Journal of the Korean Applied Science and Technology (한국응용과학기술학회지)

The Korean Society of Applied Science and Technology (한국응용과학기술학회)
권호 표지
DOI QR코드

DOI QR Code

Factors Associated with Unawareness of Early Symptoms of Stroke and Myocardial Infarction in Adults with Hypertension and Diabetes: Focused on Management related to Disease

고혈압, 당뇨병 성인의 뇌졸중 및 심근경색증 조기 증상 비인지 관련 요인: 질병 관리 관련 특성을 중심으로

  • Received : 2021.01.27
  • Accepted : 2021.02.17
  • Published : 2021.02.28
Download PDF
⟨ Previous Next ⟩

Abstract

The purpose of this research was to determine the degree of awareness of early symptoms of stroke and myocardial infarction in adults diagnosed with hypertension and diabetes, and to analyze factors related to unawareness. Raw data from the 2017 Community Health Survey were utilized. A total 12,277 adults older than 40 years were included in analysis finally. The early symptom awareness rates of stroke and myocardial infarction were 53.6% and 46.8%, respectively. Logistic analysis was performed to assess factors associated with unawareness of early symptom of stroke and myocardial infarction. After correcting for socio-demographic variables, education for the management of hypertension, recognition of blood pressure level and HbA1c level were significantly related to stroke early symptom unawareness on multivariate analysis. (Education for the management of hypertension, recognition of blood pressure level and HbA1c level were significantly related to the unawareness of early stroke symptoms even after socio-demographic variables were corrected in multivariate analysis.) Recognition of blood pressure level and HbA1c level were also significantly associated with unawareness of early symptoms of myocardial infarction. Therefore, it is required to interventions and strategies to improve the level of awareness of early symptoms of cardio-cerebrovascular disease, such as accelerating promotion and strengthening education for high-risk groups who must manage both hypertension and diabetes.

본 연구의 목적은 고혈압 및 당뇨병을 진단 받은 성인의 뇌졸중 및 심근경색증의 조기 증상 인지 정도를 파악하고 비인지와 관련된 요인을 분석하기 위함이다. 2017년 지역사회건강조사 원시자료를 활용하여, 40세 이상 성인 12,277명의 자료를 분석하였다. 뇌졸중 및 심근경색증의 조기 증상 인지율은 각각 53.6%와 46.8%였다. 뇌졸중 및 심근경색증 조기 증상 비인지 요인을 평가하기 위해 로지스틱 분석을 수행하였다. 고혈압 관리 교육, 혈압 수치 및 당화혈색소 수치 인식은 다변량 분석에서 인구사회학적 변수를 보정한 후에도 뇌졸중 조기 증상 비인지와 유의한 관련이 있었다. 혈압 수치 및 당화혈색소 수치 인식은 심근경색증 조기 증상 비인지와 유의한 관련이 있었다. 그러므로 고혈압과 당뇨병을 모두 관리해야 하는 고위험군에 대한 홍보 촉진 및 교육 강화 등 심뇌혈관질환 조기 증상 인지 수준 개선을 위한 중재 및 전략의 개발이 요구된다.

