Public knowledge of cardiovascular disease and its risk factors in Kuwait: a cross-sectional survey

BMC Public Health

Hala Al-Nafisi¹  Abdelmoneim Awad¹ 

[1] Department of Pharmacy Practice, Faculty of Pharmacy, Kuwait University, P.O. Box 24923, Safat 13110, Kuwait

关键词: Kuwait;    Stroke;    Heart attack;    Risk factors;    Symptoms;    Knowledge;    Cardiovascular disease;   

Others  :  1123072
DOI  :  10.1186/1471-2458-14-1131

 received in 2014-08-11, accepted in 2014-10-21,  发布年份 2014

【 摘 要 】

Background

Cardiovascular disease (CVD) is estimated to cause 46% of all mortalities in Kuwait. To design effective primary and secondary prevention programs, an assessment of a population’s prior CVD knowledge is of paramount importance. There is scarcity of data on the existing CVD knowledge among the general Kuwaiti population. Hence, this study was performed to assess the level of knowledge towards CVD types, warning symptoms of heart attack or stroke, and CVD risk factors. It also explored public views on the community pharmacists’ role in CVD prevention and management.

Methods

A descriptive cross-sectional survey was performed using a pretested self-administered questionnaire on a sample of 900 randomly selected Kuwaiti individuals. Descriptive and multivariate logistic regression analysis were used in data analysis.

Results

The response rate was 90.7%. Respondents’ knowledge about types of CVD, heart attack or stroke symptoms was low. Almost 60% of respondents did not know any type of CVD, and coronary heart disease was the commonest identified type (29.0%). Two-fifths of participants were not aware of any heart attack symptoms, and the most commonly known were chest pain (50.4%) and shortness of breath (48.0%). Approximately half of respondents did not recognize any stroke symptoms, and the most commonly recognized were ‘confusion or trouble speaking’ (36.4%) and ‘numbness or weakness’ (34.7%). Respondents’ knowledge regarding CVD risk factors was moderate. The commonest factors identified by over four-fifths of participants were smoking, obesity, unhealthy diet and physical inactivity. In the multivariate logistic regression analysis, independent predictors of better level of CVD knowledge were females, age 50–59 years, high level of education, regular eating of healthy diet, and had a family history of CVD. Most of respondents only identified the role that pharmacists had to play is to help patients manage their medications, with a minimal role in other aspects of CVD prevention and management.

Conclusions

There are deficiencies in CVD knowledge among Kuwaiti population, which could turn into insufficient preventative behaviours and suboptimal patient outcomes. There is an apparent need to establish more wide-spread and effective educational interventions, which should be sensitive to the perceptions, attitudes, and abilities of targeted individuals.

