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Published in: BMC Neurology 1/2013

Open Access 01-12-2013 | Research article

Stroke knowledge among diabetics: a cross-sectional study on the influence of age, gender, education, and migration status

Authors: Birgitta M Weltermann, Youcef Driouach-Bleckmann, Sabrina Reinders, Peter Berndt, Stefan Gesenhues

Published in: BMC Neurology | Issue 1/2013

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Abstract

Background

Stroke campaigns are educating about the need to immediately contact the emergency medical system if symptoms occur. Despite higher stroke rates among patients with diabetics and some migrant populations, there are few data about stroke knowledge in these groups.

Methods

We performed a cross-sectional questionnaire survey among 250 diabetes patients from Germany and Turkey in a primary care and diabetes practice center. The two-page questionnaire asked for stroke knowledge and socio-demographic data. Also, medical and communication data were obtained. Stroke knowledge was defined as good if a participant knew (1) at least two stroke symptoms (good symptom knowledge) and (2) that immediate hospital admission or an emergency call is necessary in case of stroke symptoms (good action knowledge).

Results

A total of 231 of 250 patients took part in the survey (participation rate 92.4%) with 134 natives (53.6%), 84 migrants from Turkey (33.6%) and 13 migrants (5.2%) from other countries. Comparing natives and migrants from Turkey good symptom knowledge was documented in 52.8% of the participants, good action knowledge in 67.9%, and good stroke knowledge in nearly forty percent (39.4%) of patients (n = 218). A logistic regression analysis showed better stroke knowledge if patients were younger than 61 years, had good language abilities and were living in an one-generation household (p < 0.05), while gender, years since migration and diabetes control did not play a role.

