INTRODUCTION:

Health is an ideal state of well—being resulting from harmonious interaction of body, mind, spirit and environment.¹

Coronary artery disease is also called Coronary arteriosclerosis. Coronary artery disease (CAD) is the most common type of heart disease. It is the leading cause of death in the India both men and women. CAD occurs when the arteries that supply blood to heart muscles become hardened and narrowed. This is due to the buildup of cholesterol and other material, called plaque, on their inner walls. This build up is called atherosclerosis.

As it grows, blood can flow through the arteries. As a result, the heart muscles unable get the blood or oxygen it needs. This can lead to chest pain (angina) or a heart attack. Mainly heart attacks happen when blood clots suddenly stop the heart’s blood supply, causing permanent heart damage. Over time, CAD can also weaken the heart muscle and contributes to heart failure and arrhythmias.²

The heart is the engine of human life. Beating almost 100,000 times a day, more than 36 million times each year, endless beating examines the heart is a muscle pushing approximately five quarts of blood in an endless course to deliver oxygen to every cell of the human body.5 The incidence of cardiovascular disease is on the rise in the modern world. Coronary artery disease (CAD) is a leading cause of cardio vascular mortality worldwide with >4.5 million death occurring in developing world.³

Cardiovascular deaths in India are estimated to be 2.5 million per year. Prevalence of coronary artery disease in India is 3-4 folds are higher than in America and Europe. The high risk and wide prevalence of coronary artery disease among the general Indian population is well established⁴.

Coronary artery disease remains the highest cause of mortality in India and the majority of cases are due to risk factors that include hypertension, diabetes mellitus, and smoking and elevated serum cholesterol levels.⁵

The risk factors are characteristics or conditions that are statistically associated with high incidence of disease. Many risk factors have been associated with coronary artery diseases which are mainly of modifiable risk factors and non modifiable risk factors. Modifiable risk factor includes smoking, hypertension, elevated serum cholesterol level, physical inactivity, obesity and diabetes. Non modifiable risk factors include age, gender and family history.⁶

STATEMENT OF THE PROBLEM:

A study to assess the level of knowledge regarding risk factors and its prevention of coronary artery disease among patients attending medicine outpatient department in Dasmesh Hospital, Faridkot.

OBJECTIVES:

1. To assess the level of knowledge regarding risk factors and its prevention of coronary artery disease among patients attending medicine outpatient department in Dasmesh Hospital, Faridkot.

2. To find out the association between the knowledge scores of prevention and risk factor of coronary artery disease among patients.

ASSUMPTIONS:

· It is assumed that patients attending medicine outpatient department have inadequate level knowledge regarding coronary artery disease.

DELIMITATION:

· Only 50 samples will be included.

· The study will be conducted only in medicine outpatient department in Dasmesh Hospital, Faridkot.

REVIEW OF LITERATURE:

Parisa Parsa (2019) conducted a study To determine the knowledge of patient regarding coronary artery disease. To find out the relationship between knowledge level and selected demographic variables. Method: The study design was descriptive survey design. The purposive sampling technique was used to draw 75 patients as samples. Data was collected by administering the CAD questionnaire to assess the knowledge. Results: The result shows that there was significant relationship between knowledge level and age group, occupation, and education with odds ratio [95% confidence interval], age group between 25-35years have OR 1.632 (0.208, 1.934), age group of 36-45years OR 1.325 (0.352, 4.989) (verses age group of 46-55 years) and Pre university OR 1.442 (0.423,4.91) Diploma OR 1.02 (0.287,3.489), Private employee OR 1.513 (0.136, 1.939), Govt.employee OR 1.418(0.083, 2.114). But there was no significant relationship between knowledge level and religion, any related diseases and when was diagnosed to have CAD. Interpretation and conclusion: The findings of the study showed that patients have moderate level of knowledge regarding CAD.⁷

