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Original Research (Original Article) 


Amar F. Khalifa et al, 2020;4(2):286–290.

International Journal of Medicine in Developing Countries

Knowledge and attitude of bronchial asthma among Riyadh population, Saudi Arabia

Amar F. Khalifa1, Muaadh Yahya Ba Mhraz2*, Turki R. Alrumayh2, Saud M. Alhaqqan2, Majed K. Alanazi2, Meshal D. Alanazi2, Moayed A. Alqarni2, Meshari Z. Almutairi2, Amro A. Al-Gamdi2

Correspondence to: Muaadh Yahya Ba Mhraz

*Almaarefa University, Ad Diriyah, Saudi Arabia.

Email: mbamhraz [at] gmail.com

Full list of author information is available at the end of the article.

Received: 08 October 2019 | Accepted: 13 November 2019


ABSTRACT


Background:

Asthma affects an estimated 300 million individuals worldwide, with an expected increase to 400 million, by 2025. Health education is an important aspect of asthma management and outcome. This study aims to identify the level of knowledge regarding bronchial asthma.


Methodology:

This is a descriptive cross-sectional study with convenience sampling technique, including 384 participants of Riyadh population. Inclusion criteria included all ages, sexes, and nationalities. The questionnaire comprised a series of close-ended questions, covered mainly triggering factors, complication, symptoms, and signs. The data were analyzed using the statistical package (Statistical Package for Social Sciences) version 22 and Microsoft excel to generate figures and charts. Chi-square test was also used. p-value of 0.05 or less for significance. Consent obtained before data collection from all the participants.


Results:

About 75.5% of participants had good knowledge regarding treatment, while 24.5% had poor knowledge. The majority of participant’s (66.4%) had a positive attitude, and 32.3% had a moderate attitude that might be helpful, while 1.3% had negative action. Most of the participants (60.4%) had good knowledge regarding complication as they knew that respiratory distress is a complication of bronchial asthma, while 39.6% had poor knowledge regarding complication of bronchial asthma. There was a significant statistical relationship between the level of knowledge regarding triggering factors and gender (p value = 0.008).


Conclusion:

The knowledge regarding bronchial asthma was relatively good, while the attitude needs improvement, especially the attitude toward the distressed asthmatic patient. On the other hand, the female participants showed a higher level of knowledge than males.


Keywords:

Asthma, risk factor, treatment, knowledge.


Introduction

Asthma is increasing and is affecting 10% to 15% of children worldwide. It also affects an estimated 300 million individuals globally with an expected increase to 400 million by 2025 globally. Bronchial asthma is a reactive airway disease characterized by airway obstruction or narrowing, which is reversible either spontaneously or with treatment, which revolutionized by the advent of inhaled Corti-steroids. Bronchial asthma causes difficulty in breathing, recurrent wheezing, recurrent cough, and chest tightness at rest. It can lead to mild, moderate, and severe impairment in the quality of life [1].

Despite all advances in the management of bronchial asthma, the morbidity and mortality rates are increasing. The physician, as well as patients and their families, play a significant role in the under-treatment and mismanagement of the bronchial asthma. Patients and their family education are becoming an essential area of service provision, with increasing rate of chronic diseases and conditions requiring long-term management in the community [14]. The education of child and parents is the main role of the nurse because she remains mostly in contact with them. Health education of parents is also an important aspect of asthma management. An educational package should contain a basic explanation about asthma and the factors that influence asthma (asthma triggers), correct inhalation techniques, the importance of adherence to the prescribed medication regime, and description of how to recognize when asthma control is deteriorating, and administration of medication when this occur [1]. Proper management of bronchial asthma requires attention to the behavior of asthmatic patients and their families and also to the underlying beliefs which drive that behavior. Mostly, the complications of bronchial asthma could be influenced by poor knowledge, poor use of inhaler, non-compliance, and negative attitude toward the illness and the drugs [2].

Control of symptoms in bronchial asthma is an ideal goal for most of the patients but cannot be achieved unless the patient maintains an appropriate drug regimen and avoids precipitating factors. In Saudi Arabia, the reported prevalence of asthma is 12% in Riyadh. Two Recent surveys in Saudi Arabia concluded that asthma control is still one of the major concerns in our population, as only 5% were controlled, 31% were partially controlled, and 64% were uncontrolled. Therefore, an understanding of the patient’s attitude, concerns, and knowledge regarding asthma is necessary to identify the level of knowledge and practice of bronchial asthma among participants [3].

Table 1. Demographic data.

