Date of Conferral

2022

Degree

Ph.D.

School

Public Health

Advisor

Shawn M. Munford

Abstract

AbstractIncidence of cardiovascular accident (CVA), also referred to as a stroke, has increased in Bermuda. Understanding key contributing factors is necessary to reduce incidences that are associated with this disease process. This dissertation examined the outcome of stroke education and management on CVA patients in Bermuda. The health belief model, incorporating a reflection of the public health framework, guided the analysis of a quantitative dataset obtained through Bermuda Hospitals Board’s Neurology Department. A cross-sectional study design was used to sample 253 stroke patients over a 2-year period (2019 -2021). The Wilcox test was employed to compare two groups – stroke education (yes or no) and length of stay (continuous outcome). The results revealed that stroke education on risk factors, warning signs, and activation of emergency medical service (EMS) significantly reduced the length of stay on CVA patients in Bermuda. The chi-square test assessed the association between patients accepting medical strategies and management and the discharging decision (home or rehab) process but indicated there was no association between patients accepting medical strategies and management and the discharging decision (home or rehab) process. Logistic regression assessed potential significance between tissue plasminogen activator (tPA) administration and the odds of complications among the elderly aged 60 and above in Bermuda, controlling for age and gender. The null hypothesis was accepted, indicating no statistical significance between these variables. Specific changes in the education campaigns and guidance for policymakers regarding the importance of health literacy and lifestyle changes being incorporated in stroke knowledge could result in positive social change.

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