Journal List > Korean J Adult Nurs > v.31(4) > 1130755

Korean J Adult Nurs. 2019 Aug;31(4):403-413. Korean.
Published online Aug 23, 2019.
© 2019 Korean Society of Adult Nursing
Factors Influencing Unawareness of Warning Signs of Stroke among Hypertensive Diabetic Patients at a High Risk for Stroke: The 2017 Nationwide Community Health Survey in Korea
Mirae Jo,1 Heeyoung Oh,2 Suk-Yong Jang,3 and Ahra Jo4
1Doctoral Student, Graduate School, College of Nursing, Eulji University, Daejeon, Korea.
2Professor, College of Nursing, Eulji University, Daejeon, Korea.
3Assistant Professor, Department of Preventive Medicine, School of Medicine, Eulji University, Daejeon, Korea.
4Assistant Professor, Department of Nursing, Songho University, Hoengseong, Korea.

Corresponding author: Oh, Heeyoung. College of Nursing, Eulji University, 77 Gyeryong-ro, 771 beon-gil, Jung-gu, Daejeon 34824, Korea. Tel: +82-42-259-1713, Fax: +82-42-259-1709, Email:
Received Apr 30, 2019; Revised Jun 10, 2019; Accepted Jun 25, 2019.

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.



The purpose of this study was to assess the awareness of warning signs of stroke and identify the risk factors influencing such awareness among diabetics with hypertension who are at a high risk for stroke.


Data from the 2017 Korea Community Health Survey were used. A total of 15,536 adults older than 30 years diagnosed with hypertension and diabetes mellitus were included in the final analysis. Data were analyzed using frequency, percentage, χ2 test, and logistic regression with SPSS/WIN 24.0 program.


Among the five warning signs of stroke, “sudden trouble in speaking or understanding” (79.0%) was the most commonly identified one and “sudden severe headache with an unknown cause” (65.2%) was the least. Only 48.8% participants identified all five warning signs and 11.8% could not identify any of them. In the logistic regression model, the risk of unawareness of warning signs of stroke was significantly higher among those aged 30~49 years and 70 years or older, with a lower educational level, without a spouse, and with a heavy alcohol consumption and current smoking status.


The level of awareness of warning signs was low in hypertensive diabetic adults. To improve awareness of warning signs of stroke, a customized educational program should be provided to hypertensive diabetic adults considering the risk factors relevant to unawareness of warning signs of stroke. The education on warning signs of stroke can potentially lead to a reduction in morbidity in the survivors.

Keywords: Stroke; Awareness; Hypertension; Diabetes mellitus


Table 1
Socio-demographic and Health-related Characteristics of Patients (N=15,536)
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Table 2
Awareness of Warning Signs of Stroke among Hypertensive Diabetic Patients (N=15,536)
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Table 3
Differences in Unawareness of Warning Signs of Stroke according to Socio-Demographic and Health-related Characteristics (N=15,536)
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Table 4
Factors Influencing Unawareness of Warning Signs of Stroke among Hypertensive Diabetic Patients (N=15,536)
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CONFLICTS OF INTEREST:The authors declared no conflict of interest.


  • Study conception and design acquisition - JM, OH and JS-Y.

  • Data collection - None (secondary data analysis).

  • Analysis and interpretation of the data - JM.

  • Drafting and critical revision of the manuscript - JM, OH, JS-Y and JA.

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