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The Effect of an Educational Pamphlet on Patient Knowledge of and Intention to Discuss Screening for Obstructive Sleep Apnea in the Acute Ischemic Stroke Population

Donald, Ryan, A.; Arays, Ruta; Elliott, John, O.; Jordan, Kim

Journal of Neuroscience Nursing: June 2018 - Volume 50 - Issue 3 - p 177–181
doi: 10.1097/JNN.0000000000000361

ABSTRACT Background: The relationship between obstructive sleep apnea (OSA) and stroke is well established, thus supporting the importance of secondary prevention via screening and treatment for acute ischemic stroke survivors. Educational pamphlets are commonly used for patient education; however, none currently available on OSA have evaluated. The aim of this study was to evaluate the effect of a brief educational intervention on patient knowledge and interest in OSA screening. Methods: Adult acute ischemic stroke patients were enrolled into a nonrandomized, single-group, pretest and posttest study. Inclusion criteria included minor or moderate stroke per the National Institutes of Health Stroke Scale score of 1 to 15, with a level of consciousness score of 0. Patients with known dementia or OSA were excluded. After the preintervention survey, patients were given an educational pamphlet reviewing OSA and stroke. A postintervention survey was administered 24 to 72 hours later. Outcomes included an 8-question knowledge test standardized to percentiles, intention to speak with a physician about screening on a 7-point scale (1, not at all likely, to 7, very likely), and perception of the pamphlet’s educational value on a 7-point scale (1, not valuable, to 7, quite valuable). Results: Of 124 eligible patients, 36 consented and 26 completed both preintervention and postintervention surveys. Preintervention knowledge scores averaged 69.7% (SD, 21.3%), postintervention scores averaged 80.8% (SD, 21.0%), P = .005, with an effect size of 1.00. Likelihood of speaking with a physician about OSA testing improved from 3.5 (SD, 2.0) to 5.0 (SD, 1.8), P = .001, with an effect size of 0.89. Pamphlet educational value was scored at 5.2 (SD, 1.7). Conclusions: A brief educational pamphlet written using health literacy concepts was considered valuable and improved patient knowledge and intention to discuss OSA screening with a physician. Further work is needed to determine whether the pamphlet can promote a discussion and referral for OSA screening at the primary care level.

Questions or comments about this article may be directed to John O. Elliott, PhD MPH, at He is a Research Specialist, Medical Education, Riverside Methodist Hospital, and OhioHealth Research Institute, Columbus, OH.

Ryan A. Donald, MD, is Clinical Assistant Professor, Division of Pulmonary, Critical Care, and Sleep Medicine, The Ohio State University, Columbus, OH.

Ruta Arays, MD, is Hematology-Oncology Fellow, University of Kentucky, Lexington, KY.

Kim Jordan, MD FACP, is Associate Program Director, Internal Medicine, Department of Medical Education, OhioHealth Riverside Methodist Hospital, Columbus, OH.

All authors participated in the conceptualization and design of the study, interpretation of the results, and draft and revisions of the article. All authors have approved the final draft of the article for submission.

This project was supported by the OhioHealth Research Institute’s resident research fund.

The authors declare no conflicts of interest.

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© 2018 American Association of Neuroscience Nurses