【 授权许可】

   
2014 Awad and Al-Nafisi; licensee BioMed Central Ltd.

【 参考文献 】

• [1]World Health Organization: Cardiovascular diseases. http://www.euro.who.int/en/health-topics/noncommunicable-diseases/cardiovascular-diseases/cardiovascular-diseases2/definition-of-cardiovascular-diseases webcite
• [2]World Health Organization: Cardiovascular diseases (CVDs): Fact sheet No. 317. http://www.who.int/mediacentre/factsheets/fs317/en/ webcite
• [3]Zubaid M, Rashed WA, Husain M, Mohammad BA, Ridha M, Basharuthulla M, Rezq MA, Smid J, Thalib L: A registry of acute myocardial infarction in Kuwait: patient characteristics and practice patterns. Can J Cardiol 2004, 20:783-787.
• [4]World Health Organization:: World Health Statistics - Kuwait: country profiles -noncommunicable diseases. http://www.who.int/gho/countries/kwt/country_profiles/en/index.html webcite
• [5]Alarouj M, Bennakhi A, Alnesef Y, Sharifi M, Elkum N: Diabetes and associated cardiovascular risk factors in the State of Kuwait: the first national survey. Int J Clin Pract 2013, 67:89-96.
• [6]International Diabetes Federation: IDF diabetes atlas: sixth edition. http://www.idf.org/diabetesatlas webcite
• [7]Pearson TA, Palaniappan LP, Artinian NT, Carnethon MR, Criqui MH, Daniels SR, Fonarow GC, Fortmann SP, Franklin BA, Galloway JM, Goff DC Jr, Heath GW, Frank AT, Kris-Etherton PM, Labarthe DR, Murabito JM, Sacco RL, Sasson C, Turner MB: American Heart Association Guide for Improving Cardiovascular Health at the Community Level, 2013 update: a scientific statement for public health practitioners, healthcare providers, and health policy makers. Circulation 2013, 127:1730-1753.
• [8]Becker MH, Maiman LA, Kirscht JP, Haefner DP, Drachman RH: The Health Belief Model and prediction of dietary compliance: a field experiment. J Health Soc Behav 1977, 18:348-366.
• [9]Ford ES, Jones DH: Cardiovascular health knowledge in the United States: findings from the National Health Interview Survey, 1985. Prev Med 1991, 20:725-736.
• [10]McKinley S, Dracup K, Moser DK, Ball C, Yamasaki K, Kim CJ, Barnett M: International comparison of factors associated with delay in presentation for AMI treatment. Eur J Cardiovasc Nurs 2004, 3:225-230.
• [11]Sug Yoon S, Heller RF, Levi C, Wiggers J, Fitzgerald PE: Knowledge of stroke risk factors, warning symptoms, and treatment among an Australian urban population. Stroke 2001, 32:1926-1930.
• [12]Jafary FH, Aslam F, Mahmud H, Waheed A, Shakir M, Afzal A, Qayyum MA, Akram J, Khan IS, Haque IU: Cardiovascular health knowledge and behavior in patient attendants at four tertiary care hospitals in Pakistan–a cause for concern. BMC Public Health 2005, 5:124. BioMed Central Full Text
• [13]Perk J, De Backer G, Gohlke H, Graham I, Reiner Z, Verschuren WM, Albus C, Benlian P, Boysen G, Cifkova R, Deaton C, Ebrahim S, Fisher M, Germanò G, Hobbs R, Hoes A, Karadeniz S, Mezzani A, Prescott E, Ryden L, Scherer M, Syvanne M, Scholte Op Reimer WJ, Vrints C, Wood D, Zamorano JL, Zannad F: European Guidelines on cardiovascular disease prevention in clinical practice (version 2012). The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts). Eur J Prev Cardiol 2012, 19:585-667.
• [14]Al Hamarneh YN, Crealey GE, McElnay JC: Coronary heart disease: health knowledge and behaviour. Int J Clin Pharm 2011, 33:111-123.
• [15]Gill R, Chow CM: Knowledge of heart disease and stroke among cardiology inpatients and outpatients in a Canadian inner-city urban hospital. Can J Cardiol 2010, 26:537-540.
• [16]Khan MS, Jafary FH, Jafar TH, Faruqui AM, Rasool SI, Hatcher J, Chaturvedi N: Knowledge of modifiable risk factors of heart disease among patients with acute myocardial infarction in Karachi, Pakistan: a cross sectional study. BMC Cardiovasc Disord 2006, 6:18. BioMed Central Full Text
