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Research Article | Volume 5 Issue 1 (Jan-June, 2024) | Pages 1 - 8
Unlocking Anesthesia Awareness: Evaluating Public Knowledge about General Anesthesia in District Chamba, Himachal Pradesh
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1
Junior resident, Department of Anaesthesiology, Dr RPGMC Tanda, Kangra HP, India
2
Medical Officer (Specialist), Department of Anaesthesia, Pt. JLNGMCH, Chamba (H. P.), India.
3
Assistant Professor, Department of Anesthesia, Pt. JLNGMCH, Chamba (H.P.), India
Under a Creative Commons license
Open Access
Received
March 20, 2024
Revised
May 25, 2024
Accepted
May 30, 2024
Published
June 29, 2024
Abstract
Anesthesia, Public Awareness, Knowledge Assessment, Patient Safety, Surgical Outcomes, District Chamba, Himachal Pradesh.
Keywords
INTRODUCTION

Anesthesia is a cornerstone of modern medical practice, playing a crucial role in facilitating a wide range of surgical and diagnostic procedures. Its primary purpose is to induce a reversible loss of sensation and consciousness, allowing patients to undergo surgeries and other invasive interventions without experiencing pain or distress. The development and refinement of anesthetic techniques have significantly advanced the field of medicine, contributing to improved surgical outcomes and enhanced patient safety. However, despite its importance, there is often a lack of awareness and understanding about anesthesia among the general public.1-5

 

In District Chamba, Himachal Pradesh, the unique geographic and demographic characteristics pose particular challenges to healthcare delivery. The region is marked by its remote and mountainous terrain, which can limit access to advanced medical facilities and specialized care. In such settings, the role of anesthesia becomes even more critical, as it enables the performance of essential surgical procedures that might otherwise be inaccessible. Given these challenges, it is imperative that the general public possesses a basic understanding of anesthesia, including its purpose, benefits, risks, and the role of anesthesiologists in the healthcare system.

 

Awareness and knowledge about anesthesia are vital for several reasons. Firstly, informed patients are more likely to engage in their healthcare decisions actively, leading to better compliance with preoperative and postoperative instructions and, consequently, improved surgical outcomes. Secondly, understanding the importance of anesthesia can alleviate common fears and misconceptions, reducing anxiety and enhancing the overall patient experience. Thirdly, public awareness can support the development of community-based educational initiatives, promoting a culture of informed consent and patient safety.6-9

 

Previous studies have highlighted significant gaps in public knowledge regarding anesthesia.10-16 These deficiencies are often attributed to a lack of targeted educational programs and limited public health communication about the role and safety of anesthesia. Addressing these gaps is essential to empower patients, ensuring they can make informed decisions about their healthcare. Moreover, enhancing public knowledge can foster greater trust in medical professionals, particularly anesthesiologists, whose work is often behind the scenes but is integral to patient care.

 

This study aims to assess the awareness and knowledge about the importance of anesthesia among the general public of District Chamba, Himachal Pradesh. By identifying current knowledge levels and areas needing improvement, this research seeks to contribute to the development of effective educational strategies and public health initiatives. The ultimate goal is to elevate the overall understanding of anesthesia in the community, thereby supporting better healthcare outcomes and enhancing patient safety. The findings of this study will be instrumental in guiding future efforts to educate the public about anesthesia, ensuring that individuals are well-informed and confident in their healthcare choices.

 

Objectives of the Study:

 

The primary objective is to gauge awareness and knowledge about importance of anesthesia among general public of District Chamba ,Himachal Pradesh. 

Research Methodology
  • Research Approach -Descriptive

  • Research Design- Cross-sectional survey design

  • Study area: District Chamba , Himachal Pradesh

  • Study duration- between January  2024 to May 2024

  • Study population: The study's target population encompassed all adults aged 18 and above who had been residents of District Chamba Himachal Pradesh for a minimum of 12 months

  • Sample size- A robust sample size of 400 adults was determined using a 95% confidence level, an estimated knowledge level of 50% regarding importance of anesthesia, a precise 5% absolute error margin, and a conservative 5% non-response rate. 

  • Study tool: A google form questionnaire consisting of questions regarding socio-demography and knowledge regarding importance of anesthesia was created. The questionnaire was initially pre-tested on a small number of participants to identify any difficulty in understanding by the respondents. 

