SECTION A: BACKGROUND INFORMATION

Name : D G SURYA DHARSHNI

Enrollment No : 2201393222

Study Centre : CENTRE FOR ONLINE EDUCATION

Course Title : DNHE - 4

Address : 16, Seenivasa nagar 1st street,Tirunagar,Madurai-625006

Name and Designation of Project Counsellor : Dr. PREETI MEHTA

TITLE OF PROJECT: A STUDY ON KNOWLEDGE, ATTITUDE AND PRACTICE

ABOUT HYPERTENSION AND DIABETES AMONG PEOPLE
OF MADURAI

THEME SELECTED: 4

NAME OF PLACE WHERE

PROJECT IS TO BE CONDUCTED: MADURAI

STATE WHERE PLACE IS LOCATED: TAMILNADU

SECTION B : PROJECT PROPOSAL

“A STUDY ON KNOWLEDGE ATTITUDE AND

PRACTICE ABOUT

HYPERTENSION AND DIABETES AMONG

PEOPLE OF MADURAI”

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INTRODUCTION
Diabetes mellitus and Hypertension is the silent killer diseases worldwide.Diabetes mellitus

is a major risk factor for many other diseases like cardiovascular diseases, stroke, renal

diseases, and many other. Hypertension is a chronic condition of concern due to its role in the

causation of Coronary heart disease, Stroke and Vascular complications. They are also the

most important reasons to visit the physician . India presently has the large number of

diabetic patients in world and has been infamously dubbed as the diabetic capital of the

world. Across the income group of countries, the prevalence of raised blood pressure was

consistentlyhigh with low,lower middle and upper middle income countries all having rates

of around 40% of both sexes. Studies show that many patients did not have appropriate

knowledge about the diseases like Hypertension and Diabetes.

Hypertension is the commonest cardiovascular disorder,posing a major public health

challenge to population in socioeconomic and epidemiological transition. It is one of the

major risk factors for cardiovascular mortality, which accounts for 20-50% of all deaths.The

prevalence of Hypertension was varying from 17-21% in all states with marginal rural-urban

differences.

Diabetes mellitus (DM) is a chronic metabolic disorder associated with high morbidity and

mortality among patients. Today, with a global prevalence of more than 138 million people, it

is projected that the number of diabetic patients would continue to increase, making DM a

pandemic. Plausible reasons for the steady increase in the prevalence of Diabetes mellitus

and Hypertension in Asian countries may include poor lifestyle and dietary habits, rapid

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westernization, lack of knowledge, and unsatisfactory attitude and practices toward DM and

Hypertension among the general population and diabetic patients.

Moreover, there also exists an apparent gap between knowledge and the attitude toward

diabetes among diabetic and Hypertensive patients. Knowledge about DM and Hypertension

, appropriate attitude and practices are vital to reduce the incidence and morbidity associated

with DM and Hypertension.

Poor awareness and practices are some of the important variables influencing the

development and progression of diseases like Diabetes,Hypertension and its complications,

which are largely preventable. Preventive strategies need to be formulated based on factors

contributing to the development and progression of disease. If a patient has knowledge about

the disease, patient will be more careful about the management, and a better control can be

achieved. This study will be conducted to know about the knowledge, attitude, and practice.

(KAP) about diabetes in the adult patients. The emergence of diabetes, Hypertension and as

public health problem is strongly related to the aging of the populations, urbanization, and

socioeconomic changes favoring sedentary lifestyle, obesity, alcohol consumption, and salt

intake, among others.

In this context, Diabetes and Hypertension presents a major area of intervention because

these are the frequent conditions and are amenable to control through non-pharmacological

lifestyle factors and pharmacological treatment. Lifestyle measures include reduced sugar

intake for DM, reduced salt intake and controlling stress and tension to reduce over activity

of sympathetic nervous system for Hypertension and Reduced alcohol intake, increased

physical activity, and control of overweight are common interventional measures for both

DM and Hypertension.

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A proper assessment and understanding of KAP factors is particularly helpful in the area of

chronic conditions such as diabetes and hypertension, for which prevention and control

necessitate a lifelong adoption of healthy lifestyles. In this study, we examine KAP for

diabetes in adults to help improve their condition and also to control the complications.

There is no doubt that the knowledge and attitudes of patients have an impact on the

management of their illnesses, and improving knowledge is known to improve compliance

with treatment in conditions such as diabetes, hypertension. Poor compliance with prescribed

drugs is a common and important problem in clinical practice which can result in treatment

failure and poor outcomes. Obtaining information about the level of awareness is the first

step in formulating a preventive program for the disease. There is a need to investigate KAP

among the general population to aid in future development of programs and techniques for

effective health education. This study aims to assess the baseline levels of KAP of the general

population toward Hypertension and Diabetes.