Variable Number Percentage
Gender
Male 166 43.3%
Female 218 56.7%
Age
17–24 183 47.7%
25–34 120 31.3%
35–44 43 11.2%
≥45 38 9.9%
Education
Illiterate 2 0.5%
Primary 1 0.3%
Middle 7 1.8%
Secondary 114 29.7%
University 260 67.7%
Occupation
Employed 144 37.5%
Unemployed 79 20.6%
Student 153 39.8%
Self-employed 3 0.8%
Non-skilled labor 5 1.3%

Methodology

A descriptive cross-sectional study conducted in Riyadh, Saudi Arabia with a sample size of 384 participants. The inclusion criteria included Riyadh population ≥17-year old, all sexes, and nationalities, and the study excluded participants younger than 17-year old of Riyadh population.

Convenience sampling, consecutive till completion of the sample size. Questionnaire included a series of close-ended questions, covered mainly triggering factors, complication, symptoms, and signs. Questionnaire was subjected to Probe before data collection to ensure the validity and reliability. The collected data were tabulated and analyzed by using the statistical package Statistical Package for Social Sciences version 22 and Microsoft excel to generate figures and charts. Chi-square test was used to analyze data. p-value at 0.05 or less used for significance. Consent was obtained before data collection emphasizing confidentiality and stated the right of participants to withdraw at any point of time.


Results

The majority of participants were females (56.7%), and the majority of age was (47. 7%) ranged from 17 to 24 years old and the minority age was (9.9%) ranged from 45 years and older. Also, the educational level represents that 67.7% participants had university level of education and the minority (0.3%) had primary level of education. Moreover, the majority of the participants (37.5%) were employed, whereas only 0.8% of the participants were self-employed.

Table 2 reveals the attitude of the majority of participants toward an asthmatic patient. It revealed that 66.4% of the participants would buy his medication, which is the preferable action to take, while 19.3% of the participants would call for help, also 13% of the participants help him sit and the minority (1.3%) would do nothing.

Table 2. Frequency regarding attitude toward bronchial asthma.

What should you do when you face asthmatic patient in the attack?
Help him sit Call for help Bring his medication Nothing Total
Number 50 74 255 5 384
Percentage 13% 19.3% 66.4% 1.3% 100%
Good Moderate Poor
Number: 255 Percentage: 66.4% Number: 124 Percentage: 32.3% Number: 5 Percentage: 1.3%

p-value = 0.708, which is insignificant, and we accepted the null hypothesis. Almost every participant (100%) with the primary level of education has a positive attitude, while 66.9% of the participants with university level of education has a positive attitude.

The majority of the participants (60.4%) had a good knowledge regarding complication as they knew that respiratory distress is a complication of bronchial asthma, while 39.6% of the participants had poor knowledge regarding complication of bronchial asthma, so 23.4%, 15.9%, and 0.3% of the participants picked I don’t know, tuberculosis, and anemia, respectively.

Table 5 reveals that 39.3% of the participants knew that salbutamol, steroids, and antihistamine were the regimen used for the treatment of asthma, while 39.1% of the participants thought salbutamol as the unique treatment. Also, 5.7% of the participants believed steroids were the only drugs in use for treatment of asthma, as well as 15.9% of the participants misinformed that antihistamine was the single drug for treatment of asthma. However, 75.5% of the participants had good knowledge regarding treatment, while 24.5% had poor knowledge.

p-value = 0.008, which is significant, and we reject the null hypothesis. Among the participants, 67.5% of males had good knowledge regarding triggering factors, while 81.2% of females also had good knowledge. Table 6 shows that there is a statistical relationship between the level of knowledge regarding triggering factors and gender.

p-value = 0.744, which is insignificant. Among the participants, 31.1% participants, who did not know the complication of asthma, thought that asthma is high in severity, while 34.5% of those who knew respiratory distress as a complication of asthma thought that asthma is high in severity.

Table 3. Relation between education and the attitude toward bronchial asthma.

What you should do when you face asthmatic patient in attack?
Education / Attitude Nothing Help him sit Call for help Bring his medication Total
Illiterate 0 1 0 1 2
50% 50% 100%
Primary school 0 0 0 1 1
100% 100%
Middle school 0 0 3 4 7
42.9% 57.1% 100%
Secondary school 2 19 18 75 114
1.8% 16.7% 15.9% 65.8% 100%
University 3 30 53 174 260
1.2% 11.5% 20.4% 66.9% 100%
Total 5 50 74 225 384

Table 4. Level of knowledge about bronchial asthma regarding complication.

What are the complications of bronchial asthma?
Respiratory distress Anemia Tuberculosis I don’t know Total
Number 232 1 61 90 384
percentage 60.4% 0.3% 15.9% 23.4% 100%
Good Poor
Number: 232 Percentage: 60.4% Number: 152 Percentage: 39.6%

Table 5. Level of knowledge regarding treatment.

What is the treatment of asthma?
Salbutamol Steroids Antihistamine All of the above Total
Number 150 22 61 151 384
percentage 39.1% 5.7% 15.9% 39.3% 100%
Good Poor
Number: 1159 Percentage: 75.5% Number: 377 Percentage: 24.5%

Table 6. Relation regarding the level of knowledge about triggering factors and gender.