Nidhin Abraham (2017) conducted diabetes increases the risk of coronary artery disease at least by two-to threefold in diabetic patients compared with non-diabetic patients. Improved management of modifiable risk factors of coronary artery disease reduces the chances of its onset. Objectives: 1. To assess the pre-test knowledge of patients with diabetes mellitus regarding modifiable risk factors of the coronary artery disease. 2. To evaluate the effectiveness of STP on knowledge of patients with diabetes mellitus regarding modifiable risk factors of coronary artery disease. 3. To associate the level of knowledge of patients with diabetes mellitus with the selected demographic variables. Hypothesis:H1:-There will be a significant different between the pre-test and post-test knowledge regarding modifiable risk factors of coronary artery disease among patients with diabetes mellitus in selected rural area of Mehsana district. H2: There will be significant association between level of knowledge regarding modifiable risk factors of coronary artery disease among patients with diabetes mellitus and the selected demographic variables. Design: Quasi experimental one group pre-test post-test design was used. Participation: 60 diabetic patients were selected using Non–probability convenient sampling techniques in rural areas of Mehsana District. Tool: Questionnaire was used to assess the level of knowledge among diabetic patients. Results: During pre-test the mean level of knowledge was 11.45 the standard deviation was 2.3697. During post-test, the mean level of knowledge was 15 and standard deviation was 2.0084. The obtained ‘t’ test value is 10.74. This value is significant at p<0.05 level. Conclusion: Structured teaching programme had increase level of knowledge of patients with diabetes on management of modifiable risk factors of coronary artery disease and thus structured teaching programme was proved to be effective.⁸

Sr. Kanikkai Parvin et al (2020) conducted a study intended to assess the risk status for coronary artery disease among the bus drivers of Tamilnadu state transport corporation of Madurai district. Method: Quantitative research approach was adopted with the research design being non-experimental descriptive research design. Purposive sampling technique was used to select 200 bus drivers. Assessment of risk status was done using Coronary Artery Disease Risk Assessment Tool (CADRAT) and the techniques used were interview and biophysical measurements. Data was analyzed using descriptive and inferential statistics. Results: Among 200 drivers, 19% were overweight and 49% were obese; 46% had a waist circumference between 94 – 102 cm and 26% had > 102 cm; 24,5% were current smokers; 44% had the habit of consuming alcohol; 11% did not have the habit of performing exercise; 89.5% moderately healthy dietary pattern and 2% followed unhealthy dietary pattern; 72.5% were either moderately or severely stressful; 23.5% were diabetics; 33.5% had pre hypertension, 16.5% had stage I hypertension and 42.5% had isolated hypertension; and 11..5% had family of CAD. In terms of risk status, 71.5% had medium risk for CAD and 28.5% had high risk for CAD. Conclusion: The current study findings conclude that there is high prevalence of certain risk factors among bus drivers increasing their risk to develop CAD. There is a vast scope for modification of risk factors among the bus drivers that has the potential to alter the natural history of atherosclerosis and slow CAD progression.⁹

Sumanpreet Kaur (2016) conducted a descriptive study to assess the prevalence of Cardiovascular risk factors among adolescents in selected schools of Banga, District Shaheed Bhagat Singh Nagar, Punjab.Method of study: The aim of the study was to study the prevalence of cardiovascular risk factors among adolescents (13-19 yrs) and prepare an information guide booklet on prevention of cardiovascular disorders. The present study assesses the prevalence of cardiovascular risk factors among adolescents in selected schools of Banga, District Shaheed Bhagat Singh Nagar, Punjab. Stratified cluster sampling technique was followed to select sample. Data was collected by 3 tools Part- A comprises of socio-demographic variable profile i.e. age, gender, dietary pattern, physical activity, BMI, area of residence., life style, type of family, family history of cardiovascular diseases. Part- B comprises of Anthropometric measurement by using measuring tape, weighing machine, stadiometre, body mass index and stress and Part-C was self structured Likert scale on cardiovascular risk factors. Analysis and interpretation of study was done by applying descriptive statistics and chi square findings were represented in forms of table and graphs. Result: The results showed that among 100 adolescents nearly equal division of adolescent in age group of 13-14 years i.e. 30% in age group of 15-16 32% and in age group 17-19 years is 38%. Majority of adolescent were male 52% and 48% were females. Regarding to BMI majority of adolescents were normal weighted. Majority of adolescents belonged to rural areas 63% and 37% belonged to urban area. Majority of adolescent were vegetarian 59% and 47% were non-vegetarian. About 17% of adolescents were underweight, 33% adolescents were normal, 28% were overweight and 19% were obese class-1 were at risk. Majority (53%) of adolescents were having mild risk and followed by (27 %) having no risk followed by those having moderate risk (13%) and least (7.0%) were having high risk of developing cardiovascular disorders. Conclusion: With regard to association of cardiovascular risk factors with selected socio-demographic variables such as age (in years), dietary pattern, sex, BMI, area of residence, type of family, family history of cardiovascular diseases, type of family, Association of cardiovascular risk factors with Dietary pattern, BMI, life style, family history of cardiovascular diseases was found statistically significant at p<0.05.¹⁰

