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\def\RunningAuthor{Bhuvaneshwari G et al.}
\firstPage{2983}
\articleType{Original Article}
\receivedDate{07.04.2019}
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\title{A study to evaluate the magnitude of understanding on harm's way associated with heart disease among clients attending NCD clinic at nemam PHC}
\author{Bhuvaneshwari~G\textsuperscript{*},  
            Selvarani~R,  
            Suriyamathi~B,  
            Allwyn~Moses~M, 
            Kalichwaran~S~\\[5pt]{Department Of Community Health Nursing\unskip, Saveetha College Of Nursing, SIMATS, Chennai, Tamil Nadu, India}}

\begin{abstract}
Non-communicable Disease (NCD), almost completely heart diseases, malignancy, diabetes and chronic obstructive pulmonary diseases are the main source of demise worldwide killing additional human beings further wise entire further sources merge. In 2008 nearly two-thirds of the demises were due to NCD, a 36 million out of 57. Out of this almost completely 80\% of demise happens in little and medium earnings nation with over 50\% of them happening amid human beings completely amount 70 years old and 29\% under 60 years of age. At current heart diseases (CVD) are the numeral single sources of demise worldwide with little and medium earning nations existence pretentious uneven. So the current research is ready to evaluate the magnitude of understanding on harm's way associated with heart disease among clients attending NCD clinic at nemam PHC. A descriptive research design was chosen to evaluate the magnitude of understanding on harm's way associated with heart disease among clients attending NCD clinic at nemam PHC 100 samples are included within our study. Prospective sampling techniques method was utilized in selecting the samples. A self-arranged questionnaire was utilized to gather statistics. The evaluate the magnitude of understanding on harm's way associated with heart disease among clients attending NCD clinic at nemam PHC are Inadequate knowledge: 23\%Moderate knowledge: 56\% Adequate knowledge: 21\%. The study concludes that there is moderation risk factors associated with heart disease among clients attending NCD clinic at Nemam PHC. 
\end{abstract}\def\keywordstitle{Keywords}

\begin{keywords}Risk factors,\newline heart diseases,\newline knowledge
\end{keywords}
\twocolumn[ \maketitle {\printKwdAbsBox}]
\makeatletter{\raggedright\textsuperscript{*}Corresponding Author\par Name:\ Bhuvaneshwari~G~\\ Phone:\ 9043872624~\\  Email:\ bhuvana.prabha191@gmail.com
        \par}\vspace*{-11pt}\hrulefill\par{\fontsize{12}{14}\selectfont ISSN: 0975-7538}\par% 
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\section{Introduction}
CVDs are the numeral 1 source of demise worldwide . Further human beings die yearly from CVDs than from some further source . An approximated 17.9 million human beings died from CVDs in 2016, constituting 31\% of completely worldwide demises. Of these demises, 85\% are due to heart attack and stroke. Over three areas of CVD demises take place in low- and medium-income nations. Out of the 17 million early demises (under the age of 70) due to non communicable diseases in 2015, 82\% are in low- and medium-income nations, and 37\% are sourced by CVDs .Almost completely heart diseases can be stopped by communicating attitude risk factors such as tobacco utilize, destructive diet and obesity, physical inactivity and damage utilize of alcohol using people-broad strategies \unskip~\citep{576174:13320498}.

The encouraging of heart diseases (CVD) has enhance an startle well being difficulty beyond the world. The Worldwide Implication of Diseases study has declared that by the year 2025, CVD would be the utmost source of demise completely over the world inclusive the progressing nations. As stated by to World Well being Report 2002, CVD will be the huge source of demise and disability in India by 2020. South Asians have an elevated currency of coronary heart disease as compared to furtherracialcategorys \unskip~\citep{576174:13320499}.

Coronary heart disease is the major source of demise in the US. The American Heart Association has suggested upgrading final heart well being by encouraging elements of perfect heart well being, inclusive well-being behaviours (not smoking, systematic exercise, and well binge diet) and well-being factors (perfect body mass index, cholesterol, blood pressure, and blood sugar) \unskip~\citep{576174:13320500}.

Heart disease (CVD) is a leading nonetheless preventable source of demise worldwide, considering for an approximated 29\% of completely demises. The comparative contribution of CVD to the implication of disease residue elevated in low, medium and elevated income nations of the world \unskip~\citep{576174:13320501}.

Risk factors include elevated blood pressure (BP); tobacco utilize, inclusive subjection to second-hand smog; damage utilize of alcohol; elevated total blood cholesterol; elevated fasting plasma glucose (FPG); elevated body mass index (BMI); elevated intake of dietary sodium; little dietary intake of fruits and vegetables; less physical activity; and household and ambient air impurity \unskip~\citep{576174:13320502}.

