Interdisciplinary

Healthcare Workers in Rural China Lack Critical Stroke Treatment Knowledge

AI Insight

This study evaluated stroke management knowledge among 225 non-neurological healthcare professionals in an underdeveloped county in southwestern China using a culturally adapted Chinese version of the Acute Stroke Management Questionnaire. While 69.4% demonstrated good overall performance, significant knowledge gaps were identified, with nurses, female healthcare workers, staff at non-comprehensive facilities, and those without neurologist colleagues scoring significantly lower. Job position and medical facility level emerged as independent factors influencing stroke management knowledge scores.


The findings reveal critical gaps in stroke management knowledge among frontline healthcare workers in underdeveloped regions of China, where access to specialized neurological care is limited. Targeted training programs for nurses and staff at smaller medical facilities could improve stroke treatment rates and reduce stroke-related disability and mortality in underserved populations.


by Xia Huang, Yuanbin Zhao, Shiquan Wang, Chao Lin, Li Xie, Ping Li, Xilin Liu, Zihan He, Lili Yang

Objective

This study aims to investigate the knowledge of stroke management among non-neurological healthcare professionals (HCPs) in an underdeveloped county in western China.

Methods

The study proceeded in two phases. First, the Acute Stroke Management Questionnaire (ASMaQ) underwent a systematic intercultural adaptation into Chinese, followed by an evaluation of its psychometric properties. Second, a cross‑sectional survey using the adapted Chinese ASMaQ was administered to non‑neurological HCPs working in an underdeveloped county in southwestern China. A convenience sampling method was used in the recruitment. Demographic information, including age, gender, years of service, job position (doctor/nurse), department, professional level, medical facility level (comprehensive hospital/noncomprehensive medical facility), and whether the participant had a neurologist partner or not during routine practice, was collected. The internal consistency was then measured with Cronbach’s α. Further statistical analyses were conducted to identify potential influencing factors of the ASMaQ score.

Results

After a standardized intercultural adaptation and evaluation process, a reliable localized Chinese version of ASMaQ was obtained, with an overall Cronbach’s α value of 0.77. A total of 252 HCPs completed the questionnaires, and 225 qualified questionnaires were included in the statistical analysis. The results revealed that the rate of good performance of overall ASMaQ among non-neurological HCPs was 69.4%. For the three subscales of ASMaQ, the rates of good performance for general stroke knowledge (GSK), hyperacute stroke management (HSM), and advanced stroke management (ASM) were 73.3%, 64.7%, and 70.1%, respectively. Furthermore, we found that the factors influencing the overall ASMaQ score were primarily gender, job position, medical facility level, and with/without neurologist partners. Specifically, females performed worse than males did (106.7 ± 7.7 vs. 110 ± 8.1; P = 0.003), nurses performed worse than doctors did (106.3 ± 7.6 vs. 110.0 ± 7.9; P < 0.001), the HCPs in noncomprehensive medical facilities performed worse than those in comprehensive hospitals did (105.2 ± 9.3 vs. 108.5 ± 7.3; P = 0.02), and the HCPs without neurologist partner in the routine clinical practise performed worse than those with (106.1 ± 8.1 vs 109 ± 7.5, P = 0.005). Multiple regression analysis revealed that the job position and the level of medical facility were the independent influencing factors for the total ASMaQ score (P < 0.001).

Conclusion

The Chinese version of ASMaQ comprehensively assesses the understanding of stroke management knowledge among HCPs. This study reflected the lack of stroke management knowledge among non-neurological HCPs in underdeveloped western regions of China for the first time and revealed that nurses and HCPs in noncomprehensive medical facilities were more likely to have insufficient knowledge of stroke management. Strengthening their training will significantly help improve stroke treatment rates, thereby reducing the burden of stroke-related morbidity and mortality.

Source: Evaluating the knowledge of stroke management among the non-neurological healthcare professionals in an underdeveloped county in Southwestern China