Conclusions

We documented stroke knowledge deficits among patients with diabetes, both natives and migrants. Additional information strategies for these high risk populations are needed.
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Literature
1.
go back to reference Goldstein LB, Bushnell CD, Adams RJ, Appel LJ, Braun LT, Chaturvedi S, Creager MA, Culebras A, Eckel RH, Hart RG, Hinchey JA, Howard VJ, Jauch EC, Levine SR, Meschia JF, Moore WS, Nixon JV, Pearson TA: Guidelines for the primary prevention of stroke. A guideline for healthcare professionals from the American heart association/American stroke association. Stroke. 2010, 42: 517-584.CrossRefPubMed Goldstein LB, Bushnell CD, Adams RJ, Appel LJ, Braun LT, Chaturvedi S, Creager MA, Culebras A, Eckel RH, Hart RG, Hinchey JA, Howard VJ, Jauch EC, Levine SR, Meschia JF, Moore WS, Nixon JV, Pearson TA: Guidelines for the primary prevention of stroke. A guideline for healthcare professionals from the American heart association/American stroke association. Stroke. 2010, 42: 517-584.CrossRefPubMed
2.
3.
go back to reference Rubia M, Marcos I, Muennig PA: Increased risk of heart disease and stroke among foreign-born females residing in the United States. Am J Prev Med. 2002, 22: 30-35.CrossRefPubMed Rubia M, Marcos I, Muennig PA: Increased risk of heart disease and stroke among foreign-born females residing in the United States. Am J Prev Med. 2002, 22: 30-35.CrossRefPubMed
4.
go back to reference Wolfe CDA, Corbin DOC, Smeeton NC, Gay GHE, Rudd AG, Hennis AJ, Wilks RJ, Fraser HS: Estimation of the risk of stroke in black populations in Barbados and South London. Stroke. 2006, 37: 1986-1990.CrossRefPubMed Wolfe CDA, Corbin DOC, Smeeton NC, Gay GHE, Rudd AG, Hennis AJ, Wilks RJ, Fraser HS: Estimation of the risk of stroke in black populations in Barbados and South London. Stroke. 2006, 37: 1986-1990.CrossRefPubMed
5.
go back to reference Gholap N, Davies M, Patel K, Sattar N, Khunti K: Type 2 diabetes and cardiovascular disease in South Asians. Prim Care Diabetes. 2011, 5: 45-56.CrossRefPubMed Gholap N, Davies M, Patel K, Sattar N, Khunti K: Type 2 diabetes and cardiovascular disease in South Asians. Prim Care Diabetes. 2011, 5: 45-56.CrossRefPubMed
6.
go back to reference Gunarathne A, Patel JV, Potluri R, Gammon B, Jessani S, Hughes EA, Lip GYH: Increased 5-year mortality in the migrant South Asian stroke patients with diabetes mellitus in the United Kingdom: the West Birmingham Stroke Project. Int J Clin Pract. 2008, 62: 197-201.CrossRefPubMed Gunarathne A, Patel JV, Potluri R, Gammon B, Jessani S, Hughes EA, Lip GYH: Increased 5-year mortality in the migrant South Asian stroke patients with diabetes mellitus in the United Kingdom: the West Birmingham Stroke Project. Int J Clin Pract. 2008, 62: 197-201.CrossRefPubMed
7.
go back to reference Bos V, Kunst AE, Keij-Deerenberg IM, Garssen J, Mackenbach JP: Ethnic inequalities in age- and cause-specific mortality in The Netherlands. Int J Epidemiol. 2004, 33: 1112-1119.CrossRefPubMed Bos V, Kunst AE, Keij-Deerenberg IM, Garssen J, Mackenbach JP: Ethnic inequalities in age- and cause-specific mortality in The Netherlands. Int J Epidemiol. 2004, 33: 1112-1119.CrossRefPubMed
8.
go back to reference Kothari R, Sauerbeck L, Jauch E, Broderick J, Brott T, Khoury J, Liu T: Patients’ awareness of stroke signs, symptoms, and risk factors. Stroke. 1997, 28: 1871-1875.CrossRefPubMed Kothari R, Sauerbeck L, Jauch E, Broderick J, Brott T, Khoury J, Liu T: Patients’ awareness of stroke signs, symptoms, and risk factors. Stroke. 1997, 28: 1871-1875.CrossRefPubMed
9.
go back to reference Williams O, Desorbo A, Noble J, Shaffer M, Gerin W: Long-term learning of stroke knowledge among children in a high-risk community. Neurology. 2012, 79: 802-806.CrossRefPubMedPubMedCentral Williams O, Desorbo A, Noble J, Shaffer M, Gerin W: Long-term learning of stroke knowledge among children in a high-risk community. Neurology. 2012, 79: 802-806.CrossRefPubMedPubMedCentral
10.
go back to reference Uiters E, Deville W, Foets M, Spreeuwenberg P, Groenewegen PP: Differences between immigrant and non-immigrant groups in the use of primary medical care; a systematic review. BMC Health Serv Res. 2009, 9: 76-CrossRefPubMedPubMedCentral Uiters E, Deville W, Foets M, Spreeuwenberg P, Groenewegen PP: Differences between immigrant and non-immigrant groups in the use of primary medical care; a systematic review. BMC Health Serv Res. 2009, 9: 76-CrossRefPubMedPubMedCentral
11.
go back to reference Ujcic-Voortman JK, Baan CA, Seidell JC, Verhoeff AP: Obesity and cardiovascular disease risk among Turkish and Moroccan migrant groups in Europe: a systematic review. Obes Rev. 2012, 13: 2-16.CrossRefPubMed Ujcic-Voortman JK, Baan CA, Seidell JC, Verhoeff AP: Obesity and cardiovascular disease risk among Turkish and Moroccan migrant groups in Europe: a systematic review. Obes Rev. 2012, 13: 2-16.CrossRefPubMed
12.
go back to reference Weltermann BM, Rogalewski A, Homann J, Berger K, Schulte H, Assmann G, Ringelstein EB: Knowledge about stroke among the German population. Dtsch Med Wochenschr. 2000, 125: 416-420.CrossRefPubMed Weltermann BM, Rogalewski A, Homann J, Berger K, Schulte H, Assmann G, Ringelstein EB: Knowledge about stroke among the German population. Dtsch Med Wochenschr. 2000, 125: 416-420.CrossRefPubMed
13.