Heart disease (CVD), (Coronary artery heart disease (CAHD) and stroke), is the major destroyer in western civilization and its currency is also increasing flamboyant in progressing nations. As stated by WHO Worldwide atlas on CVDs prevention and control 2011, heart diseases remain the huge source of demises worldwide. Further than 17million human beings died from CVDs in 2008, out of which 7.3 million demises were due to heart attacks. Further than 3 million of these demises occurred before the age of 60 and could have been stopped. The percentage of early demises from CVDs spans from 4\% in elevated-income nations to 42\% in little income nations\unskip~\citep{576174:13320503}.

Coronary Artery Disease (CAD) has been named the modern ``outbreak'' by WHO. It is the source of 25-30\% of demises in almost completely technical countries now. Out of 50.5 million demises occurring per year worldwide, 6.1 million demises are attributed to coronary artery disease. In India, the currency has been found to be 65.4 and 47.8 per 1000 males and females respective (WHO). In India the incidence has grown from 1.05\% in 1960 to 9.67\% in 2001 (ST Yavagal, Cardiology Society of India, Bangalore)\unskip~\citep{576174:13320504}.

\textbf{Objectives}

To evaluate the magnitude of understanding on harm's way of heart disease among clients attending Neman PHC and To determine the association between the risk factors of the heart disease with demographic variable among clients attending Neman PHC
    
\section{Materials and Methods}
A sample of 100 rural human beings are selected by prospective sampling techniques. The descriptive study was conducted during a one week period. Data collection was conducted in mapped. After getting permission from the suburb panchayat. A demographic variable consists of age, sex, well-being status, occupation, habit. A self-arranged questionnaire was utilized to gather data. The study investigators explained to the adults about the study's objectives, rational and requirement of consent to participate in the study. The investigators then provided instructions for filling the questionnaire, and then guided the adults. Understanding of each question was checked by asking the individuals to repeat the meaning. During the filling of questionnaires, the investigators helped the individuals throughout and helped to simplify the meaning of every question, clarifying doubts and checking for completeness of filling up the questionnaire Chi-square test was utilized to test the union betwixt unconditional varying. P \textless\ 0.05 was taken as statistic completely significant.
\begin{table*}[!htbp]
\caption{\boldmath {Presentation of repetition and percent issue of numerical of rural human beings in nemam PHC} }
\label{tw-6a541cbf5831}
\centering 
\begin{threeparttable}

\def\arraystretch{1.1}
\ignorespaces 
\centering 
\begin{tabulary}{\linewidth}{LLLL}
\tbltoprule 
S.no &
  Demogrphic variable &
  Frequency &
  percentage\\
 1 &
  Sex &
   &
  \\
 &
  A)Male \mbox{}\protect\newline B)Female &
  49 \mbox{}\protect\newline 51 &
  49\% \mbox{}\protect\newline 51\%\\
2 &
  Age group &
   &
  \\
 &
  A)20-29 years \mbox{}\protect\newline B)30-39 years \mbox{}\protect\newline C)40-48 years  \mbox{}\protect\newline D)Above 50 years &
  16 \mbox{}\protect\newline 35 \mbox{}\protect\newline 22 \mbox{}\protect\newline 27 &
  16\% \mbox{}\protect\newline 35\% \mbox{}\protect\newline 22\% \mbox{}\protect\newline 27\%\\
3  &
  Habit &
   &
  \\
 &
  A)smoking \mbox{}\protect\newline B)tobacco \mbox{}\protect\newline C)alcoholism \mbox{}\protect\newline D)furthers  \mbox{}\protect\newline E)none &
  26 \mbox{}\protect\newline 7 \mbox{}\protect\newline 25 \mbox{}\protect\newline 11 \mbox{}\protect\newline 31 &
  26\% \mbox{}\protect\newline 7\% \mbox{}\protect\newline 25\% \mbox{}\protect\newline 11\% \mbox{}\protect\newline 31\%\\
4 &
  Occupation &
   &
  \\
 &
  A)farmer \mbox{}\protect\newline B)factory workers \mbox{}\protect\newline C)housewife \mbox{}\protect\newline D)furthers &
  20 \mbox{}\protect\newline 17 \mbox{}\protect\newline 30 \mbox{}\protect\newline 33 &
  20\% \mbox{}\protect\newline 17\% \mbox{}\protect\newline 30\% \mbox{}\protect\newline 33\%\\
5 &
  health status &
   &
  \\
 &
  A)hypertension \mbox{}\protect\newline B)HDL \mbox{}\protect\newline  C)cholesterol \mbox{}\protect\newline D)Diabetes mellitus \mbox{}\protect\newline E)None &
  24 \mbox{}\protect\newline 12 \mbox{}\protect\newline 17 \mbox{}\protect\newline 42 &
  24\% \mbox{}\protect\newline 12\% \mbox{}\protect\newline 17\% \mbox{}\protect\newline 42\%\\
\tblbottomrule 
\end{tabulary}\par 
\begin{tablenotes}\footnotesize 
    
