk factor for stroke. Around 82% of respondents knew that bed sores are an important complication of stroke. A third of respondents knew that the optimal time for hospitalization of stroke patients is within three hours. Moreover, it was found that 88% of the respondents mentioned drugs as the most important treatment modality for stroke. The present study demonstrates reasonable knowledge among caregivers of stroke. Education provided to caregivers may reduce the risk factors for stroke and complications, which can be a low-cost and effective strategy to minimize the burden of stroke in Bangladesh.
Cite this paper
Fatema, K. and Sheikh, S. P. (2023). Awareness Regarding Stroke among the Caregivers of Stroke Survivors at a Tertiary Level Hospital in Bangladesh. Open Access Library Journal, 10, e285. doi: http://dx.doi.org/10.4236/oalib.1110285.
Donkor, E.S. (2018) Stroke in the 21st Century: A Snapshot of the Burden, Epidemiology, and Quality of Life. Stroke Research and Treatment, 2018, Article ID: 3238165. https://doi.org/10.1155/2018/3238165
Aho, K., Harmsen, P., Hatano, S., Marquardsen, J., Smirnov, V.E. and Strasser, T. (1980) Cerebrovascular Disease in the Community: Results of a WHO Collaborative study. Bulletin of the World Health Organization, 58, 113-130.
Saleheen, D., Zhao, W. and Rasheed, A. (2014) Epidemiology and Public Health Policy of Tobacco Use and Cardiovascular Disorders in Low- and Middle-Income Countries. Arteriosclerosis, Thrombosis, and Vascular Biology, 34, 1811-1819.
https://doi.org/10.1161/ATVBAHA.114.303826
Bhat, A.B., Ahmed, K.I., Sharna, R.N. and Barman, S. (2016) Knowledge, Attitude and Practice Regarding Stroke amongst the Close Relatives of Stroke Victims at a Tertiary Care Hospital in Bangladesh. International Journal of Cardiovascular and Cerebrovascular Disease, 4, 35-40. https://doi.org/10.13189/ijccd.2016.040302
Rapsomaniki, E., Timmis, A., George, J., Pujades-Rodriguez, M., Shah, A.D., Denaxas, S., White, I.R., Caulfield, M.J., Deanfield, J.E., Smeeth, L., Williams, B., et al. (2014) Blood Pressure and Incidence of Twelve Cardiovascular Diseases: Lifetime Risks, Healthy Life-Years Lost, and Age-Specific Associations in 1·25 Million People. The Lancet, 383, 1899-1911. https://doi.org/10.1016/S0140-6736(14)60685-1
Olsen, M.H., Angell, S.Y., Asma, S., Boutouyrie, P., Burger, D., Chirinos, J.A., Damasceno, A., Delles, C., Gimenez-Roqueplo, A.P., Hering, D., López-Jaramillo, P., et al. (2016) A Call to Action and a Lifecourse Strategy to Address the Global Burden of Raised Blood Pressure on Current and Future Generations: The Lancet Commission on Hypertension. The Lancet, 388, 2665-2712.
https://doi.org/10.1016/S0140-6736(16)31134-5
Mahmood, S.A., Ali, S. and Islam, R. (2013) Shifting from Infectious Diseases to Non-Communicable Diseases: A Double Burden of Diseases in Bangladesh. Journal of Public Health and Epidemiology, 5, 424-434.
