Effectiveness of a BEFAST-Based Stroke Education Module on Knowledge, Attitudes and Practices Among Stroke Patients at a Malaysian Tertiary Hospital: A Pre-Post Intervention Study

Stroke is a major health problem in Malaysia. Many stroke patients do not know how to recognize stroke symptoms quickly or when to seek emergency help. The BEFAST mnemonic (Balance, Eyes, Face, Arm, Speech, Time) is a simple tool to help people remember stroke warning signs. This study tests whether a single stroke education session based on BEFAST improves knowledge, attitudes, and emergency response intentions among stroke patients admitted to a Malaysian tertiary hospital. The study will use a pre-post intervention design with follow-up at one month. Participants will be the stroke patients admitted to the neurology ward. They will receive a one-hour structured education module covering BEFAST symptoms, risk factors, and the importance of reaching a hospital within 4.5 hours. Education will is delivered by doctors and nurses using presentations, pamphlets, posters, videos, and follow-up WhatsApp messages. Outcomes will be assessed using a validated questionnaire measuring knowledge, attitudes, and practices at three time points: before the intervention, immediately after, and at one month. Associations between demographic factors and outcomes will also be explored.

Inclusion Criteria: 1. Over 18 years old 2. Diagnosed with acute stroke (either ischemic or hemorrhagic) confirmed via MRI or CT scan according to WHO criteria 3. Clinically stable as determined by the attending neurologist using standardized assessment protocols 4. Cognitively able to participate 5. Able to understand Malay or English language as confirmed through structured communication assessment Exclusion Criteria: 1. Under 18 years of age 2. Significant cognitive impairment preventing informed consent 3. Severe aphasia precluding meaningful participation as assessed by speech-language pathologists 4. Too medically unstable to participate as determined by the clinical team 5. Previous documented diagnosis of dementia or other neurodegenerative conditions 6. Severe visual or hearing impairments preventing educational material comprehension 7. Expected to be discharged within 24 hours of admission