A Descriptive Study to Assess the Health Profile and Warning Signs of Cancer among adults Residing in Selected Rural areas of District Roopnagar Punjab

 

Ms. Kritika Sharma¹, Dr. Raman Kalia², Mrs Manpreet³, Mrs Shaveta Sharma⁴

¹M Sc. Nursing Student, Saraswati Nursing Institute, Dhianpura

²Principal, Saraswati Nursing Institute, Dhianpura

³Lecturer, Medical Surgical Nursing, Saraswati Nursing Institute, Dhianpura

 

ABSTRACT:

Health is the level of functional or metabolic efficiency of a living being. In humans, it is the general condition of a person’s mind and body, usually meaning to be free from illness, injury or pain. According to the World Health Organization (WHO) health is a “state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.[1] The cancer is the most dreadly disease and refers to malignant tumors, neoplasm which is caused by abnormal growth of new tissue. According to a report published by NCRP, Indian Council of Medical Research, Bangalore, the total cancer cases are likely to go up from 979,786 cases in the year 2010 to 1,148,757 cases in the year[2]. Keeping this in view, the present study was conducted to assess the health profile and warning signs of cancer among adults residing in selected community areas of Distt. Roopnagar Punjab. The objective of the study was to assess the health profile of adults residing in selected rural areas of Roopnagar Distt. Punjab. To assess the warning signs of cancer among adults. To determine the association between warning signs of cancer with the selected socio- demographic variables among adults. Total 300 adults were selected by convenience sampling technique. Socio-demographic sheet, health profile sheet and warning signs of cancer assessment sheet were used to collect data to assess the health profile and warning signs of cancer among adults. Content validity of the tool was determined by experts. Reliability of the tools was calculated by split half method and tools found reliable. Descriptive and inferential statistics were used for data analysis. The result revealed that no major warning signs of cancer were present among the subjects. 25(8.3%) of the subjects had constipation and 17(5.7%) of the subjects had indigestion among all subjects. The study concluded that general population should be educated regarding early identification of warning signs of cancer.

 

 

 

 

INTRODUCTION:

Cancer is a disease characterized by an unstrained growth of abnormal cells which, if untreated, eventually destroys the patient. Cancer is viewed as being synonymous with death, pain & disfiguration. Education of health care professionals & the public is essential if current attitudes about cancer and prevention of cancer to become more positive & realistic [3].

Cancer is a generic term for a large group of diseases that can affect any part of the body. One defining feature of cancer is the rapid creation of abnormal cells that grow beyond their usual boundaries, and which can then invade adjoining parts of the body and spread to other organs. This process is referred to as metastasis which is the major cause of death from cancer [4].

 

According to the Indian Council of Medical Research, cancer scenario in India is quite alarming with nearly 25 lakh of patients in the country currently suffer from the deadly disease. The burden of the cancer doubled globally between 1975 and 2000. It reveals certain signs and symptoms, popularly called the danger or warning signals. Cancer can be repulse, cured in most forms if it discovered in its precancerous stage. Even with the advancement of technology in medical oncology, this is exciting and challenging. Cancer is curable and many thousands of patients are living testimony to this fact. Many still die from cancer and others live with their disease under control [5].

 

The international cancer society is showing the burden of cancer is estimated to be double by 2020 and nearly triple by 2030. According to the forecasted figures for 2030, there are likely to be 20 to 25 million new cancer diagnoses and 13-17 million cancer related deaths.[6]

 

According to survey on cancer in 2013 in Punjab , cancer cases per lakh population, or the prevalence of cancer, has been worked out as 91 .1, with the highest 136.3 in Muktsar district and lowest 40.9 in Tarn Taran district. Mansa, Faridkot, Bathinda, Ferozepur and Fatehgarh Sahib districts with prevalence 134.8, 134.6, 125.8, 113.9, 106.3 respectively are other districts above the state average [7].

 

Through early education and widened community awareness, modifiable risk factors can decrease the population’s lifetime risk and some studies have shown that, despite the scientific evidence, the public is not well informed about the link between cancer and lifestyle and other causes that there are many factors that make population at risk for getting cancer [8].

 

While working in hospital and community, investigator observed that there is a need of early detection of warning sign of cancer, as majority of the people are unaware about warning signs of cancer and they hesitate in reaching the necessary nearby health faculty. Many cancer death could be prevented by early detection of warning signs of cancer. Through extensive literature review and personal experience, the investigator has strong desire to conduct the study to assess the health profile and warning signs of cancer

 

 

MATERIALS AND METHODS:

A Non-Experimental, Quantitative research approach and descriptive research design was adopted in the present study to assess the health profile and warning signs of cancer among adults residing in selected rural areas of district Roopnagar Punjab. Non probability convenience sampling technique was used to collect the data. The population for this study was all adults residing in selected rural areas. The sample size for the present study was 300.