Islam, M.N., Moniruzzaman, M., Khalil, M.I., Basri, R., Alam, M.K., Loo, K.W. and Gan, S.H. (2013) Burden of Stroke in Bangladesh. International Journal of Stroke, 8, 211-213. https://doi.org/10.1111/j.1747-4949.2012.00885.x
Gunarathne, A., Patel, J.V., Gammon, B., Gill, P.S., Hughes, E.A. and Lip, G.Y. (2009) Ischemic Stroke in South Asians: A Review of the Epidemiology, Pathophysiology, and Ethnicity-Related Clinical Features. Stroke, 40, e415-e423.
https://doi.org/10.1161/STROKEAHA.108.535724
Kumar, S., Selim, M.H. and Caplan, L.R. (2010) Medical Complications after Stroke. The Lancet Neurology, 9, 105-118. https://doi.org/10.1016/S1474-4422(09)70266-2
Pandian, J.D., Kaur, A., Jyotsna, R., Sylaja, P.N., Vijaya, P., Padma, M.V., Venkateswaralu, K., Sukumaran, S., Mathew, R., Kaur, P., Singh, Y.P., et al. (2012) Complications in Acute Stroke in India (CAST-I): A Multicenter Study. Journal of Stroke and Cerebrovascular Diseases, 21, 695-703.
https://doi.org/10.1016/j.jstrokecerebrovasdis.2011.03.003
Tsai, P.-C., Yip, P.-K., Tai, J.J. and Lou, M.-F. (2015) Needs of Family Caregivers of Stroke Patients: A Longitudinal Study of Caregivers’ Perspectives. Patient Preference and Adherence, 9, 449-457. https://doi.org/10.2147/PPA.S77713
Hafsteinsdóttir, T.B., Vergunst, M., Lindeman, E. and Schuurmans, M. (2011) Educational Needs of Patients with a Stroke and Their Caregivers: A Systematic Review of the Literature. Patient Education and Counseling, 85, 14-25.
https://doi.org/10.1016/j.pec.2010.07.046
Visser-Meily, A., van Heugten, C., Post, M., Schepers, V. and Lindeman, E. (2005) Intervention Studies for Caregivers of Stroke Survivors: A Critical Review. Patient Education and Counseling, 56, 257-267. https://doi.org/10.1016/j.pec.2004.02.013
Ostwald, S.K., Bernal, M.P., Cron, S.G. and Godwin, K.M. (2009) Stress Experienced by Stroke Survivors and Spousal Caregivers during the First Year after Discharge from Inpatient Rehabilitation. Topics in Stroke Rehabilitation, 16, 93-104.
https://doi.org/10.1310/tsr1602-93
Wasay, M., Khatri, I.A. and Kaul, S. (2014) Stroke in South Asian Countries. Nature Reviews Neurology, 10, 135-143. https://doi.org/10.1038/nrneurol.2014.13
Visser-Meily, A., Post, M., Gorter, J.W., Berlekom, S.B., Van Den Bos, T. and Lindeman, E. (2006) Rehabilitation of Stroke Patients Needs a Family-Centred Approach. Disability and Rehabilitation, 28, 1557-1561.
https://doi.org/10.1080/09638280600648215
Takai, M., Takahashi, M., Iwamitsu, Y., Oishi, S. and Miyaoka, H. (2011) Subjective Experiences of Family Caregivers of Patients with Dementia as Predictive Factors of Quality of Life. Psychogeriatrics, 11, 98-104.
https://doi.org/10.1111/j.1479-8301.2011.00354.x
Bakas, T., Clark, P.C., Kelly-Hayes, M., King, R.B., Lutz, B.J. and Miller, E.L. (2014) Evidence for Stroke Family Caregiver and Dyad Interventions: A Statement for Healthcare Professionals from the American Heart Association and American Stroke Association. Stroke, 45, 2836-2852.
https://doi.org/10.1161/STR.0000000000000033
Adams, A.M., Islam, R. and Ahmed, T. (2015) Who Serves the Urban Poor? A Geospatial and Descriptive Analysis of Health Services in Slum Settlements in Dhaka, Bangladesh. Health Policy and Planning, 30, i32-i45.
https://doi.org/10.1093/heapol/czu094
Islam, A. and Biswas, T. (2014) Health System in Bangladesh: Challenges and Opportunities. American Journal of Health Research, 2, 366-374.
https://doi.org/10.11648/j.ajhr.20140206.18
Venketasubramanian, N. and Mannan, M. (2021) Stroke Burden and Stroke Services in Bangladesh. Cerebrovascular Diseases Extra, 11, 69-71.
