Knowledge of acute stroke management and the predictors among Malaysian healthcare professionals

Abstract

Background Despite rapid advances in acute ischaemic stroke (AIS) management, many healthcare professionals (HCPs) might not be aware of the latest recommended management of AIS patients. Therefore, we aimed to determine the level and factors associated with AIS management knowledge among Malaysian HCPs. Methods This cross-sectional online questionnaire study was conducted nationwide among 627 HCPs in Malaysia using the Acute Stroke Management Questionnaire (ASMaQ). Multiple logistic regression was used to predict the relationship between the independent variables (age, gender, years of service, profession, work setting, work sector, seeing stroke patients in daily practice, and working with specialists) and the outcome variable (good vs poor knowledge). Results Approximately 76% (95% CI [73–79%]) of HCPs had good overall knowledge of stroke. The highest proportion of HCPs with good knowledge was noted for General Stroke Knowledge (GSK) [88.5% (95% CI [86–91%])], followed by Advanced Stroke Management (ASM) [61.2% (95% CI [57–65%])] and Hyperacute Stroke Management (HSM) [58.1% (95% CI [54–62%])]. The odds of having poor knowledge of stroke were significantly higher among non-doctor HCPs [adjusted OR = 3.46 (95% CI [1.49–8.03]), P = 0.004]; among those not seeing stroke patients in daily practice [adjusted OR = 2.67 (95% CI [1.73–4.10]), P < 0.001]; and among those working without specialists [adjusted OR = 2.41 (95% CI [1.38–4.18]), P = 0.002]. Conclusions Stroke education should be prioritised for HCPs with limited experience and guidance. All HCPs need to be up-to-date on the latest AIS management and be able to make a prompt referral to an appropriate facility. Therefore, more stroke patients will benefit from advanced stroke care.

The Use of the Acute Stroke Management Questionnaire to Measure Acute Care Nurses' Stroke Knowledge

“…The ASMaQ scores are categorized into good and poor stroke knowledge based off cutoff points determined through stroke expert opinion. 14 Individual item scores of 1 to 3 are considered poor knowledge, whereas scores of 4 and 5 are considered good knowledge, with 3.5 being the cutoff point between good and poor knowledge. 14 Poor overall stroke knowledge scores range from 29 to 101.4, whereas good overall stroke knowledge scores range from 101.5 to 145.…”

“…14 Individual item scores of 1 to 3 are considered poor knowledge, whereas scores of 4 and 5 are considered good knowledge, with 3.5 being the cutoff point between good and poor knowledge. 14 Poor overall stroke knowledge scores range from 29 to 101.4, whereas good overall stroke knowledge scores range from 101.5 to 145. The total ASMaQ score is calculated by summing all item scores after completing reverse coding for the 6 negatively scored items.…”

“…14 The types of healthcare professionals included in the study testing the ASMaQ were “medical practitioners” and “allied healthcare professionals from various medical disciplines.” 14 Healthcare professionals who did not work with stroke patients daily had 2.67 times the odds of poor stroke knowledge compared with those working with stroke patients daily ( P < .001). 14 This finding is essential to consider, because most IHSs occur in cardiovascular and surgical areas. 1,3,4,7,8,15,16 However, the ASMaQ has not been used on a nursing-specific or US population.…”

“…14 Healthcare professionals who did not work with stroke patients daily had 2.67 times the odds of poor stroke knowledge compared with those working with stroke patients daily ( P < .001). 14 This finding is essential to consider, because most IHSs occur in cardiovascular and surgical areas. 1,3,4,7,8,15,16 However, the ASMaQ has not been used on a nursing-specific or US population.…”

“…13 The ASMaQ has been used to evaluate healthcare professionals' knowledge of acute stroke management and predictors of knowledge in a Malaysian population. 14 The types of healthcare professionals included in the study testing the ASMaQ were "medical practitioners" and "allied healthcare professionals from various medical disciplines." 14 Healthcare professionals who did not work with stroke patients daily had 2.67 times the odds of poor stroke knowledge compared with those working with stroke patients daily ( P < .001).…”