  • Description of Tool- 

  1. Demographic data survey instrument: The demographic form elicited information on participants’ background: age, marital status, religion, employment, education and many more.

  2. Questionnaire: The questionnaire contains 20 structured knowledge related questions regarding importance of anesthesia. One mark was given for each correct answer and zero for incorrect answer. The maximum score was 20 and minimum score was zero. Scoring was done on the basis of marks as >80%(16-20)=very good,60-79%(12-15) =Good,41-59% ( 8-11)=Fair,<40% (< 8)=poor

  • Validity of tool - by the experts in this field

  • Data collection- Data was collected under the guidance of supervisors. The google form questionnaire was circulated among the residents of District Chamba Himachal Pradesh for responses using online modes like e-mail and social media platforms like Whatsapp groups, Facebook, Instagram and Linkedin till the 400 responses were collected. 

  • Data analysis- Data was collected and entered in Microsoft excel spread sheet, cleaned for errors and analyzed with Epi Info V7 Software with appropriate statistical test in terms of frequencies and percentage. 

  • Ethical Considerations- Participants confidentiality and anonymity was maintained.
RESULTS

The study assessed 400 adults from District Chamba, Himachal Pradesh, focusing on their socio-demographic characteristics and knowledge of the importance of anesthesia.

 

Table 1 presents the socio-demographic characteristics of the study participants. The age distribution indicates a predominantly young cohort, with 112 participants (28%) aged less than 25 years, 98 participants (24.5%) aged 25-34 years, 82 participants (20.5%) aged 35-44 years, 61 participants (15.25%) aged 45-54 years, and 47 participants (11.75%) aged 55 years and above. Gender distribution shows a higher proportion of males (217 participants, 54.25%) compared to females (183 participants, 45.75%). Regarding marital status, a majority of the participants were single (207 participants, 51.75%), followed by married individuals (179 participants, 44.75%), and a small fraction were divorced or widowed (14 participants, 3.5%). Educational levels varied among the participants: 33 participants (8.25%) had no formal education, 78 participants (19.5%) had primary education, 122 participants (30.5%) had secondary education, 89 participants (22.25%) had higher secondary education, and 78 participants (19.5%) were graduates or had higher education. Employment status revealed that 257 participants (64.25%) were employed, 107 participants (26.75%) were unemployed, 26 participants (6.5%) were retired, and 10 participants (2.5%) were students.

 

Table 1: Socio-Demographic Variables of Participants (N = 400)

Variable

Frequency

Age Group

 

Less than 25 years

112

25-34 years

98

35-44 years

82

45-54 years

61

55 years and above

47

Gender

 

Male

217

Female

183

Marital Status

 

Single

207

Married

179

Divorced/Widowed

14

Education Level

 

No formal education

33

Primary education

78

Secondary education

122

Higher secondary

89

Graduate and above

78

Employment Status

 

Employed

257

Unemployed

107

Retired

26

Student

10

 

 

Table 2 summarizes the frequency of correct answers to 20 structured questions assessing participants' knowledge about anesthesia. The results indicate a generally high level of awareness among participants regarding basic concepts of anesthesia. A significant majority (352 participants, 88%) correctly identified what anesthesia is, and 335 participants (83.75%) understood its primary purpose. Knowledge about different types of anesthesia was correctly identified by 303 participants (75.75%), and 324 participants (81%) recognized that anesthesia is generally safe. Regarding the potential side effects of anesthesia, 283 participants (70.75%) were aware, while the role of an anesthesiologist was correctly identified by 262 participants (65.5%). Knowledge about the necessity of anesthesia for all surgeries was accurate among 269 participants (67.25%), and 298 participants (74.5%) knew that local anesthesia could be used for minor procedures. When asked about the risks associated with anesthesia, 219 participants (54.75%) responded correctly, while 198 participants (49.5%) were aware that anesthesia could cause allergies. Informed consent before administering anesthesia was correctly understood by 332 participants (83%), and 307 participants (76.75%) knew that anesthesia could be administered in emergency situations. Preoperative instructions for anesthesia were correctly identified by 229 participants (57.25%), and 341 participants (85.25%) knew that patients should avoid eating or drinking before anesthesia. Postoperative monitoring necessity was understood by 287 participants (71.75%), while common side effects of anesthesia were correctly identified by 214 participants (53.5%). Knowledge about the impact of anesthesia on chronic health conditions was lower, with only 193 participants (48.25%) responding correctly. However, a significant majority (334 participants, 83.5%) understood the importance of informing the anesthesiologist about their medical history. Tailoring anesthesia to individual patient needs was known by 238 participants (59.5%), and 319 participants (79.75%) recognized the importance of following specific instructions after anesthesia.