https://doi.org/10.1159/000517234
Mackenzie, A., Perry, L., Lockhart, E., Cottee, M., Cloud, G. and Mann, H. (2007) Family Carers of Stroke Survivors: Needs, Knowledge, Satisfaction and Competence in Caring. Disability and Rehabilitation, 29, 111-121.
https://doi.org/10.1080/09638280600731599
National Research Council (2010) Informal Caregivers in the United States: Prevalence, Caregiver Characteristics, and Ability to Provide Care. In: The Role of Human Factors in Home Health Care: Workshop Summary, National Academies Press (US), Washington DC.
Mou, H., Lam, S.K.K. and Chien, W.T. (2022) Effects of a Family-Focused Dyadic Psychoeducational Intervention for Stroke Survivors and Their Family Caregivers: A Pilot Study. BMC Nursing, 21, Article No. 364.
https://doi.org/10.1186/s12912-022-01145-0
Garrett-Jones, E.C., Anakor, E.A., Mamin, F.A., Fatema, U.K. and Das, S.K. (2019) The Long-Term Challenges Faced by Stroke Survivors and Their Caregivers Following a Stroke in Bangladesh: A Qualitative Study. Journal of Global Health Reports, 3, e2019053. https://doi.org/10.29392/joghr.3.e2019053
Cho, E. (2007) A Proposed Theoretical Framework Addressing the Effects of Informal Caregivers on Health-Related Outcomes of Elderly Recipients in Home Health Care. Asian Nursing Research, 1, 23-34.
https://doi.org/10.1016/S1976-1317(08)60006-7
Kothari, R., Sauerbeck, L., Jauch, E., Broderick, J., Brott, T., Khoury, J. and Liu, T. (1997) Patients’ Awareness of Stroke Signs, Symptoms, and Risk Factors. Stroke, 28, 1871-1875. https://doi.org/10.1161/01.STR.28.10.1871
Pohl, M., Hesszenberger, D., Kapus, K., Meszaros, J., Feher, A., Varadi, I., Pusch, G., Fejes, E., Tibold, A. and Feher, G. (2021) Ischemic Stroke Mimics: A Comprehensive Review. Journal of Clinical Neuroscience, 93, 174-182.
https://doi.org/10.1016/j.jocn.2021.09.025
Weltermann, B.M., Homann, J., Rogalewski, A., Brach, S., Voss, S. and Ringelstein, E.B. (2000) Stroke Knowledge among Stroke Support Group Members. Stroke, 31, 1230-1233. https://doi.org/10.1161/01.STR.31.6.1230
Fantom, N.J. and Serajuddin, U. (2016) The World Bank’s Classification of Countries by Income. World Bank Policy Research Working Paper, No. 7528. World Bank, Washington DC. https://doi.org/10.1596/1813-9450-7528
Aslam, A., Grojec, A., Little, C., Maloney, T. and Tamagni, J. (2014) The State of the World’s Children 2014 in Numbers: Every Child Counts. Revealing Disparities, Advancing Children’s Rights. United Nations Children’s Fund (UNICEF), New York.
Mamin, F.A., Islam, M.S., Rumana, F.S. and Faruqui, F. (2017) Profile of Stroke Patients Treated at a Rehabilitation Centre in Bangladesh. BMC Research Notes, 10, Article No. 520. https://doi.org/10.1186/s13104-017-2844-x
Siddiqui, M.R., Islam, Q.T., Iqbal, M.J. and Binte-Mosharraf, S.S. (2013) Socio-Demographic Status & Associated Risk Factors of the Stroke Patient’s in a Tertiary Care Hospital of Bangladesh. Anwer Khan Modern Medical College Journal, 4, 18-22. https://doi.org/10.3329/akmmcj.v4i2.16920
Mondal, B.A., Chowdhury, R.N., Rahman, K.M., Khan, S.U., Hasan, A.T., Hoque, M.A., Haque, B., Khan, M.Z., Habib, M. and Mohammad, Q.D. (2012) Major Co-Morbidities in Stroke Patients: A Hospital Based Study in Bangladesh. Journal of Dhaka Medical College, 21, 16-22. https://doi.org/10.3329/jdmc.v21i1.13233
Maaijwee, N.A., Rutten-Jacobs, L.C., Schaapsmeerders, P., Van Dijk, E.J. and de Leeuw, F.E. (2014) Ischaemic Stroke in Young Adults: Risk Factors and Long-Term Consequences. Nature Reviews Neurology, 10, 315-325.