\item{It Shows that, regarding age out of 60 samples 22(37\%) samples were come under type of age category of 20-30 years, 17(28\%) samples were under the age category of 30-40 years, 21(35\%) samples exist under the age category of 40-50 yrs. Regarding gender out of 60 samples, 25(42\%) samples were male, 35(58\%) samples were female. }
\end{tablenotes}
\end{threeparttable}

\end{table*}

    
\section{Results and Discussion}
Utmost of the human beings51 (51\%) are females, and 49(49\%) were males. Almost completely of them are age category of 30-39 years 35(35\%) and above 50 years 27(27\%) the human beings 24 (24\%) is having hypertension , 12 (12\%)human beings are having HDL cholesterin,17(17\%)are having Diabetes mellitus.85(85\%)human beings are the non-vegetarian utmost of the human beings had moderate adequate knowledge 56(56\%), and 21\% of adequate knowledge and 23\% are inadequate knowledge regarding risk factors of heart diseases (Table~\ref{tw-6a541cbf5831}).


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\caption{\boldmath {This figures shows that the percentage of risk factors of the heart disease among clients attending Neman PHC its showed that about 24\% hypertension, 12 \% HDL cholesterol, 17 \% diabetes mellitus }}
\label{f-83f135fbfc58}
\end{figure}
\egroup
Frequency and percentage issue of the level of knowledge showed that almost completely of the human beings 56\% had moderate knowledge regarding risk factors of heart disease and 21\% of adequate knowledge and 23\% are inadequate knowledge regarding risk factors associated with heart disease among clients attending nemam PHC (Figure~\ref{f-83f135fbfc58}). The association between demographic variables with the level of knowledge regarding risk factors of heart disease among clients attending nemam PHC showed that there was an association between the demographic variable and knowledge regarding risk factors of heart disease among clients attending nemam PHC. There was statistic completely significant found between the source of information and the level of knowledge regarding risk factors of heart disease among clients attending nemam PH (Table~\ref{tw-bdeea9179e09}), (Table~\ref{tw-fb0da56827ae}).


\begin{table*}[!htbp]
\caption{\boldmath {Repetition and percent issue of the level of magnitude regarding riskfactors of heart diseases} }
\label{tw-bdeea9179e09}
\centering 
\begin{threeparttable}

\def\arraystretch{1.1}
\ignorespaces 
\centering 
\begin{tabulary}{\linewidth}{p{\dimexpr.4857000000000001\linewidth-2\tabcolsep}p{\dimexpr.285\linewidth-2\tabcolsep}p{\dimexpr.2293\linewidth-2\tabcolsep}}
\tbltoprule \rowcolor{kwdboxcolor}Level of knowledge  & Frequency & Percentage\\
\tblmidrule 
Inadequate knowledge  &
  23 &
  23\%\\
Moderate adequate knowledge &
  56 &
  56\%\\
Adequate knowledge &
  21 &
  21\%\\
Total &
  100 &
  100\%\\
\tblbottomrule 
\end{tabulary}\par 
\begin{tablenotes}\footnotesize 
    
\item{It shows that utmost of the human being shad modest adequate knowledge 56 (56\%) and 21\% of adequate knowledge and 23\% are inadequate knowledge regarding risk factors of heart diseases}
\end{tablenotes}
\end{threeparttable}

\end{table*}

\begin{table*}[!htbp]
\caption{\boldmath {The mean and standard deviation for a level of knowledge regarding risk factors of heart diseases the mean deviation is 10.49, and the standard deviation is 3.30} }
\label{tw-fb0da56827ae}
\def\arraystretch{1.1}
\ignorespaces 
\centering 
\begin{tabulary}{\linewidth}{p{\dimexpr.82\linewidth-2\tabcolsep}p{\dimexpr.17999999999999996\linewidth-2\tabcolsep}}
\tbltoprule \rowcolor{kwdboxcolor}level of knowledge regarding risk factors of heart diseases & Frequency\\
\tblmidrule 
Mean deviation\\
Standard deviation &
  3.30\\
\tblbottomrule 
\end{tabulary}\par 
\end{table*}
The present study to evaluate the magnitude of understanding. The results shows approximately that out of 100 samples. moderate adequate knowledge 56(56\%) and 21\% of adequate knowledge and 23\% are inadequate knowledge regarding risk factors of heart diseases