What are the triggers that lead to worsening the symptoms of asthma?
Gender/treatment Smoke Dust Invasive exercise All of the above Total
Male 10 38 6 112 166
50% 50% 100%
Female 12 27 2 177 218
100% 100%
Total 22 65 8 289 384

Table 7. Relation between perceived knowledge regarding severity and level of knowledge regarding the complication of bronchial asthma.

In a scale from 1 to 10, how would you describe the danger of bronchial asthma?
Complication / Perceived severity Low Moderate High
I don’t know 12 50 28 90
13.3% 55.6% 31.1% 100%
Anemia 0 1 0 1
100% 100%
Tuberculosis 4 32 25 61
6.6% 52.5% 41% 100%
Respiratory distress 25 127 80 232
10.8% 54.7% 34.5% 100%
Total 41 210 133 384

Discussion

In our population, it is known that the high level of education has a great impact on one’s positive attitude in general, so we found that all of the primary levels of education had positive attitude, whereas the majority of university-level of education had positive action, thus there’s no statistical relation between education level and positive attitude toward asthmatic patient as p value is 0.708. In comparison with a study in Aseer, Saudi Arabia [2], the majority of illiterates had poor attitude toward bronchial asthma. Therefore, Aseer’s study went in contrary with our research for the reason that the prevalence of asthma in Riyadh is almost twice as that in Aseer, since in Riyadh, it is 12%, whereas in Aseer, it is 6.9% [2].

There was a statistical relationship between the level of knowledge regarding triggering factor and gender, as p-value was significant (0.008). However, our research showed that the females had better knowledge about bronchial asthma’s triggering factors than males. The result was also supported by two other studies, one was done in Pakistan [5], which showed a mean Standard deviation of 10.6 (−/+2.56) toward high knowledge of bronchial asthma in females than males and the other study was done in Lisbon [6], which showed that females had significantly higher score than males (p =0.015), so all in all our study and other two went in line that females had high level of knowledge regarding triggering factors of bronchial asthma.

It is obvious that higher the prevalence of a disease is, the higher the awareness should be regarding that disease, coming to our study we had a prevalence of 12% among the population based in Aseer, Riyadh [2], so the majority of participants had good knowledge regarding complications of bronchial asthma and they knew that respiratory distress was a complication of bronchial asthma. Although there was a high prevalence of bronchial asthma among Riyadh population, there were more than one-third of participants who did not know the complications of bronchial asthma for the reason that 81.5% of the participants did not have asthma.

There was no statistical relation between perceived severity and the level of knowledge regarding complications and p-value (0.744), which is insignificant for the reason that all of the participant, who thought anemia is a complication of bronchial asthma, believed that bronchial was moderate in severity, while just more than the half of the participants who had good knowledge about complications of bronchial asthma believed that bronchial asthma was moderate in severity.


Conclusion

In the light of the present study, the knowledge regarding bronchial asthma was relatively good while the attitude is in need of improvement, especially the attitude toward the distressed asthmatic patient. On the other hand, the female participants showed a greater knowledge than males. Finally, this study showed that knowledge of bronchial asthma is irrelevant to education.


Recommendations

  • Ministry of Health should develop an educational program to increase the knowledge regarding triggering factors of bronchial asthma.
  • The educational program should focus on the good attitude toward asthma as one-third of the participants did not have the appropriate attitude, as well as on complications of bronchial asthma as more than one-third had poor knowledge and this is supported by the fact that negligence plays a major role in death among asthmatic patients.
  • Researchers should make use of the health belief model in exploring the relationship between attitude and knowledge of bronchial asthma

Conflict of interest

The authors declare that there is no conflict of interest regarding the publication of this article


Funding

None.


Consent for publication

Informed consent was obtained from all the participants.


Ethical approval

The local Research and Ethics committee approved the research proposal via letter number (11/191).


Author details

Amar F. Khalifa1, Muaadh Yahya Ba Mhraz2, Turki R. Alrumayh2, Saud M. Alhaqqan2, Majed K. Alanazi2, Meshal D. Alanazi2, Moayed A. Alqarni2, Meshari Z. Almutairi2, Amro A. Al-Gamdi2

  1. Assistant Professor, Almaarefa University, Ad Diriyah, Saudi Arabia
  2. Internship House Officer, Almaarefa University, Ad Diriyah, Saudi Arabia

Reference

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  3. Yousef HA, Koura M, Yousef AA. Knowledge about bronchial asthma management in primary health care physicians in Al-Khobar City, Saudi Arabia. J Family Community Med. 2015;22(1):1–7. https://doi.org/10.4103/2230-8229.149567
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  5. Aqeel T, Akbar N, Dhingra S, Noman-Ul-Haq. Assessment of knowledge and awareness regarding asthma among school teachers in urban area of Quetta, Pakistan. J Pharm Pract Community Med. 2015;1(1):18–23. https://doi.org/10.5530/jppcm.2015.1.5
  6. Leiria Pinto P, Cordeiro M, Pinto R. Adolescents and school asthma knowledge and attitudes. Allergol Immunopathol (Madr). 1999;27(5):245–53.