https://doi.org/10.1038/nrneurol.2014.72
Trygged, S., Ahacic, K. and Kåreholt, I. (2011) Income and Education as Predictors of Return to Working Life among Younger Stroke Patients. BMC Public Health, 11, Article No. 742. https://doi.org/10.1186/1471-2458-11-742
Yahya, T., Jilani, M.H., Khan, S.U., Mszar, R., Hassan, S.Z., Blaha, M.J., Blankstein, R., Virani, S.S., Johansen, M.C., Vahidy, F., Cainzos-Achirica, M. and Nasir, K. (2020) Stroke in Young Adults: Current Trends, Opportunities for Prevention and Pathways Forward. American Journal of Preventive Cardiology, 3, Article ID: 100085. https://doi.org/10.1016/j.ajpc.2020.100085
Hossain, A.M., Ahmed, N.U., Rahman, M., Islam, M.R., Sadhya, G. and Fatema, K. (2011) Analysis of Sociodemographic and Clinical Factors Associated with Hospitalized Stroke Patients of Bangladesh. Faridpur Medical College Journal, 6, 19-23.
https://doi.org/10.3329/fmcj.v6i1.7405
Yesilbalkan, O.U., Karadakovan, A., Dogru, B.V., Akman, P., Ozel, E. and Bozturk, Y. (2019) Awareness of Risk Factors and Warning Signs of Stroke among Caregivers of Patient with and Not with Stroke: Results from Questionnaire. Journal of the Pakistan Medical Association, 69, 1114-1118.
Kaddumukasa, M., Kayima, J., Kaddumukasa, M.N., Ddumba, E., Mugenyi, L., Pundik, S., Furlan, A.J., Sajatovic, M. and Katabira, E. (2015) Knowledge, Attitudes and Perceptions of Stroke: A Cross-Sectional Survey in Rural and Urban Uganda. BMC Research Notes, 8, Article No. 819. https://doi.org/10.1186/s13104-015-1820-6
Ashraf, V.V., Maneesh, M., Praveenkumar, R., Saifudheen, K. and Girija, A.S. (2015) Factors Delaying Hospital Arrival of Patients with Acute Stroke. Annals of Indian Academy of Neurology, 18, 162-166. https://doi.org/10.4103/0972-2327.150627
Lee, K.W., Choi, S.J., Kim, S.B., Lee, J.H. and Lee, S.J. (2015) A Survey of Caregivers’ Knowledge about Caring for Stroke Patients. Annals of Rehabilitation Medicine, 39, 800-815. https://doi.org/10.5535/arm.2015.39.5.800
van den Heuvel, E.T., de Witte, L.P., Nooyen-Haazen, I., Sanderman, R. and Meyboomde Jong, B. (2000) Short-Term Effects of a Group Support Program and an Individual Support Program for Caregivers of Stroke Patients. Patient Education and Counseling, 40, 109-120. https://doi.org/10.1016/S0738-3991(99)00066-X
Lincoln, N.B., Francis, V.M., Lilley, S.A., Sharma, J.C. and Summerfield, M. (2003) Evaluation of a Stroke Family Support Organiser: A Randomized Controlled Trial. Stroke, 34, 116-121. https://doi.org/10.1161/01.STR.0000047850.33686.32