 

Table 2: Awareness and Knowledge Questions on Importance of Anesthesia (N = 400)

Question

Correct Answer Frequency

1. What is anesthesia?

352

2. What is the primary purpose of anesthesia?

335

3. Are there different types of anesthesia?

303

4. Is anesthesia safe?

324

5. Can anesthesia have side effects?

283

6. What is the role of an anesthesiologist?

262

7. Is anesthesia necessary for all surgeries?

269

8. Can local anesthesia be used for minor procedures?

298

9. What are the risks associated with anesthesia?

219

10. Can anesthesia cause allergies?

198

11. Is informed consent necessary before administering anesthesia?

332

12. Can anesthesia be administered in emergency situations?

307

13. What are the preoperative instructions for anesthesia?

229

14. Should patients avoid eating or drinking before anesthesia?

341

15. Is postoperative monitoring necessary after anesthesia?

287

16. What are the common side effects of anesthesia?

214

17. Can anesthesia affect chronic health conditions?

193

18. Is it important to inform the anesthesiologist about medical history?

334

19. Can anesthesia be tailored to individual patient needs?

238

20. Should patients follow specific instructions after anesthesia?

319

 

 

Table 3 categorizes the overall knowledge scores of participants into four groups: Very Good (16-20 correct answers), Good (12-15 correct answers), Fair (8-11 correct answers), and Poor (<8 correct answers). The data reveal that 119 participants (29.75%) fell into the Very Good category, demonstrating a strong understanding of anesthesia. Another 153 participants (38.25%) were classified as Good, indicating satisfactory knowledge levels. Fair scores were observed in 81 participants (20.25%), while 47 participants (11.75%) scored Poorly, highlighting areas where substantial improvement is needed. This distribution suggests that while a majority of participants have a solid foundation in understanding anesthesia, there is still a significant portion that requires further education to improve their knowledge and awareness levels.

 

Table 3: Overall Knowledge Scores on Importance of Anesthesia (N = 400)

Score Category

Frequency

Very Good (16-20)

119

Good (12-15)

153

Fair (8-11)

81

Poor (<8)

47

 

Table 4 provides a univariate analysis of factors associated with knowledge levels on the importance of anesthesia, revealing significant relationships between various socio-demographic variables and knowledge scores. Age showed a significant association with knowledge levels (chi-square = 12.34, p = 0.045). Among participants aged less than 25 years, 43 scored Very Good, 33 scored Good, 19 scored Fair, and 17 scored Poor. For those aged 25-34 years, 29 scored Very Good, 40 scored Good, 20 scored Fair, and 9 scored Poor. Participants aged 35-44 years had 20 scoring Very Good, 31 scoring Good, 21 scoring Fair, and 10 scoring Poor. In the 45-54 years age group, 15 scored Very Good, 19 scored Good, 16 scored Fair, and 11 scored Poor. Finally, among participants aged 55 years and above, 12 scored Very Good, 30 scored Good, 5 scored Fair, and none scored Poor. This trend suggests that younger participants tend to have higher knowledge levels compared to older age groups. Gender also showed a significant association with knowledge levels (chi-square = 10.29, p = 0.039). Among male participants, 66 scored Very Good, 87 scored Good, 42 scored Fair, and 22 scored Poor. Among female participants, 53 scored Very Good, 66 scored Good, 39 scored Fair, and 25 scored Poor, suggesting that males generally performed slightly better than females. Education level was another significant factor influencing knowledge (chi-square = 15.67, p = 0.023). Participants with no formal education had the lowest knowledge levels, with 2 scoring Very Good, 11 scoring Good, 12 scoring Fair, and 8 scoring Poor. Those with primary education had 8 scoring Very Good, 21 scoring Good, 30 scoring Fair, and 19 scoring Poor. Secondary education participants had 17 scoring Very Good, 41 scoring Good, 40 scoring Fair, and 24 scoring Poor. Higher secondary education participants had 36 scoring Very Good, 37 scoring Good, 10 scoring Fair, and 6 scoring Poor. Graduates and above had the highest knowledge levels, with 56 scoring Very Good, 43 scoring Good, 3 scoring Fair, and 2 scoring Poor, indicating that higher education correlates with better knowledge of anesthesia. Employment status also showed a significant association with knowledge levels (chi-square = 11.78, p = 0.037). Among employed participants, 79 scored Very Good, 102 scored Good, 49 scored Fair, and 27 scored Poor. Unemployed participants had 21 scoring Very Good, 30 scoring Good, 20 scoring Fair, and 36 scoring Poor. Retired participants had 9 scoring Very Good, 9 scoring Good, 5 scoring Fair, and 3 scoring Poor. Students had 10 scoring Very Good, 6 scoring Good, 7 scoring Fair, and 2 scoring Poor, suggesting that employment status, particularly being employed, is associated with higher knowledge levels about anesthesia.

