Abstract | Uvod: Ishemijski moždani udar (IMU) predstavlja hitno medicinsko stanje te zahtijeva hitan prijevoz i zbrinjavanje bolesnika u adekvatno opremljenu zdravstvenu ustanovu. IMU je povezan s visokom stopom smrtnoga ishoda. U dvije trećine preživjelih bolesnika zaostaje različiti stupanj neurološkog deficita, dok čak trećina oboljelih biva trajno onesposobljena i potpuno ovisna o tuđoj pomoći. Radi se o bolesti čiji su rezultati liječenja u izravnoj korelaciji s vremenom proteklim od pojave prvih simptoma do trenutka pravodobne medicinske intervencije. Mnogi čimbenici pridonose kašnjenju u primjeni adekvatnog liječenja akutnog IMU, a jedan od najbitnijih i relativno lako modificirajućih je znanje o rizičnim čimbenicima i simptomima moždanog udara.
Cilj: Procijeniti poznavanje činjenica o moždanom udaru, znakovima upozorenja i hitnim mjerama koje treba poduzeti u slučaju moždanog udara, među bolesnicima na Klinici za neurologiju i Klinici za unutarnje bolesti KBC-a Split.
Ispitanici i metode: Prikupljeni su podaci od 100 bolnički liječenih osoba zbog različitih bolesti, srednje dobi 65(29-87) godina. Ispitanici su ispunili upitnik koji je sadržavao 32 pitanja. Pitanja su se odnosila na simptome upozorenja, rizične čimbenike, uzroke moždanog udara i prve mjere koje valja poduzeti u slučaju moždanog udara. Od ukupno 100 ispitanika, njih 50 su bili bolesnici Klinike za neurologiju koji su već pretrpjeli moždani udar, a njih 50 bolesnici Klinike za unutarnje bolesti s visokim rizikom za moždani udar.
Rezultati: Obaviještenost između navedenih skupina se nije statistički razlikovala, ali su ispitanici koji su pretrpjeli moždani udar bolje odgovorili na anketna pitanja srednje vrijednosti medijana 24 (min-maks 17-31), za razliku od ispitanika s visokim rizikom za moždani udar srednje vrijednosti medijana 21 (min-maks 10-31). Postoji pozitivan koeficijent korelacija točnih odgovora s životnom dobi (r=0,357; P< 0,001), tako da su osobe starije životne dobi bolje odgovarale na postavljena anketna pitanja. U skupini ispitanika s moždanim udarom 28 (56%) je ispitanika starijih od 65 god. a u skupini ispitanika s povećanim rizikom za moždani udar njih 19 (38%) što je za 1,5 puta više pa smo stoga napravili dvosmjernu analizu varijance. Nismo dokazali statistički značajnu razliku ukupnog zbroja bodova izraženog postotka u odnosu na maksimalan broj pozitivnih odgovora po pojedinom ispitaniku u odnosu na skupine ispitanika s moždanim udarom i bez njega korigirano za dob (F=1,08; P=0,301).
Zaključak: Usprkos činjenici da su ispitanici znali dosta o moždanom udaru, narav moždanog udara i s njim povezani problemi često izazivaju zbunjenost ili krivo tumačenje. Potrebna je daljnja izobrazba javnosti kako bi se poboljšalo raspoznavanje znakova upozorenja i rizičnih čimbenika, poglavito među bolesnicima s povećanim rizikom za moždani udar. |
Abstract (english) | Background: Ischemic stroke is a medical emergency and requires emergency transport and patient care in properly equipped medical facility. Ischemic stroke is associated with a high death rate. Two-thirds of stroke survivors terminate with different degree of neurological deficit, while one-third of patients becomes permanently disabled and totally dependent on foreign aid. It is a disease whose treatment results are in direct correlation with the time elapsed since the onset of symptoms until the timely medical intervention. Many factors contribute to delays in the implementation of adequate treatment of acute ischemic stroke, and one of the most important and relatively easy modifying factor is the knowledge about risk factors and symptoms of stroke.
Objective: To assess knowledge of the facts about stroke, warning signs and emergency measures to be taken in case of stroke among patients at the Department of Neurology and Department of Internal Medicine, University Hospital Split.
Patients and Methods: Data were collected from 100 hospitalized patients for a variety of diseases, mean age 65 (29-87) years. Respondents were asked to complete a questionnaire containing 32 questions. Questions were related to the warning signs, risk factors, causes of stroke and the first measures to be taken in the event of a stroke. Out of 100 respondents, 50 were patients of Neurology Clinic who have already suffered a stroke, and 50 of them patients Department of Internal Medicine at high risk for stroke.
Results: Informing between these groups were not statistically different, but the participants who had suffered a stroke better respond to the survey questions mean median 24 (min-max 17-31), in contrast to patients with a high risk for a stroke average of the median 21 (min-max 10-31). There is a positive correlation coefficient of correct responses with increasing age (r=0.357, P<0.001), so that the elderly were more responsive to the set of survey questions. In the group of patients with stroke, 28 (56%) of the respondents older than 65 years. In the group of patients with an increased risk of stroke 19 (38%), which is 1.5 times more so we made a two-way analysis of variance. We demonstrated a statistically significant difference in the total sum of scores expressed as a percentage of the maximum number of positive responses by each respondent in relation to the groups of patients with stroke and without corrected for age (F=1.08, P=0.301).
Conclusion: Despite the fact that the respondents knew enough about stroke, the nature of stroke and associated problems often cause confusion or misunderstanding. Needs further education of the public in order to improve recognition of warning signs and risk factors for stroke, especially among patients at increased risk for stroke. |