How to Cite this Article
Pubmed Style

Khalifa AF, Mhraz MYB, Alrumayh TR, Alhaqqan SM, Alanazi MK, Alanazi MD, Alqarni MA, Almutairi MZ, Al-Gamdi AA. Knowledge and attitude of bronchial asthma among Riyadh population, Saudi Arabia. IJMDC. 2020; 4(2): 286-290. doi:10.24911/IJMDC.51-1566219446


Web Style

Khalifa AF, Mhraz MYB, Alrumayh TR, Alhaqqan SM, Alanazi MK, Alanazi MD, Alqarni MA, Almutairi MZ, Al-Gamdi AA. Knowledge and attitude of bronchial asthma among Riyadh population, Saudi Arabia. https://www.ijmdc.com/?mno=61874 [Access: January 28, 2022]. doi:10.24911/IJMDC.51-1566219446


AMA (American Medical Association) Style

Khalifa AF, Mhraz MYB, Alrumayh TR, Alhaqqan SM, Alanazi MK, Alanazi MD, Alqarni MA, Almutairi MZ, Al-Gamdi AA. Knowledge and attitude of bronchial asthma among Riyadh population, Saudi Arabia. IJMDC. 2020; 4(2): 286-290. doi:10.24911/IJMDC.51-1566219446



Vancouver/ICMJE Style

Khalifa AF, Mhraz MYB, Alrumayh TR, Alhaqqan SM, Alanazi MK, Alanazi MD, Alqarni MA, Almutairi MZ, Al-Gamdi AA. Knowledge and attitude of bronchial asthma among Riyadh population, Saudi Arabia. IJMDC. (2020), [cited January 28, 2022]; 4(2): 286-290. doi:10.24911/IJMDC.51-1566219446



Harvard Style

Khalifa, A. F., Mhraz, . M. Y. B., Alrumayh, . T. R., Alhaqqan, . S. M., Alanazi, . M. K., Alanazi, . M. D., Alqarni, . M. A., Almutairi, . M. Z. & Al-Gamdi, . A. A. (2020) Knowledge and attitude of bronchial asthma among Riyadh population, Saudi Arabia. IJMDC, 4 (2), 286-290. doi:10.24911/IJMDC.51-1566219446



Turabian Style

Khalifa, Amar F., Muaadh Yahya Ba Mhraz, Turki R. Alrumayh, Saud M. Alhaqqan, Majed K. Alanazi, Meshal D. Alanazi, Moayed A. Alqarni, Meshari Z. Almutairi, and Amro A. Al-Gamdi. 2020. Knowledge and attitude of bronchial asthma among Riyadh population, Saudi Arabia. International Journal of Medicine in Developing Countries, 4 (2), 286-290. doi:10.24911/IJMDC.51-1566219446



Chicago Style

Khalifa, Amar F., Muaadh Yahya Ba Mhraz, Turki R. Alrumayh, Saud M. Alhaqqan, Majed K. Alanazi, Meshal D. Alanazi, Moayed A. Alqarni, Meshari Z. Almutairi, and Amro A. Al-Gamdi. "Knowledge and attitude of bronchial asthma among Riyadh population, Saudi Arabia." International Journal of Medicine in Developing Countries 4 (2020), 286-290. doi:10.24911/IJMDC.51-1566219446



MLA (The Modern Language Association) Style

Khalifa, Amar F., Muaadh Yahya Ba Mhraz, Turki R. Alrumayh, Saud M. Alhaqqan, Majed K. Alanazi, Meshal D. Alanazi, Moayed A. Alqarni, Meshari Z. Almutairi, and Amro A. Al-Gamdi. "Knowledge and attitude of bronchial asthma among Riyadh population, Saudi Arabia." International Journal of Medicine in Developing Countries 4.2 (2020), 286-290. Print. doi:10.24911/IJMDC.51-1566219446



APA (American Psychological Association) Style

Khalifa, A. F., Mhraz, . M. Y. B., Alrumayh, . T. R., Alhaqqan, . S. M., Alanazi, . M. K., Alanazi, . M. D., Alqarni, . M. A., Almutairi, . M. Z. & Al-Gamdi, . A. A. (2020) Knowledge and attitude of bronchial asthma among Riyadh population, Saudi Arabia. International Journal of Medicine in Developing Countries, 4 (2), 286-290. doi:10.24911/IJMDC.51-1566219446