Stroke awareness in urban and rural populations from northern Portugal: knowledge and action are independent.

BACKGROUND: Several studies conducted in hospital emergency departments have shown that most patients delay in responding to stroke symptoms. In the general population, recognition of stroke and the appropriate reactions are important for prevention and acute treatment, particularly in areas with a high stroke incidence. The objective of this study was to compare general knowledge about stroke/TIA and prompt action in urban and rural populations.

METHODS: In the first half of 2007, a cross-sectional study on stroke knowledge was undertaken in rural and urban populations from the Viana do Castelo district. About 1% of people aged at least 18 years registered at three community health centers were asked to check a list of vascular risk factors (VRF), stroke/TIA warning signs, and other non-specific signs, as well as indicate how they would react in the presence of warning signs or stroke/TIA.

RESULTS: The 347 urban participants were on average younger than the 316 rural participants (46 vs. 51 years) and fewer had a low educational level (44 vs. 62% had less than 5 years of full education). About 50% identified at least 8 out of 13 VRF and indicated the brain as the body location; 39.7% recognized simultaneously the three key warning signs of the FAST campaign - irrespective of gender, educational level, and residential area. Education and urban environment increased the odds of calling the emergency medical services (EMS), while age had the opposite effect. After adjustment, recognition of brain location and calling EMS in case of paralysis/weakness or dizziness/vertigo increased the odds of calling the EMS in case of stroke, while recognition of the warning signs was not associated with an EMS call.

CONCLUSIONS: People's reaction to stroke depends mostly on their sociodemographic profile and their reaction to specific warning signs, independently of recognizing them as 'originating from stroke'.