Discussion
This survey was conducted among relatives of outpatients presenting to the hospital and therefore may be more biased toward an increased accuracy of responses, given that the population that seeks medical care is more knowledgeable in recognizing a problem than someone who is completely unaware. A population-based survey and telephonic interviews in the community are not readily feasible in developing countries, owing to the lack of financial resources and other logistic issues. The demographic profiles in this study are representative of the population of India and Punjab (urban more than rural), except in age group aged 41 to 60 years and religion (Table 1).14 However, age did not influence our results in both univariate and in multivariate analysis. The religion did not match with the Indian data because the dominant religion in Punjab is Sikhism. Even though this is a hospital-based survey, the findings indicate that there is lack of awareness among the general public about stroke warning symptoms and risk factors. A minority of subjects correctly identified the brain as the affected organ in stroke, and ignorance of the warning symptoms and risk factors for stroke was common. There is lack of awareness about stroke among the public even in developed countries like the United States8 and Australia.10 Ten percent of respondents in this survey had difficulty in differentiating heart attacks and strokes, even after the survey instrument was “fine-tuned” to differentiate between the 2 in the vernacular. This response was also seen in other studies from Australia10 Michigan,15 and Ireland16 (Table 4). Occlusion of a vessel as the cause of stroke was correctly stated by 291 (31%) of the respondents. One hundred and thirty-nine (15%) participants mentioned that rupture of a vessel could lead to stroke. In a similar study from Ireland,16 60.3% of the study population mentioned that stroke occurred as a result of a blood clot in the brain.