Effectiveness of stroke education in the emergency department waiting room

The purpose of this study was to evaluate the effectiveness of stroke education provided to patients and their significant others in the emergency department (ED) waiting area. Our focus was on the 4 main aspects of stroke: signs and symptoms, risk factors, behavior modification, and the urgency to seek medical attention. We hypothesized that showing educational videos, providing one-on-one counseling, and distributing literature would result in greater stroke knowledge and positive behavioral modification.

In this pilot, randomized controlled trial, our research team enrolled patients and visitors in the fast-track waiting area of the ED. After obtaining informed written consent, participants were randomly assigned to the control group or to the intervention group. The intervention group received an educational video program, one-on-one counseling, and stroke education materials, and completed a 13-question test after receiving the education. The control group completed the same test without receiving any education. Both groups completed the same test again at 1 and 3 months to assess stroke knowledge retention.

There were a total of 329 participants: 151 in the control group and 178 in the intervention group. Gender, age, and educational level of participants did not differ between groups. At all time points of the study, participants receiving stroke education demonstrated better test scores than those in the control group. However, knowledge retention in the intervention group gradually declined during the follow-up. Individuals enrolled in the intervention group appeared to be more motivated to reduce their smoking habits, compared with control subjects; however, the number of cigarettes they smoked per day did not dramatically decrease in comparison with their own baseline. Receiving the education session did not result in positive diet or physical activity changes.

ED stroke education, which includes video program, one-on-one counseling, and written educational materials, is able to significantly increase stroke knowledge. Modification and reinforcement of education is needed to achieve better knowledge retention and favorable lifestyle modifications.