Assessment of Knowledge, Attitude and Practice in Identification of Early Neurologic Deterioration in Stroke Patients among Health Professionals in Addis Ababa, Ethiopia.
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Date
2021-11
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Addis Abeba University
Abstract
ABSTRACT
Background: - Worldwide, Stroke is the second most common cause of mortality and disability.
In Ethiopia stroke is the 5
th
cause of death accounting 7% from the top 10causes of death. Post
stroke neurological deterioration is a significant clinical condition that affects up to a third of
patients. Early neurological deterioration in stroke patients is a common event and is associated
with poor outcomes. Therefore, attempts to prevent and treat early neurological deterioration
should be made promptly and aggressively. Although studies have found that being aware of
common causes of neurological deterioration can help for optimal care and preventive measures,
so far there is no publication as to the knowledge and practice in identification of early
neurological deterioration and associated factors in stroke patients among health professionals
done in Ethiopia.
Objective: To assess the knowledge, attitude, and practice towards identification of early
neurologic deterioration in stroke patients among health care professionals in Addis Ababa
Ethiopia.
Methods: -We conducted a Facility based cross sectional analysis of data collected from June
2021 to September 2021 from 214 health professionals who are mostly involved in the care of
stroke patients. Participants filled out pretested self-administered questionnaire. It includes
demographic information, three sections to assess knowledge, practice and attitude towards early
neurologic deterioration in stroke patient. Data was entered in to SPSS version 25. Categorical
variables were summarized by frequency and percentages. Associations were done by binary and
multivariable logistic regression to see the association between Knowledge-attitude, KnowledgePractice
and
Practice-attitude.
Results:-A total of 209study participants responded to the study questions among a total of 214
participants making the response rate of 97.6%. Most of the respondents were male 114(54.5%).The mean
age of the study participant is 29+/- 3.9. Nurses account for largest number of respondents 101(48.3%)
followed by internal medicine residents 46(22%).Majority of respondents 111(53.1%) were from TASH,
41(19.6%) from Zewditu memorial hospital, The mean knowledge score of general practitioners and
residents was 9.3 and the majority of internal medicine and Neurology residents scored above 9.3.Higher
numbers of respondents 71.8% have positive attitude towards the causes of early neurologic deterioration
in stroke patients could be prevented. Individuals who have training on acute care for stroke patients had
2.8 times (AOR = 2.8, CI = 1.4, 6.8) and neurological residents had 6.6 times (AOR = 6.6, CI = 1.2, 7.4 )
more likely to have stroke knowledge. Regarding stroke knowledge level, knowledgeable subjects had
2.7 times (AOR = 2.7, CI = 1.3, 3.5) more likely to have positive attitude towards stroke related early
neurological deterioration as compared to those who were not knowledgeable. Health
professionals below age 24 year were 0.58 times (AOR = 0.58, CI = 0.16, 2.1) less likely to practice
preventive measures of early neurologic deterioration than those within the age range between 3444.
Conclusion:-This study leads to the belief that there is a crucial need to rationalize and update
knowledge regarding the predictors of early neurologic deterioration and preventive measures. It is
important to have and use hospital based protocols to achieve optimum patient outcome and high quality
of interdisciplinary care. Assessment to knowledge gap, current practice and attitude helps to fill the gaps
as well as for provision of comprehensive, interactive and holistic approach to acute care of stroke and
rehabilitation.
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Keywords
Stroke patients,Neurologic deterioration,Health professionals