Dorien Brouwer

94 Chapter 2.1 PART 2 Figure 1. The steps and influences in the process of health education aiming at reduction of case fatality and disability from stroke Health education in stroke and TIA patients Knowledge Many studies evaluated TIA and stroke patients’ knowledge about etiology, warning signs and risk factors of their own disease. [14–18] The proportion of patients who are able to mention at least one warning sign varied between 39% and 93%. [14, 15, 17, 18] Hemiparesis was the most commonly cited warning sign. [14, 15] A variable proportion of stroke patients, 38–98%, was able to name at least one major risk factor. [14, 15, 17] This proportion depended on the type of question: open-ended or multiple choice. The latter resulted in the highest proportions. The most commonly mentioned vascular risk factors were hypertension, hypercholesterolemia and smoking. [14, 17, 19] Only a quarter to half of the stroke patients could mention the brain as an affected organ. [14–16] Most studies investigated the knowledge of stroke patients in the acute phase. In this stage, patients may not have received an appreciable amount of information yet. Therefore, the knowledge of stroke and TIA patients in the acute phase would be limited and not be very different of knowledge in the general population. The HE to stroke patients can be provided by different persons; a general practitioner, a stroke nurse specialist or a neurologist. No studies have compared the quality and effect of HE provided by different persons. There are many ways by which HE can be provided, both actively and passively. Examples of passive methods are booklets, a computer programme and computer-generated individualized written information. Active methods are information presented to a group or individual by, for example, a multidisciplinary team including a specialist stroke nurse, by means of presentations and interactive sessions. Few randomized controlled trials investigated the effect of