Correlation Between Patient Understanding of Health Information on Prostate Diseases and Health Status on Presentation to Hospital
Moi University College of Health Sciences, Department of Surgery, Eldoret, Kenya.
Correspondence to: Dr. Musau Pius; Email: email@example.com
Received: 15 Feb 2021 ; Revised: 21 Jul 2021; Accepted: 23 Jul 2021; Available online: 3 Sep 2021
Background: Many countries have poor patient health education and understanding of prostate diseases. The
Kenyan situation has not been adequately documented. Objective: To establish the relationship between sources of health education on prostate diseases and patient health status at presentation to hospital. Methods: A hospital-based census study was conducted using interviewer-administered questionnaire after ethical approval. Patients who presented to a urology clinic for the first time with prostatism were recruited after they provided informed consent. Collected data were analyzed using the Statistical Package for Social Sciences version 20.0 and statistical significance was set at p≤0.05. Results: A total of 126 patients were recruited from July 2016 to June 2018. The three sources of information were Informal sources such as friends and relatives (81%), the Internet (8.7%), and Health Workers (10.3%). Thirty-two (25.4%) patients had health information on prostate and its diseases. The duration of symptoms ranged from 1 month to 4 years. The difference in the proportions of those who presented within the first year of symptoms was statistically significant (p<0.001) for those whose sources were Health Workers (76.7%), the Internet (72.7%), and Informal sources (43.1%). Conclusion: Health education on prostate diseases is positively correlated with the health status at presentation.
Keywords: Health information, Prostate diseases, Health status, Prostatism, Internet, Health Workers
Ann Afr Surg. 2021 ; 18(4): 230-234
Conflicts of Interest: None
© 2021 Author. This work is licensed under the Creative Commons Attribution 4.0 International License
An informed patient with prostate disease is likely to have a better understanding of his problem principally because he will be conversant with the basis of the problem and the need to seek medical attention early enough to preempt complications (1-3). This information might be acquired through a number of ways, including formal schooling or information from sources as the media, peers, health workers, or Internet search (4). The level of exposure to information has been found to correlate with the state of the patient at first presentation to hospital and likely outcome of instituted interventions (5). Aging men older than 50 years often develop lower urinary tract symptoms due to the enlarging prostate. A combination of age, culture and myths may play a role in what these men know about the prostate disease they end up presenting to hospital with (6). Studies worldwide have shown that, in many countries, understanding of the prostate and its diseases is generally poor. The Kenyan situation has not been adequately documented. This article explored the sources of health information and how these related to patient health status at presentation to a tertiary health facility in the western region of Kenya
Materials and methods
A census study was conducted on men aged 50 years and older presenting to the urology clinic of Moi Teaching and Referral Hospital (MTRH), Eldoret, Kenya, for the first time with prostatitis, benign prostatic hyperplasia, or prostate cancer. The age of the participants was within the scientifically known period when aging men manifest urinary symptoms due to prostate disorders. The 2-year study period was from July 2016 and June 2018. Formal approval was obtained from the Institutional Research and Ethics Committee (IREC) (approval number FAN: IREC 1643). The participants provided informed consent. These patients were informed about the study and were requested to participate after clinical and investigative assessments revealed diagnosis of one of the three prostate diseases mentioned above. A purposive consecutive sampling was used until the end of the study period. Data collection was by the author using an interviewer administered questionnaire. It included the patients’ demographics, chief complaints, duration of symptoms, presence of complications, comorbidities, past admission to hospital, and the source of health information on prostate diseases.The collected data were coded and transcribed into a spreadsheet before being entered into a computer using the Statistical Package for Social Sciences version 20.0 (IBM Corp., Armonk, NY, USA). The data were analyzed by cross-tabulation, correlations, and logistic regression. Discrete data were summarized using frequencies, proportions, and percentages whereas continuous data were presented as means and standard deviations. Statistical significance was set at an alpha of p-value ≤0.05.
There were 165 patients during the study period, but 39 were excluded due to concomitant bladder and urethral pathologies, and finally, 126 patients were included in the study. Their ages ranged from 51 to 88 years, with mean of 67.1±9.7 years. The duration of symptoms ranged from 1 month to 4 years. The three main sources of health information on prostate diseases were informal sources such as relatives and friends (81%), the Internet (8.7%), and health workers (10.3%). Some (5.7%) of the respondents had multiple sources of health education, but the primary one mentioned was considered among the three sources of information. Thirty-two (25.4%) patients were aware of prostate diseases, of which 46.7% were aware of more than one disease state. The specific conditions mentioned were enlargement (43.8%), infections (6.3%), and malignancies (3.2%). Those who relied on informal sources of health information accounted for 25% of those aware of prostate diseases. All those who were informed through the Internet or by health workers were aware of prostate diseases. The patients who actively sought health information prior to getting symptoms of prostate disease accounted for 17.5% of the respondents. Table 1 shows the distribution of patients in terms of source of health information and active search of the information.
Most (41%) of those who actively sought information used the Internet. Patients older than 70 years wholly depended on informal sources for information and did not have any active search of health information prior to manifesting the symptoms. Those in the sixth decade led in both active search for information and Internet use. Age had strong positive correlation with both active search of information and the sources of information (p≤0.001 for both). Those 60 years and younger had modern sources of information, whereas those older had the traditional approach to information through informal sources and word of mouth. Table 2 shows the level of understanding based on the sources of information. The knowledge on the causes of prostate diseases reflected a widespread understanding of aging and prostate enlargement across the varied sources of information. Those who had health workers as their source of information were the majority among the people who knew of aging and hormonal influence as bases for prostate diseases. Table 3 shows the relationship between the sources of information and the patients’ clinical status at presentation to the clinic.