 

Table 4: Univariate Analysis of Factors Associated with Knowledge on Importance of Anesthesia

Variable

Very Good

Good

Fair

Poor

Chi-Square Value

p-Value

Age Group

Less than 25 years

43

33

19

17

12.34

0.045

25-34 years

29

40

20

9

35-44 years

20

31

21

10

45-54 years

15

19

16

11

55 years and above

12

30

5

0

Gender

Male

66

87

42

22

10.29

0.039

Female

53

66

39

25

Education Level

No formal education

2

11

12

8

15.67

0.023

Primary education

8

21

30

19

Secondary education

17

41

40

24

Higher secondary

36

37

10

6

Graduate and above

56

43

3

2

Employment Status

Employed

79

102

49

27

11.78

0.037

Unemployed

21

30

20

36

Retired

9

9

5

3

Student

10

6

7

2

DISCUSSION

The present study aimed to assess the awareness and knowledge of anesthesia among the general public of District Chamba, Himachal Pradesh. The findings provide valuable insights into the current state of public understanding of anesthesia and highlight areas requiring targeted educational interventions.

 

The socio-demographic profile of the study participants reveals a predominantly young cohort, with 28% of participants aged less than 25 years. This age distribution is indicative of a young and dynamic population, which is crucial for understanding and disseminating health-related information. The gender distribution showed a higher proportion of males (54.25%) compared to females (45.75%), reflecting a common trend seen in many community-based studies. Marital status analysis indicated that a majority of the participants were single (51.75%), followed by married individuals (44.75%), and a small fraction were divorced or widowed (3.5%). Education levels varied significantly, with 30.5% of participants having secondary education and 19.5% being graduates or having higher education. Employment status revealed that 64.25% of the participants were employed, highlighting the presence of a working-age population actively engaged in the labor force.

 

The assessment of anesthesia knowledge among the participants revealed a generally high level of awareness of key concepts. For instance, 88% of participants correctly identified what anesthesia is, and 83.75% understood its primary purpose. These results are consistent with findings from similar studies, which reported high levels of basic anesthesia knowledge among general populations.13-16  Knowledge about different types of anesthesia was correctly identified by 75.75% of participants, and 81% recognized that anesthesia is generally safe. These findings align with previous research, which highlighted the importance of public education in improving understanding of anesthesia safety.16-18

 

However, specific areas showed room for improvement. For example, only 49.5% of participants were aware that anesthesia could cause allergies, and 48.25% knew about the impact of anesthesia on chronic health conditions. These findings are similar to past researches ,who found significant gaps in public knowledge regarding the potential risks and side effects of anesthesia.18,19 Additionally, only 57.25% of participants correctly identified preoperative instructions for anesthesia, indicating a need for better preoperative education.

 

The categorization of overall knowledge scores into Very Good, Good, Fair, and Poor provided a clear indication of the competency levels among the participants. With 29.75% of the participants falling into the Very Good category and 38.25% in the Good category, it is evident that a majority possess a satisfactory understanding of anesthesia. These findings are encouraging and reflect positively on the existing public health communication efforts in the region. However, the 20.25% of participants categorized as Fair and the 11.75% as Poor highlight the need for continued education and training efforts. Similar trends have been observed in earlier studies, where continuous public education and awareness campaigns were recommended to address identified gaps in knowledge.19,20

 

The univariate analysis of factors associated with anesthesia knowledge revealed significant associations with several socio-demographic variables.

