Knowledge of Heart Disease and Stroke Symptoms and Emergency Response in Thai People Aged 15-60 Years Old in Bangkok
Keywords:
cardiovascular disease, stroke awareness, health literacy, emergency response, ThailandAbstract
Cardiovascular disease (CVD), including heart disease and stroke, remains a leading cause of morbidity and mortality worldwide, with increasing prevalence in Thailand. Early recognition of symptoms and appropriate emergency response are critical to reducing mortality; however, gaps between knowledge and action persist, particularly in urban populations. This study aimed to assess cardiovascular health literacy (knowledge of heart disease and stroke symptoms), evaluate emergency response readiness, and examine demographic factors associated with both domains among Thai adults aged 15–60 years in Bangkok. A descriptive cross-sectional survey was conducted among 1,122 participants using a structured and validated online questionnaire. Cardiovascular health literacy was measured using 20 multiple-choice items (score range: 0–20), while emergency response readiness was assessed using 10 scenario-based items (score range: 0–10). Data were analyzed using descriptive statistics, independent-samples t-tests, one-way ANOVA, Pearson’s correlation, and multiple linear regression. Statistical significance was set at p<0.05. The results showed that overall, 56.51% of participants demonstrated good cardiovascular health literacy, 35.83% moderate, and 7.66% poor. Emergency response readiness was high, with 91.09% classified as good. Age and monthly household income were significant predictors of health literacy (p<0.05), and both variables also significantly predicted emergency response readiness (p<0.05). Cardiovascular health literacy was positively associated with emergency response readiness. In conclusion, Thai adults in Bangkok demonstrate moderate to high levels of cardiovascular health literacy and strong emergency response readiness. However, disparities related to age and socioeconomic status remain. These findings highlight the importance of integrated health literacy and behavioral interventions, particularly targeting younger and lower-income populations, to improve timely response to cardiovascular emergencies and promote equitable disease prevention
References
Aekplakorn W, Suriyawongpaisal P, Sirirassamee B. Assessment of capacity for cardiovascular disease control and prevention in Thailand: a qualitative study. Southeast Asian J Trop Med Public Health [Internet]. 2005 [cited 2025 Jun 19];36(3):741–7. Available from: https://pubmed.ncbi.nlm.nih.gov/16124449/
Swanoski MT, Lutfiyya MN, Amaro ML, Akers MF, Huot KL. Knowledge of heart attack and stroke symptomology: a cross-sectional comparison of rural and non-rural US adults. BMC Public Health 2012;12:283.
Marcelo LC, Payo DP, Muñoz MM, Cisneros RP. Reduced income and its associations with physical inactivity, unhealthy habits, and cardiac complications in the hypertensive population. European J Investig Health Psychol Educ [Internet]. 2024 [cited 2025 May 19];14(8):2300–13. Available from: https://www.mdpi.com/2254-9625/14/8/153
Shahu A, Okunrintemi V, Tibuakuu M, Khan SU, Gulati M, Marvel F, et al. Income disparity and utilization of cardiovascular preventive care services among US adults. American J Prev Cardiol 2021;8:100286.
Quah JLJ, Yap S, Cheah SO, Ng YY, Goh ES, Doctor N, et al. Knowledge of signs and symptoms of heart attack and stroke among Singapore residents. Biomed Res Int [Internet]. 2014 [cited 2025 Jun 29];2014:572425. Available from: https://onlinelibrary.wiley.com/doi/10.1155/2014/572425
Alrawili NKA, Alanazi SN, Alanazi SN, Rikabi HA, Abdulkareem EM, Eltaib L. Public awareness and knowledge of stroke risk factors and symptoms in Saudi Arabia: A cross-sectional study. ARYA Atheroscler [Internet]. 2025 [cited 2025 Jun 29];21(4):26–35. Available from: https://arya.mui.ac.ir/article_32907.html
Dharmasaroja P, Uransilp N. Stroke awareness and knowledge in the at-risk population: a community-based study. Cureus [Internet]. 2024 [cited 2025 Jun 29]; Available from: https://www.cureus.com/articles/238078-stroke-awareness-and-knowledge-in-the-at-risk-population-a-community-based-study.pdf
Chang WW, Fei SZ, Pan N, Yao YS, Jin YL. Incident stroke and its influencing factors in patients with type 2 diabetes mellitus and/or hypertension: a prospective cohort study. Front Cardiovasc Med 2022;9:770025.
Kittiboonthawan P, Yingrengrueng S, Sritunya S. Perception of stroke warning signs among high-risk patients. Nurs J Minist Public Health [Internet]. 2025 [cited 2025 Jul 16];23(3):132–41. Available from: https://he02.tci-thaijo.org/index.php/tnaph/article/view/16637
Bryce TGK. Human Characteristics and School Learning, B. S. Bloom (McGraw-Hill, 1976) pp. xii plus 284, £8.95. Scott Educ Rev 1978;10(2):65–9.
Alyafei A, Carr RE. The health belief model of behavior change [Internet]. 2024 [cited 2025 Jul 16]. Available from: https://www.statpearls.com/point-of-care/161679
Nutbeam D. Health literacy as a public health goal: a challenge for contemporary health education and communication strategies into the 21st Century. Health Promot Int [Internet]. 2000 [cited 2025 Jul 16];15(3):259–67. Available from: https://academic.oup.com/heapro/article/15/3/259/551108
Lundelin K, Graciani A, Puig JG, Castillón PG, Taboada JM, Artalejo FR, et al. Knowledge of stroke warning symptoms and intended action in response to stroke in Spain: A Nationwide Population-Based Study. Cerebrovasc Dis 2012;34(2):161–8.
Bártlová S, Šedová L, Rolantová L, Hudáčková A, Dolák F, Sadílek P. General awareness of stroke in the Czech Republic. Cent Eur J Public Health 2021;29(3):230–5.
Egele VS, Klopp E, Stark R. How Valid Is Bandura’s social cognitive theory to explain physical activity behavior? Eur J Investig Health Psychol Educ [Internet]. 2025 [cited 2025 Aug 5];15(2):20. Available from: https://www.mdpi.com/2254-9625/15/2/20
Ajzen I. The theory of planned behavior. Organizational Behavior and Human Decision Processes 1991;50(2):179–211.
World Health Organization. Social determinants of health [Internet]. 2025 [cited 2025 Aug 5]. Available from: https://www.who.int/health-topics/social-determinants-of-health#tab=tab_1
Alkhawaldeh A, ALBashtawy M, Rayan A, Abdalrahim A, Musa AS, Eshah NF, et al. Application and use of Andersen’s behavioral model as theoretical framework: a systematic literature review from 2012–2021. Iran J Public Health 2023;52(7).
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