Hemorrhoids, also known as piles, are a common medical condition affecting a significant portion of the population. Despite their prevalence, there is a lack of comprehensive understanding among the general public about this condition, including its causes, symptoms, and available treatment options. Hemorrhoids are swollen and inflamed blood vessels located in the rectal and anal area. They can cause discomfort, pain, itching, and bleeding during bowel movements. Hemorrhoids can be classified into two types: internal and external. Internal hemorrhoids are located inside the rectum, while external hemorrhoids are located under the skin around the anus [1-4]. The exact cause of hemorrhoids is not fully understood, but contributing factors include chronic constipation, prolonged sitting or standing, straining during bowel movements, obesity, and pregnancy. Hemorrhoids can occur at any age, but they are more common in individuals over the age of 50 [5-7].

Despite the prevalence of hemorrhoids, studies evaluating the level of understanding among patients attending outpatient departments in rural healthcare settings are limited. Understanding the gaps in knowledge and awareness is essential for developing targeted educational interventions and improving patient outcomes [8,9].

The aim of this study is to investigate the level of understanding regarding hemorrhoids among patients attending the outpatient department of Civil Hospital, Nurpur, Himachal Pradesh. The findings of this study will provide valuable insights into the current level of understanding and awareness regarding hemorrhoids among patients in the studied population. Identification of knowledge gaps and misconceptions will inform the development of educational programs and healthcare initiatives aimed at improving early recognition, timely medical consultation, and appropriate management of hemorrhoids.

Objectives of The Study

To evaluate the level of understanding regarding hemorrhoids among patients attending the outpatient department of Civil Hospital, Nurpur, Himachal Pradesh.

Research Approach 

Descriptive

Research Design

Hospital based cross-sectional survey design

Setting of The Study

OPD in Civil hospital Nurpur, Himachal Pradesh

Study Duration

Between January 2023- April 2023

Study Population 

Patients aged above 30 years came to OPD 

Sample Size

400 patients, assuming 50% have adequate knowledge regarding hemorrhoids, 5% absolute error, 95% confidence level, and 5% non-response rate.

Sampling Technique

Convenience Sampling technique

Sampling Criteria

First five patients who came to OPD were selected everyday till the completion of sample size after explaining the purpose of the study. Informed consent was taken from them and confidentiality of the selected participants was also maintained 

Inclusive Criteria

Patients who were willing to participate in the study.

Exclusion Criteria

Patients who were not willing to participate in the study.

Description of Tool 

Demographic Data Survey Instrument

The demographic form elicited information on participants’ background: age, marital status, religion, employment, education, family’s monthly income etc.

Questionnaire

The questionnaire contains 20 structured knowledge related questions having three options (yes, no, don’t know). The participants have to choose right one. 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 by under the guidance of supervisors and patients were given 30 minutes time to complete that questionnaire and collected at the end of the prescribed time.

Data analysis with Epi Info V7 Software with appropriate statistical test in terms of frequencies, percentage.

The goal of the current study was to assess the awareness about hemorrhoids among patients attending outpatient department of Civil hospital, Nurpur, Himachal Pradesh.

A total of 400 respondents including 282 (70.5%) male patients and 118 (39.5%) female patients were participated in the study. Among the total, 137 (34.25%) were from urban area and 263 (65.75%) were from rural area (Table 1).

Table 1: Knowledge Regarding Hemorrhoids among Study Participants

In the present study 25.5% (102) participants had very good knowledge (16-20 marks) towards hemorrhoids, 41.25% (165) had good knowledge (12-15 marks), 24.5% (98) had fair knowledge (8-11 marks) and 8.75% (35) having poor knowledge (<8 marks) (Table 2).

Table 2: Knowledge Score Regarding Hemorrhoids Among Study Participants

The findings of our study shed light on the level of understanding regarding hemorrhoids among patients attending the outpatient department of Civil Hospital, Nurpur. It was observed that there is a significant knowledge gap and limited awareness among the general public about this common condition. This lack of understanding can lead to delayed diagnosis, inadequate self-care, and suboptimal treatment outcomes.

Our study explored patients' knowledge about the causes and risk factors associated with hemorrhoids. It was found that many patients had limited awareness of the factors that contribute to the development of hemorrhoids, such as chronic constipation, straining during bowel movements, prolonged sitting or standing, obesity, and pregnancy. Educating patients about these risk factors can help them make lifestyle modifications to prevent or manage hemorrhoids.

Recognizing the symptoms of hemorrhoids is essential for early detection and timely medical consultation. However, our study revealed that a significant number of patients had limited knowledge about the specific symptoms associated with hemorrhoids, such as rectal bleeding, itching, pain, and discomfort. This lack of awareness can result in delayed diagnosis and inappropriate self-treatment measures.

The study also evaluated patients' understanding of the treatment options available for hemorrhoids. It was observed that many patients had limited knowledge about the various treatment approaches, including lifestyle modifications, over-the-counter medications, and medical or surgical interventions. This lack of awareness may influence patients' decision-making processes and their ability to seek appropriate medical advice.

The findings of this study have important implications for healthcare delivery in the outpatient department of Civil Hospital, Nurpur. The identified knowledge gaps highlight the need for targeted educational interventions and patient awareness programs focused on hemorrhoids. Healthcare professionals should be proactive in providing information, addressing misconceptions, and promoting preventive measures and appropriate treatment options.

Limitations and Future Directions

This study has certain limitations. The findings are based on self-reported data and may be subject to recall bias or social desirability bias. Additionally, the study was conducted in a specific healthcare setting in Nurpur, Himachal Pradesh, which may limit the generalizability of the findings to other regions or settings. Future research should include a larger and more diverse sample from multiple healthcare facilities to obtain a comprehensive understanding of the level of understanding regarding hemorrhoids in the population.

In conclusion, our study highlights the need for improved understanding and awareness regarding hemorrhoids among patients attending the outpatient department of Civil Hospital, Nurpur. Targeted educational interventions, reliable sources of information, and the active involvement of healthcare professionals are essential for empowering patients to recognize symptoms, seek early medical consultation, and enhance the overall management of hemorrhoids.

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