Study On Knowledge,Attitude And Practice Status And Influencing Factors Of Cognitive Impairment In Stroke Patients

Objective:To develop a post-stroke cognitive impairment knowledge-attitude-practice questionnaire to investigate the current knowledge,attitude and practice of stroke patients about cognitive impairment,analyse the relevant influencing factors and provide a reference basis for the development of post-stroke cognitive impairment interventions.Methods:The study was divided into two parts.The first part was questionnaire development,in which a pool of questionnaire entries was formed through literature review and group discussion,conduct item modification and reliability and validity testing through expert consultation and pre-survey,to finally establish a post-stroke cognitive impairment knowledge-attitude-practice questionnaire.The second part was a questionnaire survey.304 stroke patients who were admitted to the neurology department of a third-class A hospital in Hebei Province were selected as the study population by convenience sampling.The survey instruments included the general information questionnaire,the Montreal Cognitive Assessment(Mo CA),and the post-stroke cognitive impairment knowledge-attitude-practice questionnaire.Epi Date 3.1 was used to create the database and SPSS 25.0 statistical software was used for statistical analysis.Multiple linear regression analysis showed the influencing factors of knowledge,attitude and practice status of cognitive impairment after stroke.Results:1.Through literature review,group discussion,expert consultation and pre-survey,the knowledge-attitude-practice questionnaire was developed,with 23 items in total,including 15 entries for the knowledge dimension,4entries for the attitude dimension and 4 entries for the practice dimension,with a score of 8 to 51 points.The Cronbach’sαcoefficients for each dimension of knowledge,attitude and practice were 0.946,0.904 and 0.841respectively,and the overall Cronbach’sαis 0.951.The content validity index of each item level is 0.830～1,and the overall content validity index of the questionnaire is 0.957.The correlation coefficients between each item and the total score ranged from 0.414 to 0.714,and the differences were statistically significant(P<0.05),and the questionnaire had good reliability and validity.2.In the survey of 304 stroke patients,the mean overall score of KAP of post-stroke cognitive impairment was(35.62±5.82),with a mean score rate of 69.91%,which was at an intermediate level.The mean score of knowledge dimension was 60.24%,the mean score of attitude dimension was80.53%,and the mean score of practice dimension was 65.69%,and the scores of knowledge,attitude and practice were positively correlated.3.The items with the lowest scoring rate in the knowledge dimension are:the related influencing factors of cognitive impairment in stroke,ranging from 29.70%to 44.04%;The item with the lowest score rate in the attitude dimension is“cognitive impairment caused by stroke,early treatment has the possibility of returning to normal”,which is 74.71%;The item with the lowest score rate in the practice dimension was“active learning of stroke rehabilitation related knowledge in the recovery process”,which was51.89%.4.The results of multiple linear regression analysis show that monthly income,cognitive function,hobbies,age,and exercise are the main influencing factors for stroke patients’knowledge,attitude and practice levels of cognitive impairment.The determination coefficient R~2=0.424,adjusted R~2=0.390,can explain 39.0%of the variance.Conclusions:1.The questionnaire on knowledge,attitude and practice of post-stroke cognitive impairment has been developed in this study,which has good reliability and validity.2.Patients’knowledge,attitude,and practice about the PSCI were at an intermediate level,with positive correlations between knowledge,attitude,and practice scores.3.Medical staff should focus on strengthening education on the influencing factors of cognitive impairment after stroke,guiding patients to establish positive treatment beliefs,and helping patients learn relevant knowledge about cognitive impairment.4.Monthly income,cognitive function,interests and hobbies,age,and exercise are the main influencing factors for stroke patients’knowledge,attitude,and practice levels of post-stroke cognitive impairment.