go back to reference Weltermann BM, Homann J, Rogalewski A, Brach S, Voss S, Ringelstein EB: Stroke knowledge among stroke support group members. Stroke. 2000, 31: 1230-1233.CrossRefPubMed Weltermann BM, Homann J, Rogalewski A, Brach S, Voss S, Ringelstein EB: Stroke knowledge among stroke support group members. Stroke. 2000, 31: 1230-1233.CrossRefPubMed
14.
15.
go back to reference Lutfiyya MN, Ng L, Asner N, Lipsky MS: Disparities in stroke symptomology knowledge among US midlife women: an analysis of population survey data. J Stroke Cerebrovasc Dis. 2009, 18: 150-157.CrossRefPubMed Lutfiyya MN, Ng L, Asner N, Lipsky MS: Disparities in stroke symptomology knowledge among US midlife women: an analysis of population survey data. J Stroke Cerebrovasc Dis. 2009, 18: 150-157.CrossRefPubMed
16.
go back to reference Lutfiyya MN, Bardales R, Bales R, Aguero C, Brady S, Tobar A, McGrath C, Zaiser J, Lipsky MS: Awareness of heart attack and stroke symptoms among Hispanic male adults living in the United States. J Immigr Minor Health. 2010, 12: 761-768.CrossRefPubMed Lutfiyya MN, Bardales R, Bales R, Aguero C, Brady S, Tobar A, McGrath C, Zaiser J, Lipsky MS: Awareness of heart attack and stroke symptoms among Hispanic male adults living in the United States. J Immigr Minor Health. 2010, 12: 761-768.CrossRefPubMed
18.
go back to reference Maffla C: Health in the age of migration: migration and health in the EU. Community Pract. 2008, 81: 32-35.PubMed Maffla C: Health in the age of migration: migration and health in the EU. Community Pract. 2008, 81: 32-35.PubMed
19.
go back to reference Vandenheede H, Deboosere P, Stirbu I, Agyemang CO, Harding S, Juel K, Rafnsson SB, Regidor E, Rey G, Rosato M, Mackenbach JP, Kunst AE: Migrant mortality from diabetes mellitus across Europe: the importance of socio-economic change. Eur J Epidemiol. 2012, 27: 109-117.CrossRefPubMed Vandenheede H, Deboosere P, Stirbu I, Agyemang CO, Harding S, Juel K, Rafnsson SB, Regidor E, Rey G, Rosato M, Mackenbach JP, Kunst AE: Migrant mortality from diabetes mellitus across Europe: the importance of socio-economic change. Eur J Epidemiol. 2012, 27: 109-117.CrossRefPubMed
20.
go back to reference Holmboe-Ottesen G, Wandel M: Changes in dietary habits after migration and consequences for health: a focus on South Asians in Europe. Food Nutr Res. 2012, 56: 18891-CrossRef Holmboe-Ottesen G, Wandel M: Changes in dietary habits after migration and consequences for health: a focus on South Asians in Europe. Food Nutr Res. 2012, 56: 18891-CrossRef
21.
go back to reference Tillin T, Hughes AD, Godsland IF, Whincup P, Forouhi NG, Welsh P, Sattar N, McKeigue PM, Chaturvedi N: Insulin resistance and truncal obesity as important determinants of the greater incidence of diabetes in Indian Asians and African caribbeans compared with Europeans: the Southall and Brent revisited (SABRE) cohort. Diabetes Care. 2013, 36 (2): 383-393.CrossRefPubMedPubMedCentral Tillin T, Hughes AD, Godsland IF, Whincup P, Forouhi NG, Welsh P, Sattar N, McKeigue PM, Chaturvedi N: Insulin resistance and truncal obesity as important determinants of the greater incidence of diabetes in Indian Asians and African caribbeans compared with Europeans: the Southall and Brent revisited (SABRE) cohort. Diabetes Care. 2013, 36 (2): 383-393.CrossRefPubMedPubMedCentral
22.
go back to reference Helman CG: Culture, health and illness. 2007, London: Hodder Arnold, 5 Helman CG: Culture, health and illness. 2007, London: Hodder Arnold, 5
23.
go back to reference Boden-Albala B, Stillman J, Perez T, Evensen L, Moats H, Wright C, Moon-Howard J, Doyle M, Paik MC: A stroke preparedness RCT in a multi-ethnic cohort: design and methods. Contemp Clin Trials. 2010, 31: 235-241.CrossRefPubMed Boden-Albala B, Stillman J, Perez T, Evensen L, Moats H, Wright C, Moon-Howard J, Doyle M, Paik MC: A stroke preparedness RCT in a multi-ethnic cohort: design and methods. Contemp Clin Trials. 2010, 31: 235-241.CrossRefPubMed
24.
go back to reference Williams O, Noble JM: ‘Hip-hop’ stroke: a stroke educational program for elementary school children living in a high-risk community. Stroke. 2008, 39: 2809-2816.CrossRefPubMed Williams O, Noble JM: ‘Hip-hop’ stroke: a stroke educational program for elementary school children living in a high-risk community. Stroke. 2008, 39: 2809-2816.CrossRefPubMed
25.
go back to reference Williams O, Desorbo A, Noble J, Gerin W: Child-mediated stroke communication: findings from Hip Hop stroke. Stroke. 2012, 43: 163-169.CrossRefPubMed Williams O, Desorbo A, Noble J, Gerin W: Child-mediated stroke communication: findings from Hip Hop stroke. Stroke. 2012, 43: 163-169.CrossRefPubMed
26.
go back to reference Guell C: Diabetes management as a Turkish family affair: chronic illness as a social experience. Ann Hum Biol. 2011, 38: 438-444.CrossRefPubMed Guell C: Diabetes management as a Turkish family affair: chronic illness as a social experience. Ann Hum Biol. 2011, 38: 438-444.CrossRefPubMed
Metadata
Title
Stroke knowledge among diabetics: a cross-sectional study on the influence of age, gender, education, and migration status
Authors
Birgitta M Weltermann
Youcef Driouach-Bleckmann
Sabrina Reinders
Peter Berndt
Stefan Gesenhues
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Neurology / Issue 1/2013
Electronic ISSN: 1471-2377
DOI
https://doi.org/10.1186/1471-2377-13-202

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