Ramya K. R., Kiran Batra (2015) conducted a study on Knowledge of Coronary Heart Disease using a pretested structured questionnaire. Findings revealed that most adolescents were not aware of the seriousness of the heart disease. Only 14.3% students thought that CHD is a public health concern, 28.6% were aware of their own body weight, and none of them had heard of the term Body Mass Index (BMI). 26.2% adolescents had moderately adequate and 73.8% had inadequate knowledge regarding CHD. Heavy alcohol consumption and smoking were perceived as important top three risk factors for CHD. However, a very small percentage could identify obesity, physical inactivity, and consumption of fatty foods as important risk factors. Study reveals that a large proportion of adolescents are not aware of the lifestyle associated risk factors of CHD and its prevention. This suggests the need for population based programmers in Kerala to increase adolescent knowledge, and skills to halt the progression of this deadly disease.¹¹

METHODS AND PROCEDURE:

Research approach and design:

Keeping in view the objectives of the study the research approach used for the study was descriptive research approach.

Research design:

The research design selected for the study was non experimental research design.

Research setting:

The present study was conducted in OPD at Dasmesh Hospital Faridkot, Punjab.

Target population:

The target population for this study including the patients who were attending medicine OPD at Dasmesh Hospital, Faridkot, Punjab.

Sample and sampling technique:

The sampling technique used was non probability convenient sampling technique. In the present study the investigator selected the sample composed of 50 patients attending medicine OPD.

Inclusion criteria:

Study subjects who were:-

available during the period of data collection.

willing to participate in the study

who could converse in English or Punjabi

both males and females included in the study

Selection and development of research tool:

Socio demographic variables.

Self structured knowledge questionnaire regarding coronary artery disease.

Description of tool:

To accomplish the objective of the study the research tool was divided in the following two parts:

Section A: Sample characteristics (Socio-demographic tools)

It comprised of 7 items seeking information on backgrounds data such as age, gender, education, occupation, marital status, smoking, hereditary.

Section B: Structured Knowledge Questionnaire.

It composed of 24 knowledge items on coronary artery disease. Every correct answer was given score 1 and every incorrect/unanswered item was given zero. The maximum score was 24 and minimum score was 0.

Level of knowledge	Score
Excellent	19-24
Good	13-18
Average	7-12
Poor	0-6

Knowledge score range regarding coronary artery disease patients.

RESULTS:

Out of 50 participants, 17(34%) respondents were in the age group of 50-59 years and 25(50%) respondents were male; 22(44%) were had middle school education, 47(94%) were married and 45(90%) were non smoker and 39(78%) were not having any hereditary history.

Table 1: Distribution of Knowledge regarding risk factor and prevention of coronary artery disease. N =50

Level of knowledge	Frequency	Score
Excellent	04	8%
Good	16	32%
Average	23	46%
Poor	07	14%

Table 1 shows that 23(46%) patients were had average level of knowledge regarding prevention and risk factors of coronary artery disease where as16 (32%) had good level of knowledge, followed by 07(14%) patients were had poor level of knowledge and only 04(8%) were had excellent level of knowledge.

Table 2: Association level of knowledge regarding coronary artery disease with their socio demographic variables

Sr. No.

Demographic variables

Level of knowledge

Chi- square

Table value

Level of Significance

Excellent

Good

Average

Poor

Age( in Years)

30-39

40-49

50-59

60-69

9.362

16.92

Gender

Male

Female

1.474

7.82

Education

Middle school

High School

Graduate

Post Graduate

7.774

16.92

Occupation

Self employed

Retried

Employed

Out of work from 1 year

5.4327

16.92

Marital Status

Married

Divorced

Widow

Unmarried

0.998

16.92

Smoking

Never smoke

Currently smoking

Trying to quit smoke

Used to smoke

5.543

16.92

Hereditary

Yes

Don’t know

3.787

12.59