Ethnic variations in the management of patients with acute stroke

Bourke, J. B.; Sylvester, Richard; Sharma, Pankaj

doi:10.1136/pgmj.2005.033647

Cited by 13 publications

(15 citation statements)

References 16 publications

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“…Ethnic differences were previously demonstrated in stroke risk factors and management of acute stroke [8,9,10,11]. Evidence of differences in incidence, burden and severity of stroke were found to be considerable.…”

Section: Introductionmentioning

confidence: 86%

Ethnic Variations in Acute Ischemic Stroke: Findings from the National Acute Stroke Israeli Survey (NASIS)

Gross

Feldman-Idov²,

Molshatzki³

et al. 2011

Cerebrovasc Dis

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Background: We intended to determine ethnic differences in the characteristics, management and outcome of acute ischemic stroke between the Israeli Arab and Jewish populations. Methods: A national survey was conducted in 2004 at all 28 hospitals in Israel. Information on demographics, transportation, risk factors, clinical presentation, stroke severity, type and subtype, management and clinical outcome was obtained. Mortality during the 36 months after hospitalization was assessed by matching with national mortality data. Results: Of the 1,540 patients, 169 (11%) were Arabs and 1,371 (89%) were Jews. The mean age of Arab patients was 9 years younger than in Jewish patients (63 ± 11 vs. 72 ± 12 years). Also, Arabs were more likely to be obese (OR = 1.72; 95% CI: 1.19–2.50) and have diabetes (OR = 1.41; 95% CI: 1.01–1.96), while Jews were more likely to have dyslipidemia (OR = 1.56; 95% CI: 1.11–2.17). A greater percentage of the Arab patients arrived at the hospital independently (OR = 3.85; 95% CI: 2.56–5.56) and were less likely to arrive within 3 h of symptom onset (OR = 2.33; 95% CI: 1.39–3.85). Arabs suffered increased rates of lacunar stroke (OR = 1.67; 95% CI: 1.14–2.43) and were discharged home more often (OR = 2.40; 95% CI: 1.35–4.25). No differences in severity of stroke, management, complications, disability or mortality were found between the 2 groups. Conclusions: The unique characteristics of the Arab and Jewish populations should be considered when planning stroke-care services and culturally oriented public education programs.

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Section: Introductionmentioning

confidence: 86%

Ethnic Variations in Acute Ischemic Stroke: Findings from the National Acute Stroke Israeli Survey (NASIS)

Gross

Feldman-Idov²,

Molshatzki³

et al. 2011

Cerebrovasc Dis

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“…87 There are only a small number of studies that examine issues of stroke management in the migrant South Asian population in the United Kingdom. 19,88 There have been no studies available for analysis from any South Asian countries. It is held that there are delays in access to health care that affect the South Asian population and result in South Asians being less likely to receive appropriate treatment.…”

Section: Stroke Managementmentioning

confidence: 99%

Ischemic Stroke in South Asians

Gunarathne

Patel

Gammon

et al. 2009

Stroke

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Background and Purpose-Within the United Kingdom, mortality from stroke is higher among South Asians compared to European whites. The reasons for this excess cerebrovascular risk in South Asians remain unclear. The aim of this review is to present a comprehensive and systematic overview of the available literature relating to ischemic stroke among South Asian populations identifying distinct features of stroke epidemiology in this group. Summary of Review-A high frequency of lacunar strokes is a familiar pattern among South Asians, which suggests a greater prevalence of small-vessel disease in South Asians. This may be a consequence of abnormal metabolic and glycemic processes. In addition, stroke mortality among South Asians appears to be explained by glycemic status, which is an independent predictor of long-term stroke mortality. Within India, there is a perceptible rural-urban gradient in stroke prevalence, underlying the dangers of the rapid transition in socioeconomic circumstances seen across the Indian subcontinent. Conclusions-This

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“…Ethnic minorities account for approximately 8% of the total population of the UK, equivalent to 4.6 million people, 1 yet their quality of healthcare has been found to be inferior compared to white Caucasians in diseases including heart disease, 2 stroke, 3 cancer, 4,5 HIV, 6 prenatal care, 7 and mental health. 8 In order for medical education to meet the goal of improving healthcare for the whole population, training needs to incorporate the principle of individualising care, including recognising the specific health needs, values and communication issues of ethnic minorities.…”

Section: Introductionmentioning

confidence: 99%

Cultural diversity training for UK healthcare professionals: a comprehensive nationwide cross-sectional survey

Bentley¹,

Stevanovic²,

Sharma³

2008

Clinical Medicine

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-Healthcare inequalities within the UK based on patients' ethnicity have been found over the last five years in a large number of medical specialties. One possible explanation for this lies in ignorance of ethnic minority healthcare needs among professionals. Cultural diversity programmes have been shown to improve patient outcomes including compliance, yet these are not as yet requirements for any UK healthcare professionals with the exception of psychiatrists. This paper documents the frequency, regional variation, characteristics and motivations for cultural diversity training through a questionnaire survey of the educational leads of every UK medical school, postgraduate deanery and schools of nursing, physiotherapy, occupational therapy, speech and language therapy, and pharmacy. The results showed a wide variation in teaching practices between healthcare professions and geographical regions. This study provides evidence for the need for national guidelines to incorporate cultural competency training by all UK healthcare professional training bodies. IntroductionEthnic minorities account for approximately 8% of the total population of the UK, equivalent to 4.6 million people, 1 yet their quality of healthcare has been found to be inferior compared to white Caucasians in diseases including heart disease, 2 stroke, 3 cancer, 4,5 HIV, 6 prenatal care, 7 and mental health. 8 In order for medical education to meet the goal of improving healthcare for the whole population, training needs to incorporate the principle of individualising care, including recognising the specific health needs, values and communication issues of ethnic minorities. 9-13 Although UK healthcare professional training bodies in medicine, nursing, physiotherapy, occupational therapy, speech and language therapy and pharmacy have all issued general guidelines that encourage equality and diversity appreciation in educational curricula, 14 there are currently no requirements for teaching centres to provide formal cultural diversity training. In this study the nationwide frequency, characteristics and motivations for formal cultural diversity teaching for the main types of UK healthcare professionals are documented. It was hypothesised that regions of the UK that have relatively small proportions of ethnic minorities would be less likely to feature cultural diversity training within their healthcare programmes. Methods Search strategyHealth professional courses for the 2006/7 year were identified through the Universities and Colleges Admission Service (UCAS) -the sole UK central organisation through which applications are processed for entry to full-time undergraduate courses, higher national diploma and university diploma -in the following subjects: medicine, physiotherapy, nursing, occupational therapy, speech and language therapy, and pharmacy. The names and contact addresses of the dean or director of medical education (or equivalent) for each training programme were subsequently identified. The list was complemented with informatio...

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Ethnic variations in the management of patients with acute stroke

Cited by 13 publications

References 16 publications

Ethnic Variations in Acute Ischemic Stroke: Findings from the National Acute Stroke Israeli Survey (NASIS)

Ethnic Variations in Acute Ischemic Stroke: Findings from the National Acute Stroke Israeli Survey (NASIS)

Ischemic Stroke in South Asians

Cultural diversity training for UK healthcare professionals: a comprehensive nationwide cross-sectional survey

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