 

DEVELOPMENT OF TOOL:

Tool used for the present study was developed specifically as per the need of the investigator. Semi-structured interview schedule was prepared under following sections:

 

Section I - Socio-demographic data sheet. This section consists of 11 variables to collect socio demographic information such as Age, Gender, Educational status, Occupation, Marital status, Monthly family income in rupees, Dietary pattern, Religion, Source of previous knowledge related to warning signs of cancer, family history of cancer, family history of any chronic illness.

 

Section II Semi-structured interview schedule to assess the health profile of the adults. This section consists of 2 parts. Part: 1 was Personal habits which consist 6 items and part: 2 was Current health problem which consist 68 items to assess the health profile of the adults. Subjects responses were scored as Never, Rarely, Sometime, Often and always.

 

Section II:

Semi-structured interview schedule to assess the warning signs of cancer. This section consists of 17 items to assess the warning signs of cancer, it consist 17 items which were scored on the basis of yes or no responses.

 

ETHICAL CONSIDERATIONS:                                                              

1.      Written permission was taken from the Principal of Saraswati Nursing Institute, Dhianpura, Roopnagar.

2.      Written permission was taken from ethical clearance committee of Saraswati Nursing Institute, Dhianpura, Roopnagar.

3.      Informed Consent was taken from each study subject prior to data collection.

4.      Confidentiality and anonymity of subject was maintained throughout the study.

 

RESULTS AND INTERPRETATION:

Data were verified and analyzed using statistical package for social sciences (SPSS) .Descriptive and inferential statistics were used for data analysis. The findings of present study showed that, 179(59.0%) of the study subjects sometime experienced fatigue and only 46 (15.4%) of the study subjects were always experienced fatigue. 143(47.7%) of the study subjects experienced light headache and only 17(5.6%) of the study subjects have always light headache. 147(49.0%) of the study subjects experienced weakness sometime and only 37 (12.3%) of the study subjects were always experienced weakness. Majority of subject were not having gastrointestinal symptom only 81(27.0%) of the study subjects were having constipation sometime. and only 25 (8.3%) of the study subjects were having constipation always. Majority of subject were not having urinary symptoms only 29(9.7%) of the study subjects having painful urination and burning micturation. Majority of subjects were not having any neurological symptom only 54(18.0) subject experienced anxiety sometime. Majority of subjects were not having respiratory symptoms only 71(23.7%) were experiencing breathlessness sometime and 18(6.0%) subjects were experiencing breathlessness. Majority of the subjects were not having endocrine symptoms only <100 subjects of the study experienced endocrine symptoms sometimes. Majority of subjects were not having integumentary symptoms. Majority of subjects were not having musculoskeletal symptom only <100 subjects experienced joint pain, muscular cramps, joint stiffness and joint swelling. Majority of subjects were not having sensory symptoms. More than half of the females study subject of the study 60(66.6%) s had sometime irregular menstruation. 45(50.0%) female subject sometime experienced dysmenorrhea. All male study subjects never experienced any reproductive symptoms. So the highest percentage of the adults were not having any health problem.

 

The result revealed that no major warning signs of cancer were present among the subjects. Constipation 25(8.3%) and indigestion 17(5.7%) was observed to be present among all subjects. There was no significant association between warning signs of cancer with their selected socio-demographic variables. The study concluded that general population should be educated regarding early identification of warning signs of cancer.

 

Table 1 :- Frequency and percentage distribution of subjects as per their socio demographic variables.  N=300

Characteristics		n	%
Age (year)	20-35Years	090	30.0
	36-50 Years	109	36.3
	51-65 Years	066	22.0
	> 65 years	035	11.6
Gender	Male	140	46.7
	Female	160	53.3
Educational status	No formal education	051	17.0
	Primary	085	28.3
	Secondary	085	28.3
	High secondary	061	20.3
	Graduate and above	018	06.0
Occupation	Unemployed	180	60.0
	Government job	009	03.0
	Private job	044	14.7
	Self employed	067	22.3

Table 1(a) Contd..:- Frequency and percentage distribution of subjects as per their socio demographic variables.  N=300

Characteristics		n	%
Marital status	Married	229	76.3
	Unmarried	026	08.7
	Separated	003	01.0
	Divorced	002	00.7
	Widow/Widower	040	13.3
Monthly family income in rupees	≤10,000	107	35.7
	10,001-20,000	131	43.7
	20,001-30,000	048	16.0
	30,001-40,000	006	02.0
	> 40,000	008	02.7
Dietary pattern	Vegetarian	153	51.0
	Non-vegetarian	147	49.0
Religion	Sikh	279	93.0
	Hindu	016	00.3
	Muslim	003	01.0
	Christian	002	00.7
	Others	-	-
Source of information related to warning signs of cancer	Family	010	03.3
	Mass media	104	34.7
	Friends	012	04.0
	Health care professional	085	28.3
	None	089	29.7
Family history cancer	Yes No	010 290	03.0 96.7
Family history of other chronic disease	Yes No	014 286	04.7 95.3

 