• [17]Mazloomy SS, Baghianimoghadam MH, Ehrampoush MH, Baghianimoghadam B, Mazidi M, Mozayan MR: A study of the knowledge, attitudes, and practices (KAP) of the women referred to health centers for cardiovascular disease (CVDs) and their risk factors. Health Care Women Int 2014, 35:50-59.
• [18]Saeed O, Gupta V, Dhawan N, Streja L, Shin JS, Ku M, Bhoi S, Verma S: Knowledge of modifiable risk factors of Coronary Atherosclerotic Heart Disease (CASHD) among a sample in India. BMC Int Health Hum Rights 2009, 9:2. BioMed Central Full Text
• [19]Kamran S, Bener AB, Deleu D, Khoja W, Jumma M, Al Shubali A, Inshashi J, Sharouqi I, Al Khabouri J: The level of awareness of stroke risk factors and symptoms in the Gulf Cooperation Council countries: Gulf Cooperation Council stroke awareness study. Neuroepidemiology 2007, 29:235-242.
• [20]Mukattash TL, Shara M, Jarab AS, Al-Azzam SI, Almaaytah A, Al Hamarneh YN: Public knowledge and awareness of cardiovascular disease and its risk factors: a cross-sectional study of 1000 Jordanians. Int J Pharm Pract 2012, 20:367-376.
• [21]Li YQ, Wright SC: Risk factors for cardiovascular disease in the Ga-Rankuwa community. Curationis 2007, 30:79-87.
• [22]Vaidya ARAU, Krettek A: Cardiovascular health knowledge, attitude and practice/behaviour in an urbanising community of Nepal: a population-based cross-sectional study from Jhaukhel-Duwakot Health Demographic Surveillance Site. BMJ Open 2013, 3:e002976.
• [23]Zhang QT, Hu DY, Yang JG, Zhang SY, Zhang XQ, Liu SS: Public knowledge of heart attack symptoms in Beijing residents. Chin Med J (Engl) 2007, 120:1587-1591.
• [24]Reeves MJ, Rafferty AP, Aranha AA, Theisen V: Changes in knowledge of stroke risk factors and warning signs among Michigan adults. Cerebrovasc Dis 2008, 25:385-391.
• [25]Attarchi M, Mohammadi S, Nojomi M, Labbafinejad Y: Knowledge and practice assessment of workers in a pharmaceutical company about prevention of coronary artery disease. Acta Med Iran 2012, 50:697-703.
• [26]Kuwait Central Statistical Bureau: General population census. http://www.csb.gov.kw/Socan_Statistic.aspx?ID=6 webcite
• [27]Dupont WD, Plummer WD Jr: Power and sample size calculations. http://biostat.mc.vanderbilt.edu/twiki/bin/view/Main/PowerSampleSize webcite
• [28]Avis NE, Smith KW, McKinlay JB: Accuracy of perceptions of heart attack risk: what influences perceptions and can they be changed? Am J Public Health 1989, 79:1608-1612.
• [29]Petricek G, Vrcic-Keglevic M, Vuletic G, Cerovecki V, Ozvacic Z, Murgic L: Illness perception and cardiovascular risk factors in patients with type 2 diabetes: cross-sectional questionnaire study. Croat Med J 2009, 50:583-593.
• [30]White CW, Albanese MA: Changes in cardiovascular health knowledge occurring from childhood to adulthood. A cross-sectional study. Circulation 1981, 63:1110-1115.
• [31]Thanavaro JL, Moore SM, Anthony MK, Narsavage G, Delicath T: Predictors of poor coronary heart disease knowledge level in women without prior coronary heart disease. J Am Acad Nurse Pract 2006, 18:574-581.
• [32]Awad A, Abahussain E: Health promotion and education activities of community pharmacists in Kuwait. Pharm World Sci 2010, 32:146-153.
• [33]International Pharmaceutical Federation: FIP Statement of policy- The role of the Pharmacist in the prevention and treatment of Chronic Disease. http://www.fip.org/www/uploads/database_file.php?id=274&table_id webcite
• [34]George J, McNamara K, Stewart K: The roles of community pharmacists in cardiovascular disease prevention and management. Australas Med J 2011, 4:266-272.
• [35]Altowaijri A, Phillips CJ, Fitzsimmons D: A systematic review of the clinical and economic effectiveness of clinical pharmacist intervention in secondary prevention of cardiovascular disease. J Manag Care Pharm 2013, 19:408-416.
• [36]Bell JS, Väänänen M, Ovaskainen H, Närhi U, Airaksinen MS: Providing patient care in community pharmacies: practice and research in Finland. Ann Pharmacother 2007, 41:1039-1046.