Mervin K Soman^1*, Nivedhya J², Anbarasu K³

¹Assistant professor, ³ UG, Department of General Medicine, Saveetha Medical College and Hospital, Saveetha Nagar, Thandalam,Chennai,INDIA-602105.

²Consultant Psychiatrist, Star Lakshmi Hospital, Ayyappanthangal, Chennai, INDIA-600056

Email: dr.mervin.k.soman@gmail.com

Table 1: Demographic variables

Majority of the caregivers were children (39% were sons and 22% were daughters), as depicted in figure 1 and figure 2.

            Figure 1                                             Figure 2

Figure 1: Relationship of the caregiver to the cardiac patient - Male(n=22); Figure 2: Relationship of the caregiver to the cardiac patient - Female(n=22)

Since, most of the caregivers are accompanying the patients to the hospital, the source of information about the general health and cardiac disease were given by doctors/health professional, nearly 82% (Table 2).

Table 2: The source of information for general and cardiac health related information

Majority (72%) of the cardiac patients were not able to take care of themselves, hence were assisted by caregivers (Table 3). Most of the caregivers(72%) accompany the patient to the hospital always(Table 4), and majority(90%) of them support the patient financially also (Table 5). Majority (75%) of the caregivers used to spent nearly 4 to 6 hrs with the patient every day (Table 6).

Table 3 : The reason for being a caregiver for the patient

Table 4 : Caregivers accompanying the patient

Table 5: Financial support by the caregivers

Table 6 : Time spent by the caregivers for the patients

Regarding the knowledge about protective factors against heart diseases among caregivers, nearly 70% stated that meditation, exercise and healthy diet can reduce the risk of heart disease and nearly 10% stated that they don’t even know any of the protective factors against cardiac disease (Table 7).

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Table 7: Knowledge about protective factors against heart disease among caregivers

Nearly three fourths (78%) of the caregivers were aware about the fact that the commonest test to diagnose cardiac disease is ECG, 15% were not aware about it and 6% of them considered angiogram as the primary test. More than three fourths (83%) of the caregivers were worried about developing further acute cardiac events in future. The awareness about the risk factors for heart disease among caregivers, including obesity, decreased physical activity, family history of heart disease, smoking, history of diabetes, hypertension and dyslipidemia, mental stress and lack of adequate sleep was assessed. The findings indicate that the more than two-thirds (70%) of the subjects were not much aware about majority of these risk factors. Caregivers were assessed about knowledge regarding the symptoms of acute cardiac events like chest pain radiating to axilla and shoulder, breathlessness, profuse sweating and epigastric pain. Results suggests that majority (75%) of them were aware about the symptoms of cardiac event. More than two thirds (71.88%) of the caregivers were aware about the role of lifestyle modifications in prevention of cardiac disease. Majority (84%) of subjects believed that cardiac diseases are not because of ancestral sins. However still few believed ancestral sins as a cause for cardiac disease. Majority of the caregivers (86%) were aware of the need to take the patient suffering from severe chest pain to the nearest hospital immediately, and the rest 14% of them were not aware about this fact. About 88% subjects believed that early intervention of patients with cardiac disease will prevent more serious complications (Table 8).

Table 8 : Role of early interventions in patients with cardiac disease

DISCUSSION

The global burden of disease due to cardiovascular diseases (CVDs) is escalating, principally due to a sharp rise in the developing countries which are experiencing rapid health transition ^[11]. In comparison to other studies on CVDs and risk factors, this population also demonstrated wide gaps in knowledge as well as a discrepancy between knowledge and practices with attitudes ^[12]. Similarly, our study population also demonstrates a wide gap between cardiovascular health knowledge, attitude and practice/behavior. In the present study, majority of the participants were females. This finding may be due to the fact that males, often being the wage earners in the family, are reluctant to attend morning clinics accompanying the cardiac patients in hospitals with its long waiting hours. Most male patients, if they attended the clinics, were reluctant to get enrolled in a study because of time constrains. It would be important to consider these behaviors in interventional studies as well as in the development and application of CVD awareness programs in situations similar to this setting. Majority of the caregivers were agricultural workers. This may be due to the fact that our hospital being located in a rural area and this population predominantly availed the free medical services provided by our centre. More than half of the caregivers were children, who are genetically closer to the cardiac patients and they are more susceptible for the disease in future. Hence this conveys the need for maximum awareness about cardiac disease among the caregivers. More than three fourths of these caregivers gained information regarding cardiac diseases from health professionals, which shows the importance of psychoeducation by health care providers. Majority of the cardiac patients were not able to take care of themselves, hence were assisted by caregivers, they accompany the patient to the hospital always, and support the patient financially also. This clearly shows high morbidity caused by the cardiac diseases and the need for better interventions. The findings of the current study show the lack of knowledge among the nearly one third of the caregivers about the factors that reduce the risk of heart attacks despite the fact that they are accompanying the patients to the hospital most of the time. In a study done by Vaidya et al ^[12] participants showed only poor knowledge of heart disease causes; 29.7% identified hypertension and 11% identified overweight and physical activity as causes, whereas only 2.2% identified high blood sugar as causative. Around 60% of respondents did not know any heart attack symptoms compared with 20% who knew 2-4 symptoms. These results were in correlation with the present study, which shows majority of the caregivers were not aware about the risk factors and symptoms of cardiac disease. This indicates the need for better education about cardiac disease among these population. This study also shows the lack of awareness about golden period of interventions in cardiovascular disorders among some caregivers.

CONCLUSION

Our study demonstrates a wide gap between cardiovascular health knowledge, attitude and practice/behavior. Even though knowledge is scored little a bit lower, the attitude and practices were high enough among the caregivers. This clearly shows the role of doctors/healthcare workers on educating the caregivers about the knowledge on cardiac diseases. Future interventions for cardiac disease patients must involve family members throughout the treatment process. Health personnel involved with cardiac health services need to be cognizant about the lack of awareness and efforts may be taken to improve information education and counselling services.

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