Keywords

References

  1. Statistics Korea. Cause of Death Statistics in 2019 [Internet]. Daejeon: Statistics Korea, c2020[cited 2020 Sep 22], Available From: http://kostat.go.kr/portal/korea/kor_nw/1/6/2/index.board?bmode=read&bSeq=&aSeq=385219&pageNo=1&rowNum=10&navCount=10&currPg=&searchInfo=&sTarget=title&sTxt=. (accessed Jan., 5, 2021).
  2. Statistics Korea. Statistics of the Elderly in 2020 [Internet]. Daejeon: Statistics Korea, c2020[cited 2020 Sep 28], Available From: http://kostat.go.kr/portal/korea/kor_nw/1/1/index.board?bmode=read&aSeq=385322. (accessed Jan., 5, 2021).
  3. Inha University Hospital. Complication of Hypertension [Internet]. Available From: https://www.inha.com/site/iccvc/information/hypertension. (accessed Jan., 5, 2021).
  4. Korean Diabetes Association. Treatment and Management [Internet]. Available From: https://www.diabetes.or.kr/general/class/medical.php?mode=view&number=7&idx=5. (accessed Jan., 5, 2021).
  5. Korea National Diabetes Program (KNDP). Treatment Guidelines for Cardiovascular Complications in Diabetes. c2007[cited 2007 Dec 28], Available From: https://kaim.or.kr/files/guide/%EB%82%B4%EB%B6%84%EB%B9%84%EB%8C%80%EC%82%AC_05.pdf. (accessed Jan., 5, 2021).
  6. A. Gonzalez-Aquines, A. C. Cordero-Perez, M. Cristobal-Nino, G. Perez-Vazquez, F. Gongora-Rivera, GECEN Investigators, "Contribution of Onset-to-Alarm Time to Prehospital Delay in Patients with Ischemic Stroke". Journal of Stroke and Cerebrovascular Diseases, Vol.28, No.11 pp. 104331, (2019). https://doi.org/10.1016/j.jstrokecerebrovasdis.2019.104331
  7. P. Goldstein, E. Wiel, "Management of Prehospital Thrombolytic Therapy in ST-segment Elevation Acute Coronary Syndrome (<12 Hours)". Minerva Anestesiologica, Vol.71, No.6 pp. 297-302, (2005).
  8. J. C. Finn, J. H. Bett, T. R. Shilton, C. Cunningham, P. L. Thompson, National Heart Foundation of Australia Chest Pain Every Minute Counts Working Group, "Patient Delay in Responding to Symptoms of Possible Heart Attack: Can We Reduce Time to Care?". The Medical Journal of Australia, Vol.187, No.5 pp. 293-298, (2007). https://doi.org/10.5694/j.1326-5377.2007.tb01247.x
  9. H. S. Kim, "Acute Myocardial Infarction Symptoms and Factors related to Prehospital Delay among Korean Patients with ST-elevation MI". Unpublished doctoral dissertation, Seoul National University, (2016).
  10. D. K. Moser, L. P. Kimble, M. J. Alberts, A Alonzo, J. B. Croft, K. Dracup, et al., "Reducing Delay in Seeking Treatment by Patients with Acute Coronary Syndrome and Stroke: A Scientific Statement from the American Heart Association Council on Cardiovascular Nursing and Stroke Council". Circulation, Vol.114, No.2 pp. 168-182, (2006). https://doi.org/10.1161/CIRCULATIONAHA.106.176040
  11. Y. M. Lee, K. Y. Kim, K. S. Kim, "Awareness of Stroke Warning Symptoms and Related Factors among Residents in a Province". Journal of the Korea Academia-Industrial cooperation Society, Vol.15, No.8 pp. 5116-5123, (2014). https://doi.org/10.5762/KAIS.2014.15.8.5116
  12. S. H. Lee, "Symptoms Awareness of Acute Myocardial Infarction and Stroke and Related Factors in Ulsan". Unpublished master's thesis, Ulsan University, (2020).
  13. J. Sim, C. N. Shin, K. An, M. Todd, "Factors Associated With the Hospital Arrival Time in Patients With Ischemic Stroke in Korea". Journal of Cardiovascular Nursing, Vol.31, No.5 pp. E10-6, (2016).
  14. K. S. Park, "Factors Affecting Awareness of Myocardial Infarction Syndromes Among the General Public in Korea". Epidemiology and Health, Vol.42, pp. e2020032, (2020). https://doi.org/10.4178/epih.e2020032
  15. S. Mahagan, J. Valero-Elizondo, R. Khera, N. R. Desai, R. Blankstein, M. J. Blaha, et al., "Variation and Disparities in Awareness of Myocardial Infarction Syndromes Among Adults in the United States". JAMA Network Open, Vol.2, No.12 pp. e1917885, (2019). https://doi.org/10.1001/jamanetworkopen.2019.17885