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SIGNIFICANCE OF STUDY

India harbors the largest number of diabetic and Hypertensive patients in the world. Poor

awareness and practices are some of the important variables influencing the development and

progression of diabetes, Hypertension and its complications, which are largely preventable.

Preventive strategies need to be formulated based on factors contributing to the development

and progression of diabetes. Considering the high morbidity and mortality due to diabetes and

Hypertension, if effective interventional plans are made these patients can lead good quality

of life.

KAP surveys are effective in providing a baseline for evaluating intervention programs. This

study benefits patients by improving their Knowledge,attitude,practice towards diabetes and

hypertension which will help in controlling and preventing the disease and its complications.

By improving knowledge,attitude and practice of patients towards diabetes and hypertension

will prevent mortality and morbidity which will reduce the burden of disease for the society.

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OBJECTIVES OF THE STUDY

The objectives of the study will be to assess the knowledge

attitude and practice about Hypertension and Diabetes among

people of Madurai.

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RESEARCH METHODOLOGY

Study Area: The study will be conducted at Jasmine Homeo Clinic, Madurai.

Study Subjects: This prospective and cross-sectional study will be carried out on 25 adult

patients with both Diabetes and Hypertension between age group (35-70) years, from

Madurai.

Sample Size: A total of 25 patients with both Hypertension and Diabetes attending the

outpatient clinic will be interviewed as per the questionnaire.

Tools and Techniques: We will question the patients and will assess the various lifestyle

factors and risk factors. The special case sheets will be prepared, containing all the

information as name, age, sex, address, family history, personal history, social history,

marital status of the patients. The special questionnaire to study the KAP of the patients

toward Hypertension and Diabetes will be also included in the case sheets and the obtained

results will be analyzed.

Data Source: The data sources used will be the articles, journals, reference books and

Literature Review published by third parties but available to the public. The World Wide

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Web (Internet) is also an important source of information related to Hypertension

and Diabetes.

QUESTIONNAIRE ON
“KAP ABOUT HYPERTENSION AND DIABETES

AMONG PEOPLE OF MADURAI”

DEMOGRAPHIC DETAILS

1. Gender:

a) Male b) Female

2. Educational status:

a)Illiterate b) Primary /Secondary school c) Graduate/Post graduate

3. Socio-Economic status

a)Low b)Lower middle c)Upper middle d)Upper

4. Residential Area

a)Urban b)Rural

5. Marital status:

a)Married b) Unmarried

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6. Age (years):

a)35-40 b) 40-50 c)50 or above

7. Smoking (cigarettes/day):

a)Non smoker b)Past smoker c)Smoker

8. Alcohol:

a)Non-alcoholic b)Past alcoholic c)Alcoholic

KNOWLEDGE-QUESTIONS INVOLVED IN ASSESSMENT

OF KAP’S OF HYPERTENSION AND DIABETES

Q1. Diabetes and Hypertension are condition that:

1. Can be cured by adopting a healthy lifestyle

2. Can be cured with tablets and / or insulin
3. Is currently not curable
4. Is always life threatening when first diagnosed
5. Do not know

Q2. What are the causes of Diabetes and Hypertension?

1. Family History
2. Obesity
3. Abnormal lifestyle
4. All of the above
5. Do not know

Q3. What should be done to control Diabetes and Hypertension?

1. Regular Exercise
2. Healthy diet
3. Take medication
4. All of the above
5. Do not know

Q4.How do you manage your hypoglycemic (low blood sugar) episode?

1. Taking sugar
2. Medicine

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3. Insulin

4. Do not know

Q5. Healthy diabetic eating includes:

1. Limiting foods that are high in sugar

2. Eating smaller portions spread out over the day

3. Being careful about when and how many carbohydrates you eat

4. All of the above

5. Do not know

Q6. Healthy eating for Hypertensives includes:

1. Limiting salt intake and salty foods

2. Eating according to body needs

3. Limited intake of Saturated fat and Increased Dietary fibre

4. All of the above

5. Do not know

Q7. What food can make you have a high blood sugar?

1. Nuts
2. Sweet Potatoes
3. Yogurt
4. Pizza
5. All of the above

Q8. What food can make you have a high blood pressure?

