People’s knowledge, awareness, and attitude (KAA) about hypertension are the cornerstone of hypertension control and/or prevention. Thus, the aim of this study was to assess the level of KAA of hypertensive populations about their disease and compare the level of KAA between rural and urban areas in Selangor, Malaysia. A cross-sectional study was conducted at Hospital Kuala Lumpur and six rural areas in Selangor, Malaysia. A valid questionnaire was used to evaluate the level of KAA of the Malaysian hypertensive population. One thousand subjects were recruited by the non-probability convenience sampling method. The mean age of the participants was 48 years old. Most of them (51.3%) had a moderate knowledge, 31.9% expressed fair awareness, and 48.8% showed moderate attitude regarding hypertension. Statistical analyses of the data revealed that the level of knowledge was found to be significantly associated with gender, age, race, education level, and source of information about hypertension (p   0.05), whereas there was a statistically significant difference in the level of awareness between participants from urban and rural areas (p < 0.05). Efforts are needed to increase KAA about hypertension through health campaigns in public places and via the media to decrease hypertensive complications and its global epidemic.

Hypertension knowledge, awareness, and attitude among the hypertensive population in Kuala Lumpur and rural areas in Selangor, Malaysia

Introduction Because of the inadequate level of public awareness of the disease, the incidence of stroke has been sharply rising. Eventually, due to the prehospital delay, many stroke cases could not be eligible for thrombolysis thereby poor rehabilitative outcome has been tremendously increased. Thus, this study aimed to review the level of knowledge, prevention practice, and associated factors of stroke among hypertensive and diabetic patients. Methods A systematic review of primarily published articles (2010-2020) related to knowledge and prevention practices of stroke was performed by searching online electronic databases like PubMed, Google Scholar, Refseek, Science direct, ResearchGate, and manual Google search by using the keywords and MeSH terms. Studies conducted on knowledge and prevention practices amongst hypertensive and/or diabetic patients were included. Results Out of 531 searched studies, 42 articles were identified to be reviewed. The reported overall knowledge of stroke was ranging from 4.4% to 79%. Knowledge to the signs/symptoms of stroke was 23.6% to 87%. However, 15% to 77% of subjects were also reported that they did not know any sign of stroke. The range of risk factor knowledge was 10.5% to 86.6%. The reported level of stroke prevention practice was 2.4% to 72% but physical activity and weight reduction practice were relatively low. Inadequate level of knowledge and prevention practice of stroke was related to elderly, female gender, uneducated, unmarried, rural residents, economically low, comorbidity and unemployed individuals. Conclusion The current finding revealed that the level of knowledge and prevention practice of stroke was inadequate. Hence, the finding highlights health educational programs should be planned as an important avenue to enhance stroke awareness among the high-risk populations.

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Knowledge, Prevention Practice and Associated Factors of Stroke Among Hypertensive and Diabetic Patients - A Systematic Review.

Background: Patients have a significant role in controlling and treating hypertension. Improving patients’ Knowledge, Attitude, and Practice (KAP) is a crucial step in controlling hypertension. Objectives: This study aimed to examine the effect of training based on the Expanded Chronic Care Model (ECCM) on KAP in patients with hypertension residing in Isfahan, Iran. Methods: The clinical trial was conducted on 190 hypertensive patients aged 36 to 80 in 2015 - 2016. Patients were randomly assigned to an intervention and a control group. The intervention plan based on ECCM was four 2-hour education sessions for the intervention group and a family member. Then, follow-ups were done by a phone call for six months. Meanwhile; there was no intervention in the control group. The data collection was done using KAP (a valid researcher-made questionnaire), before and after intervention in both groups. Results: In the intervention group, there was a statistically significant difference between the mean score of KAP before and six months after the ECCM training (P < 0.05). No significant differences were observed in the control group. The two groups were not significantly different in terms of the Mean ± SD of KAP scores before the intervention. Six months after implementing the care model, however, the Mean ± SD of KAP scores were significantly higher in the intervention group compared to in the controls (P < 0.05). Conclusions: Based on the results, a training program based on the ECCM is effective in improving the knowledge, attitude, and practice of patients. The ECCM could therefore be used as a framework for designing educational interventions for patients with hypertension.

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The Effect of Training on Knowledge, Attitude, and Practice in Patients with Hypertension; The Application of the Expanded Chronic Care Model: A Clinical Trial Study

Background: Malnutrition and mineral disparities has become increasingly common in patients with the end-stage renal disease treated with hemodialysis (HD). Lack of nutritional knowledge is one of the most significant reasons for nutritional problems leading to improper practice and causing several complications. The objectives of the study were to asses the nutrition knowledge, attitude, and practice of HD patients regarding renal diet, to counsel the patients on HD dietary guidelines and to determine the association of factors such as income and education level on nutrition management of HD Patients. To assess the nutrition knowledge, attitude, and practice of HD patients regarding renal diet. To counsel the patients on HD dietary guidelines. To determine the association of factors such as income and education level on nutrition management of HD patients. Methods: A total of 120 patients undergoing HD were assessed for the level of nutrition knowledge, attitude, and practice, regarding HD dietary guidelines, using a validated questionnaire. Results: About 60.3% of HD patients had excellent knowledge, 60% had excellent attitude, and 40% had excellent practices. There is a significant positive correlation between knowledge and attitude, as well as knowledge and practice (r < 0.01) of the patients undergoing HD regarding renal diet. There is also a significant association between the knowledge, attitude, and practice scores with the selected demographical variables (education level and income) of patients at the significance level of P < 0.001. Conclusion: Although majority of the patients have excellent knowledge, attitude, and practice, a notable number of patients are unaware about their dietary guidelines and do not adhere to the dietary regime that needs to be followed. Diet counseling by a renal dietitian using a nutrition education module can effectively upgrade the nutrition knowledge, attitude, and practice of HD dietary guidelines by the patients.

