A Cross-sectional Study to Assess the Patient's Confidence Regarding Secondary Lifestyle Modification and Knowledge of Heart Attack Symptoms Following Percutaneous Revascularization in Selected Hospitals of Navi Mumbai, India

Background of the Study: Cardiovascular Disease (CVD) is affecting millions of people in both developed and developing countries. Although the rate of death attributable to the disease has declined in developed countries in the past several decades, it is still the leading cause of death and extorts a heavy social and economic toll globally. In low-middle income countries, the prevalence of CVD has increased dramatically. By 2020, the disease is forecasted to be the major cause of morbidity and mortality in most developing nations. The Global Burden of Disease study estimate of age-standardized CVD death rate of 272 per 100000 populations in India is higher than the global average of 235 per 100000 populations.

CAD was estimated to account for around 15%–20% and 6%–9% of all deaths in India and the US. In addition to mortality, CAD is also responsible for morbidity and loss of quality of life

Materials and Methods: Qualitative cross-sectional study design with a descriptive research approach was adopted for the present study. The study was conducted in D. Y. Patil Hospital and Terna Multi-Speciality Hospital and Research Centre, Nerul, Navi Mumbai with a sample size of 75. A Non-probability purposive sampling technique was used. In this study samples were patients who underwent Percutaneous revascularization for coronary artery disease. Data was collected using an Interview technique. The data was tabulated and analysed in terms of objectives of the study, using descriptive and inferential statistics.

Results: The study results show that the majority of the respondents belonged to the age group 46 - 65 years with a frequency of 27 (36%) and were married 57 (76%). Representation of male respondents was 44 (59%) and the rest of the respondents belonged to female gender. They were educated up to high school and employed (service staff); their monthly income was <30,000. They were currently diagnosed as STEMI 22 (29.33%), NSTEMI 17 (22.66%) and CAD/IHD 36 (48%). All the respondents had undergone PCI for CAD. Majority of them presented with the selected risk factor variables mentioned in the data collection tool. The respondents had knowledge about the classical symptoms of heart attack. However, they were unable to identify the other associative symptoms of heart attack. 97.33% of the respondents verbalized the correct response that is sudden pain and heaviness on the chest (n=73) which reciprocates to and sudden pain at the back of chest bone with pain moving towards the left or both arms (n=18) which reciprocates to 24%. However, few respondents have identified that heart attack is a sudden weakness of the upper arm and lower limb on one side of the body (n=26) which reciprocates to 35% and this option remains incorrect. Although from this (n=8) which reciprocates to 10% of the respondents have also managed to verbalize the right response which suggests that they may not have complete knowledge about heart attack symptoms. There was a significant difference between the number of people who were confident and those who were not confident, also there was a significant difference between confidence to some extent and versus confident (that is P<0.05) about the items on the lifestyle modifying factors. The results indicate that fewer patients were confident about the lifestyle modifying factors. Also, the respondents showed positive correlation (< +1.0) and negative correlation (<-1.0) with risk factor variables.

The study findings revealed that, patient did not verbalize complete knowledge and confidence regarding secondary lifestyle modification through the statistical analysis. There is a significant difference between the number of people who were confident versus those who were not confident and there was a significant difference between confidence to some extent versus confidence about the items on the lifestyle modifying factors. Also, there is a significant difference between risk factors and all the lifestyle modifying variables.

Conclusion: There were substantial disparities in the confidence levels associated with lifestyle modification and recognition/response to heart attack. These gaps need to be studied further and disseminated to improve awareness in terms of health education in the population which will eventually increase their level of confidence.