1. Nuts
2. Pickle
3. Paapad
4. Pizza
5. All of the above

Q9. What is the suitable blood glucose (RBS) for diabetic patient?
1. 140- 200mg/dl
2. 200- 300mg/dl
3. >300
4. Do not know

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Q10. What range of blood pressure is called high blood pressure?
1. Systolic above 140mmHg & Diastolic above 90mmHg
2. Systolic above 130mmHg & Diastolic above 80mmHg
3. Systolic below 140mmHg & Diastolic below 90mmHg
4. Do not know

Q11.Why is insulin important for your body?

1. It helps blood sugar enter your cells
2. It lowers your blood pressure
3. It raises your cholesterol levels
4. Do not know

Q12. Hypertension and Diabetes, if not treated may result in :

1. Stroke 5. Kidney disease
2. Coronary Heart disease 6. All of the above
3. Eye disease 7. Do not know
4. Cardiovascular disease

ATTITUDE -QUESTIONS INVOLVED IN ASSESSMENT OF

KAP’S OF HYPERTENSION AND DIABETES
1) Do you exercise regularly?

· Yes
· No
2) Do you miss taking the doses of your Hypertension or diabetic medication?

· Yes
· No
3) Are you aware of blood sugar levels falling below normal when you are taking
diabetic drugs?

· Yes
· No
4) Do you think physical activity can prevent risk of diabetes and hypertension?

· Yes
· No
5) Do you think that you should be examined for diabetes/hypertension?

· Yes
· No
6) Do you think support from family and friends are important in dealing with diabetes
and hypertension?
· Yes
· No
7) Do you think diabetes can be controlled?
· Yes

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· No
8) Do you think Hypertension can be controlled?
· Yes
· No
9) Do you think should we follow avoiding consumption of too much sugar?
· Yes
· No
10) Do you think should we reduce consumption of salt?
· Yes
· No
11) Do you think that maintaining a healthy weight is important in management of
hypertension and diabetes?

· Yes
· No

PRACTICE -QUESTIONS INVOLVED IN ASSESSMENT OF

KAP’S OF HYPERTENSION AND DIABETES

Q1. How often do you visit doctor to monitor your blood glucose and blood pressure?

· Quarterly
· Half yearly
· Yearly
· Once in two years

Q2. Do you keep your weight under control?

· Yes
· No

Q3. Do you avoid refined sugar in your regular diet?

· Yes
· No

Q4. Do you avoid salt in your regular diet?

· Yes

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· No

Q5. How much time do you spend daily for exercise?

· 15min - 30min
· 30min- 45min
· 45min- 60min
· > 60 min

Q6. How often do you eat fruits?

· Never
· Everyday
· Once a week
· Once a month

Q7. Do you avoid sugar/sweets and Fatty foods in your diet?

· Yes
· No

Q8. Do you take more dietary fibre in your diet?

· Yes
· No

Q9. Do you take care to protect your feet?

· Yes
· No

Q10. Would you seek treatment if you or one of your family members gets Diabetes or
Hypertension?

· Yes
· No

Q11.When did you have your last eye examination?

· One month ago

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· Six month ago
· One year ago
· Two years ago

REFERENCES

· Williams MV, Baker DW, Parker RM, Nurss JR. Relationship of functional health

literacy to patients’ knowledge of their chronic disease. A study of patients with

diabetes. Arch Intern Med 1998;158(2):166-72.

· Mukhopadhyay P, Paul B, Das D, Sengupta N, Majumder R. Perceptions and

practices of Type-2 diabetes: A cross sectional study in a tertiary care hospital in

Kolkata. Int J DiabDevCtries 2010;30(3):143-9.

· Ng SH, Chan KH, Lian ZY, Chuah YH, Waseem AN, Kadirvelu A. Reality vs

illusion: Knowledge, attitude and practice among diabetic patients. Int J Collab Res

Int Med Public Health 2012;4(5):723-32.

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· Priyanka RC, Angadi MM. Hospital-based KAP study on diabetes in Bijapur,

Karnataka. Indian J Med Spec 2010;1(2):80.

· Al-Maskari F, El-Sadig M, Al-Kaabi JM, Afandi B, Nagelkerke N, Yeatts KB.

Knowledge, attitude and practices of diabetic patients in the United Arab Emirates.

PLoS One 2013;8(1):e52857.

· Park’s Textbook of preventive and social medicine, 24th edition

· www.google.com

· www.wikipedia.com

SECTION C : APPROVAL OF PROJECT COUNSELLOR

I certify that I have examined the project proposal submitted by the candidate

Miss.D.G.Surya dharshni and found it to be satisfactory.

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__________________________________

Signature of Project counselor

Dr.Preeti Mehta

Date :26.08.23

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