Table 2: Assessment of warning signs of cancer

Assessment of warning Signs of cancer	YES N (%)	NO N(%)
Change in frequency of stool	10(3.3)	290(96.7)
Constipation	25(8.3)	275(91.7)
Presence of blood in stool	01(0.3)	299(99.7)
Change in frequency of urine	07(2.3)	293(97.7)
Presence of blood in urine	02(0.7)	298(99.3)
Pain during urination	-	300(100.0)
A sore that does not heal	04(1.3)	296(98.7)
Unusual bleeding from the wound or natural orifice	-	300(100.0)
Unusual discharge from wound or natural orifice	02(0.7)	298(99.3)
Thickness or lumps in breast or elsewhere	03(1.0)	297(99.0)
Indigestion	17(5.7)	283(94.3)
Difficulty in swallowing	02(0.7)	298(99.3)
Asymmetry of mole or wart	03(1.0)	297(99.0)
Change in Border of mole or wart	04(1.3)	296(98.7)
Change in Shape of mole or wart	03(1.0)	297(99.0)
Change in Diameter of mole or wart	03(1.0)	297(99.0)
Nagging cough or hoarseness of voice	05(1.7)	295(98.3)

 

Table 3 Association between warning sign of cancer (constipation) with their selected socio- demographic variable. N=300

S. No.	Demographic Variables	n	Chi-square value	df and P value
1	Age( in years) 20-35 36-50 51-65 >65	090 109 066 035	.739	df=1 p=.39
2	Gender Male Female	140 160	3.818	df=1 p = .051
3	Education No formal education Primary Secondary High secondary Graduate and above	051 085 085 061 018	17.504	df=4 p =.002*
4	Occupation Unemployed Government job Private job Self employed	180 009 044 067	3.418	df=3 p =.332
5	Marital status Married Unmarried Separated Divorced Widow/Widower	229 026 003 002 040	13.42	df=4 p =.009
6	Monthly family income in rupees ≤10,000 10,001-20,000 20,001-30,000 30,000-40,000 ≥40,000	107 131 048 006 008	1.962	df=4 p =.743
7	Dietary Pattern Vegetarian Non-vegetarian	153 147	3.61	df=2 p =.164
8	Religion Sikh Hindu Muslim Christian Others	279 016 003 002 -	4.912	df=3 p =.178
9	Source of knowledge related to warning signs of cancer Family Mass media Friends Health care professional None	010 104 012 085 089	7.882	df=4 p = .096
10	Family history of cancer a)                 Yes b)                 No	010 290	0.38	df=1 p =.846
11	Family history of other chronic disease a)                 Yes b)                 No	014 286	7.874	df=1 p =0.005

 

DISCUSSION:

The findings of study showed 3(1.0%) of the subjects experienced thickness or lumps in breast. The similar findings were observed in study conducted by Katrina L, Whitakar on attributes of cancer Alarm symptoms in a community sample. Over half the respondents had experienced alarming symptoms. Cancer attribution was highest for unexplained lump i.e. 7%. The findings of the present study showed that 60(66.6%) females subjects experienced irregularity in menstruation cycle. The similar findings were observed in a study conducted by Nirmala Jaget Lakkawar Jayawani R L on menstrual disorders among medical students and its correlation with biological variables. This revealed 29% subjects were experienced irregularity in the menstrual cycle.

 

The findings of the study showed that 94(30.4%) subjects sometimes experienced joint pain and 30 (10.0%) subjects always experienced this. The similar findings were observed in a study conducted by J Adamson, SE Brahin on Prevalence and risk factors among men and women in the west of Scotland. This revealed joint pain was prevalent among the subjects.

 

The findings of the study showed that 60(66.6%) females experienced irregularity in menstruation cycle. The similar findings were observed in a study conducted by Nirmala Jaget Lakkawar Jayawani R L on menstrual disorders among medical students and its correlation with biological variables. This revealed 29% subjects were experienced irregularity in the menstrual cycle.

 

CONCLUSION:

From the present study it was concluded that few symptoms which can be warning signs of cancer were present among the subjects which need further evaluation. General population should be provided education regarding early identification of warning signs of cancer, by conducting educational programs to create awareness regarding warning signs of cancer.

 

REFERENCES:

1.       Potter and Perry , Fundamentals of nursing ,sixth edition , Elsevier Mosry, 2005, page no 90-91

2.        Luckman, Soresen. Medical surgical Nursing- A Psychophysiologic approach. 3^rd ed. Sounders; 1817 -19.

3.       Rao Y N, Suderguptta, Agrawal. National Cancer Control programme NCPP: current status and strategies: Ministry of health education: 2002.

4.       Mehta Sharma, Text book of Oncology nursing 1^st edition, jaypee publisher,2007 (P) Ltd page no. 13

5.       World Health organization http://www.who.int/cancer/en.

6.       Anandhi RJ, Changing trends, cancer epidemiology in India, ICMA, 2008,283.

7.       Government of Punjab Department of Health & Family welfare Punjab, Chandigarh

8.       A Qalawa Shereen Ahmed Cancer awareness among non medical students in Sudan International Journal of advanced research(2013),volume 1, issue 8,93-110.

 

 

 

 

Received on 24.09.2017       Modified on 29.10.2017

Accepted on 30.10.2017      ©A&V Publications All right reserved