Stroke continues to be a leading cause of death and a major cause of long-term disability in adults worldwide. Previous studies have shown a poor level of knowledge of stroke among patients with established risk factors for stroke and in the community at large. Pancioli et al. [1], in a population-based survey, found that 57% of respondents identified at least 1 out of 5 known warning signs of stroke, and 68% correctly listed at least 1 risk factor. They also reported their study population mentioning various risk factors for stroke but being largely unaware of their own increased risk.
Carroll et al. [2] reported that patients with hypertension and those with history of smoking were significantly more likely to identify these as risk factors for stroke. Surprisingly, none of the patients with current stroke, and only one-third of the at-risk group who had suffered a previous stroke or transient ischaemic attack (TIA), recognised this as being a risk factor for further stroke.
Most patients and many caregivers did not recognise the onset of stroke and their knowledge of risk factors was poor [3]. Stroke knowledge was poorest among groups that had the highest risk of stroke [1,4,5].
Increasing the speed of presentation to hospital after the onset of stroke depends on the level of knowledge of stroke [6]. As a result, patients with stroke may fail to gain the benefits of acute treatments such as acute thrombolysis, because of the narrow therapeutic window [7]. Moreover, knowledge about the risk factors for stroke can help to prevent stroke in the first place [1]. Knowledge of stroke and awareness of its associated risk factors may improve adherence to medical advice regarding lifestyle modification. Systematic reviews have shown that one-time advice from healthcare workers during routine patient interactions can have an appreciable impact on patient behaviour [8,9]. However, persons at risk often tend to misunderstand their own risk, underestimating their probability for stroke and assuming that adverse events will not happen to them [10]. Samsa et al. [11] reported that about one-fourth of patients in their study who recalled being informed of their increased stroke risk by a physician nevertheless did not perceive themselves to be at increased risk for stroke.
The abovementioned studies point to the need for intensive public education about stroke, particularly in at-risk populations.
Oman, as a developing county, is undergoing several transitions. Lifestyles are changing rapidly, including changing dietary patterns (i.e., increasingly high-fat, high-salt and calorie-dense diets) and decreased physical activity. Non-communicable diseases have emerged as the dominant form of ill health in the country. This includes increasing prevalence of important risk factors for stroke (diabetes, hypertension and cardiovascular diseases).
To our knowledge there are no studies from Oman or other developing countries regarding knowledge of stroke among patients with established risk factors for stroke. The present study aims to assess baseline knowledge of warning symptoms of stroke, impending risk factors, treatment, availability of sources of information and the perceived risk of stroke among Omani patients with increased risk for stroke.