Which is similar to findings declared by \unskip~\cite{576174:13320505} Prospective genuine enquiry managed in a tertiary supervision health center in Bangalore over 6 months. A theme in the mid of 30-89 years of age overtaking in and out-victim section of St. Philomena's Health center, Bangalore were registered in the inquiry. Theme with diabetes mellitus, hypothyroidism and who were on anti-hyper lipidemic representatives were debarred. 92 theme (44 male and 48 female) were incorporated in the inquiry, amid whom 48(52.2\%) were in the age category of 50-69 years. Abnormal total cholesterol and Little Solidity Lipoproteins were establish further in male theme, and abnormal Elevated Solidity Lipoproteins and triglycerides were establish mainly elevated in female theme. Around62\% of inquiry contributor were obese and overweight, only 34 out of 92 contributors were doing bodily pursuit, nearly 91.3\% were belonged to lower socioeconomic class, and amid male contributors, 32 of them were contemporary smog. The result indicated that as age increases, the risk of CVD raises. Our inquiry showed that the common possibility amid our theme without comorbidity were age, obesity and over-weight, dyslipidemia, bodily in pursuit, little socioeconomic status and smoking\unskip~\citep{576174:13320505}. 

\unskip~\cite{576174:13320506} An exploratory random sampling survey was managed amid 154 medical students by distributing an anonymous pretested, self-administered, and structured questionnaire. The questionnaire contained 30 multiple choice questions and was prepared, keeping in mind the key themes of identification of CVD and its possibility. Result: Utmost possibility for heart disease as recognized by students are dyslipidemia (96.8\%), obesity (94.1\%), elevated gore pressure (92.8\%), smoking (84.4\%), diabetes (82.4), age (81.8\%), male gender (80.4\%), lack of bodily pursuit (73.9\%), and family history (63.6\%). However, only 12.5\% correctly recognized Elevated solidity lipoprotein (HDL) to be the good cholesterol. These results suggest that there are few areas of concern in our medical education that needs to be reformed. A sound knowledge of CVD is essential for the medical students and to achieve this, change in the core medical curriculum starting from basic medical sciences is recommended\unskip~\citep{576174:13320506}.

\unskip~\cite{576174:13320507} A random sampling inquiry design Different administration foundation in Bahrain. Statistics was swayed from 1139 workers in the mid of October 2010 and March 2011 through meetings, inclusive bodily qualifications, victim gore exprimrent, and lapse carbon monoxide (CO) quantity as piece per million (ppm) for smog. A synopsis of amalgamation CVD possibility was recognized.\textit{\space } The backing final currency charge were declared: overweight and obesity 78.4\% and declared hypertension 36.9\% (incorporated twain those who were on and not on therapies ), with an approximated currency of 21.6\% for sustained systolic gore pressure (Sbp) \ensuremath{\geq } 140 mmHg and 23.3\% for diastolic gore pressure (dbp) \ensuremath{\geq }90 mmHg. The currency of total cholesterol quantity \ensuremath{\geq }5.2 mmol/dl was 24.2\% and LDL quantity{\textgreater}3.3 mmol/dl 10.8\%. Currency of HDL-C quantity (\ensuremath{\leq }1.03 mmol/dl) was 47.55\% and (\ensuremath{\geq }1.5 mmol/dl) in 12.31\%. The little HDL level ({\textless}1.03 mmol/dl) amid males was 64.1\%, while it was 26.6\% amid females. Divide the contributors (50.8\%) do not capture in some type of bodily pursuit. Further over, 24.3\% were not consuming everyday helping of fruits and vegetables. Regarding 16.1\% of them were contemporary smog. The utmost of the contributors (95.35\%) had either no or less than 3 CVD possibility. Only 4.65\% had 3{\textendash}5 possibility. Amid the workers in Bahrain, the elevated CVD possibility currency is obvious. CVD possibility elimination and sway are a priority\unskip~\citep{576174:13320507}.
    
\section{Conclusion}
The study concludes that there is moderation risk factors associated with heart disease among clients attending NCD clinic at Nemam PHC.
    
\section{Acknowledgement}
We would like to thankful to Prof. Dr.S.Kalabarathi, Principal of Saveetha College of Nursing, SIMATS and Ms. L.Parimala, Vice Principal of Saveetha College of Nursing, SIMATS for their encouragement, valuable suggestions, support and advice given throughout the study.
    

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