Knowledge, attitude, and practices of renal diets among hemodialysis patients

The high blood pressure (HBP), a chronic circulatory disease, is one of the most widespread non-communicable diseases (NCD) globally. More than 360,000 deaths in US in 2013 occurred due to HBP.1 The HBP is preventable, but mismanagement leads to serious medical complications, e.g., heart failure, coronary vascular disease, encephalopathy, acute renal failure and intracranial or subarachnoid hemorrhage.2 According to World Health Statistics 2017, an estimated 17.7 million deaths occurred due to cardiovascular disease, accounting for 45% of all NCD deaths.3 Unfortunately, the incidence of hypertension, a key tracer indicator of health services for cardiovascular diseases, has not declined in many low-income countries since 2000.3 In Afghanistan the NCDs have ranked low in government and donor prioritization. There has not been any national policy, strategy, targets or coordinating body for NCDs so far. The national NCDs surveillance system, which is crucial for informed policy and focused strategy, is yet to be established, and currently the surveillance for NCDs is limited.4 The Ministry of Public Health (MOPH) considers the integration of NCDs such as prevention and control of cardiovascular diseases, diabetes, and chronic pulmonary diseases in the Basic Package of Health Services (BPHS) and Essential Package of Hospital Services (EPHS). Capacity building of service providers about prevention, diagnosis and treatment of NCDs and modification of the infrastructure is needed for improving NCD management.4 The prevalence and associated complications of HBP are multi factorial like positive family history, presence of obesity, misdiagnosis, and inappropriate or insufficient therapy. In addition, HBP is associated and influenced by many genetic, hormonal, metabolic, neurological and psychological factors. The HBP is also influenced by rapid urbanization, changes in socioeconomic conditions such as sedentary life, alcohol consumption, excessive salt intake and increased stress and this burden is likely to grow in the coming decades.5 Epidemiologically, HBP is widespread globally, even in the economically developed nations such as United States where it was second most important fatality cause after tobacco.1 The HBP is one of the leading attributable risk factors for mortality in South Asia. The latest prevalence of HBP was found to be in Bangladesh: 17.9%; Bhutan: 23.9%; India: 31.4%; Maldives: 31.5%; Nepal: 33.8%; Pakistan: 25%; and Sri Lanka: 20.9%.6

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Evaluation of hypertension related knowledge, attitudes and practices at community level in Kabul

Background: Hypertension is not a disease but it is an important risk factor for cardiovascular complications. Approximately 77.9 million American adults (1 in 3 people) and one billion people worldwide have high blood pressure. Hypertension can be described as the ‘sleeping snake’ which bites when it wakes up. There is need to investigate KAP among the general population which helps in the future development programmes for effective health education The main aim of this study was to assess the patients Knowledge, Attitude and Practice regarding hypertension. Methods: This is a prospective observational study conducted in the In-patient Departments of Gandhi hospital, Secunderabad for a period of 6 months (August 2015 - January 2016) which was approved by institutional ethics committee. A total of 160 hypertensive patients with or without comorbid condition were included. . Adults of age less than 30 years, paediatrics, Pregnant and lactating women were excluded. Patients were selected by simple random sampling method. A suitably designed and validated KAP questionnaire was administered to hypertensive patients. This questionnaire was filled in at face to face interview along with inform consent Statistical analysis was performed using Graph pad prism software version 5. Data was analysed using unpaired t-test. Results: We observed a good score towards knowledge, attitude and poor score towards practice. Conclusions: Our study signifies that patients require support and guidance for practicing better disease management. Clinical activities such as patient counselling, Home Medication Review, Pharmaceutical care program help to increase the patients practice in disease management.

Assessment of patient’s knowledge, attitude and practice regarding hypertension -

Lichen simplex chronicus (LSC) is a chronic inflammation of the skin characterized by lichenification of the skin because of excessive scratching. This case report depicts a 58-year-old male with the chief complaints of pain in left hemiplegia upper and lower limbs and slurring of speech for 10 days. The patient also had complaints of itching and skin lesion over the upper and lower limbs for 1 year. The associations of LSC with depression, anxiety, obsessive-compulsive and personality disorders are well established in the literature. LSC is an irritating itchy dermatosis in which anxiety is common and affects the quality of life (QOL) of the patients.

Aruna Surakasula

Papers

Assessment of patient’s knowledge, attitude and practice regarding hypertension -

Lichen simplex chronicus