AUTHOR=Ding Gui-Bing , Sang Qiang , Han Hai-Ji , Wang Xi-Ming , Wu Yan-Feng 

TITLE=Assessment of stroke knowledge and awareness among primary healthcare providers: A cross-sectional survey from the Kezhou quality improvement in acute stroke care project

JOURNAL=Frontiers in Public Health

VOLUME=Volume 11 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2023.1136170

DOI=10.3389/fpubh.2023.1136170

ISSN=2296-2565

ABSTRACT=Objective: Acute stroke care is a highly complex type of emergency medical service involving patient-centered care in a highly unpredictable and stressful environment. The ability of primary healthcare providers (PHPs) to identify stroke onset early and further manage referrals to higher-level hospitals becomes critical. 
Methods: We conducted a cross-sectional survey about stroke knowledge and awareness among PHPs in China from September 2021 to December 2021. A total of 289 PHPs were divided into two groups, the stroke treatment window (STW) Aware group vs the STW Unaware group according to their knowledge on the time window for acute ischemic stroke management. Logistic regression analysis was performed to explore the predictors associated with knowledge of the time window for acute stroke management.
Results: Of 289 PHPs surveyed during the study period, one hundred fifteen (39.7%) participants were aware of the time window for stroke management and were in the STW Aware group, while 174 (60.2%) were in the STW Unaware group. 40% of PHPs in the STW Aware group were familiar with the secondary stroke prevention goal of <140/90 mmHg, compared with 27.01% in the Unaware group (P<0.05). A higher proportion of PHPs in the STW Aware group believed that thrombolysis was an effective treatment for AIS (96.5% vs 79.9%, P<0.01). Endovascular therapy is indicated for AIS was perceived by a higher proportion of PHPs in the STW Aware group than that in the Unaware group (62.6% vs 6.9%, P<0.01). 80% of PHPs in the STW Aware group reported attending training on stroke management compared with 58.1% in the Unaware group (P<0.01). Logistic regression results showed that the predictors of stroke knowledge and awareness among PHPs included sex (OR2.3, 95% CI, 1.2-4.6), received training (OR2.9, 95% CI, 1.60-5.1), and times of training per year (OR0.70, 95% CI, 0.6-0.9). 
Conclusions: PHPs present with a mild to moderate level of stroke management knowledge in northwest China. Strategies to help increase stroke knowledge and awareness among PHPs should be considered in order to help improve the stroke related health service system.