 

The study found a significant difference in knowledge levels related to age (chi-square = 12.34, p = 0.045). Participants under 25 years showed higher proficiency in anesthesia knowledge compared to older age groups. This trend suggests that younger individuals, who are more likely to be exposed to recent educational content and digital information, may have better access to up-to-date knowledge. This aligns with findings of earlier studies, which noted that younger age groups tend to retain more current health-related knowledge due to their recent educational experiences.21,22

 

Gender also showed a significant association with knowledge levels (chi-square = 10.29, p = 0.039). Males generally performed better than females, with 66 males scoring Very Good compared to 53 females. This disparity might be reflective of differences in health information access and engagement levels, as suggested by studies that highlight gender differences in health literacy and information-seeking behaviors. Addressing these disparities through tailored educational programs could help bridge this gap.22,23

 

Education level was another significant factor influencing knowledge (chi-square = 15.67, p = 0.023). Participants with higher levels of education demonstrated better knowledge about anesthesia. For example, graduates and above had the highest knowledge levels, with 56 scoring Very Good. This supports the findings of past studies, who highlighted the critical role of education in enhancing health literacy and understanding of medical procedures.24,25

 

Employment status also showed a significant association with knowledge levels (chi-square = 11.78, p = 0.037). Employed participants tended to have higher knowledge levels, with 79 scoring Very Good. This could be attributed to greater exposure to workplace health programs and access to medical information. Unemployed and retired participants had lower knowledge levels, indicating the need for targeted educational interventions for these groups to ensure they are well-informed about anesthesia.

 

The findings of this study have important implications for practice and policy in District Chamba and similar regions. The high level of anesthesia knowledge among a significant portion of the population is encouraging and should be maintained through regular public health campaigns and educational initiatives. For those with Fair or Poor scores, targeted educational programs should be developed to address specific gaps in knowledge and skills.

 

The significant associations between socio-demographic variables and anesthesia knowledge suggest that educational programs should be customized to address the unique needs of different groups. For instance, younger individuals and those with higher education may benefit from advanced educational content, while older and less educated groups might require more fundamental and accessible information. Additionally, gender-specific educational approaches might be considered to ensure that both males and females receive the most effective instruction.

 

Limitations

 

This study has several limitations that should be acknowledged. Firstly, the use of a cross-sectional survey design limits the ability to infer causality between the identified factors and anesthesia knowledge levels. Longitudinal studies would be more effective in establishing causal relationships. Secondly, the reliance on self-reported data through a Google form questionnaire may introduce response bias, as participants might overestimate their knowledge or provide socially desirable answers. Thirdly, the study was conducted in a single district, which may limit the generalizability of the findings to other settings with different demographic and educational profiles. Additionally, the sample size, although robust, might not capture the full diversity of the population's experiences and backgrounds. Lastly, the questionnaire, while pre-tested, might not encompass all aspects of anesthesia knowledge and skills, potentially overlooking critical areas that require attention.

CONCLUSION

In conclusion, this study provides valuable insights into the current state of anesthesia knowledge among the general public of District Chamba, Himachal Pradesh. The findings highlight a generally high level of awareness and understanding of anesthesia, with a significant portion of the population demonstrating very good and good knowledge levels. However, gaps in specific areas, such as the risks associated with anesthesia and preoperative instructions, underscore the need for ongoing public education and targeted training interventions. The significant associations between socio-demographic factors and anesthesia knowledge suggest that customized educational programs, addressing the unique needs of different demographic groups, could enhance the effectiveness of these interventions. Ensuring regular public health campaigns and providing accessible educational materials are essential steps towards maintaining and improving anesthesia knowledge in the community. By addressing these gaps and tailoring education to meet the diverse needs of the population, healthcare institutions can enhance public understanding of anesthesia, ultimately improving patient outcomes and safety in surgical settings. The findings of this study will inform future educational strategies and policy formulations aimed at strengthening public knowledge of anesthesia in similar settings.

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