  16. Y. H. Lee, Y. T. kim, G. J. Oh, N. H. Kim, K. H. Cho, H. Y. Park, et al., "Effects of Community-based Education and Advocacy Intervention on Public Awareness about the warning Signs of Stroke and the Golden Window of Time". Korean Journal of Health Education and promotion, Vol.32, No.1 pp. 1-10, (2015).
  17. M. R. Jo, H. Y. Oh, S. Y. Jang, A. R. Jo, "Factors Influencing Unawareness of Warning Signs of Stroke among Hypertensive Diabetic Patients at a High Risk for Stroke: The 2017 Nationwide Community Health Survey in Korea". Korean Journal of Adult Nursing, Vol.31, No.4 pp. 403-413, (2019). https://doi.org/10.7475/kjan.2019.31.4.403
  18. Korea Centers for Disease Control and Prevention. Community Health Survey, 2017 [Internet]. Cheongju: Korea Centers for Disease Control and Prevention, c2018 [cited 2018 Nov 29], Available From: https://chs.cdc.go.kr/chs/mnl/mnlBoardMain.do. (accessed May., 20, 2019)
  19. M. N. Kim, Y. H. Lee, N. H. Kim, "Awareness of Early Symptoms and Emergency Responses to Myocardial Infarction and Stroke in People with Diabetes Mellitus Compared to Non-diabetic Population in the Community: A Propensity Score-Matched Analysis". Health Policy and Management, Vol.30, No.3 pp. 386-398, (2020). https://doi.org/10.4332/KJHPA.2020.30.3.386
  20. S. Whitaker, T. Baldwin, M. Tahir, O. Choudhry, A. Senior, S. Greenfield, "Public Knowledge of the Symptoms of Myocardial Infarction: A Street Survey in Birmingham, England". Family Practice, Vol.29, No.2 pp. 168-173, (2012). https://doi.org/10.1093/fampra/cmr079
  21. K. Thygesen, J. S. Alpert, A. S. Jaffe, M. L. Simoons, B. R. Chaitman, H. D. White, et al., "Third Universal Definition of Myocardial Infarction". Journal of the American College of Cardiology, Vol.60, No.16 pp. 1581-1598, (2012). https://doi.org/10.1016/j.jacc.2012.08.001
  22. V. Bhat, T. Gs, A. Kasthuri, "Stroke Awareness among Elderly Hypertensives in a Rural Area of Bangalore District, India". Journal of Stroke and Cerebrovascular Diseases, Vol.30, No.1 pp. 105467, (2020). https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.105467
  23. J. M. Ramirez-Moreno, R. Alonso-Gonzalez, D. Peral-Pacheco, M. V. Millan-Nunez, J. J. Aguirre-Sanchez, "Stroke Awareness Is Worse among the Old and Poorly Educated: A Population-Based Survey". Journal of Stroke and Cerebrovascular Diseases, Vol.24, No.5 pp. 1038-1046, (2015). https://doi.org/10.1016/j.jstrokecerebrovasdis.2014.12.031
  24. Centers for Disease Control and Prevention (CDC), "Disparities in Adult Awareness of Heart Attack Warning Signs and Symptoms --- 14 States, 2005". Morbidity and Mortality Weekly Report (MMWR), Vol.57, No.7 pp. 175-179, (2008).
  25. J. M. Barnhart, O. Cohen, H. M. Kramer, C. M. Wilkins, J. Wylie-Rosett, "Awareness of Heart Attack Symptoms and Lifesaving Actions among New York City Area Residents". Journal of Urban Health : Bulletin of the New York Academy of Medicine, Vol.82, No.2 pp. 207-215, (2005). https://doi.org/10.1093/jurban/jti045
  26. I. S. Ko, G. S. Kim, M. H. Lim, K. J. Lee, T. W. Lee, H. S. Park, et al., "Effects of Health Education on the Knowledge and Self-care of Hypertension for Visiting Nursing Clients". Journal of Korean Public Health Nursing, Vol.21, No.2 pp. 134-145, (2007).
  27. J. E. Bray, R. Johnson, K. Trobbiani, I. Mosley, E. Lalor, D. Cadihac, et al., "Australian Public's Awareness of Stroke Warning Signs Improves after National Multimedia Campaigns". Stroke, Vol.44, No.12 pp. 3540-3543, (2013). https://doi.org/10.1161/STROKEAHA.113.002987
  28. H. S. Kim, "Risk of Stroke according to the Duration of Diabetes Mellitus with Hypertension". Korean Journal of Clinical Laboratory Science, Vol.52, No.3 pp. 188-193, (2020). https://doi.org/10.15324/kjcls.2020.52.3.188
  29. Medical Times. Hypercholesterolemia in Adults Steadily Increases...Hypertension Decreases. c2020[cited 2020 Dec 30]. https://www.medicaltimes.com/Users/News/NewsView.html?ID=1137991. (accessed Jan., 14, 2021)