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ABSTRACT

Chronic kidney disease is a predominant and possibly rising disease across sub-Saharan Africa with threats that comprises both communicable and non-communicable diseases. About 20 per cent of deaths in Nigerian Hospitals are linked to kidney disease. Approximately about 50 per cent of patients do not recognize the origin of their kidney disease, because it was reported late in the hospital for treatment. The burden of CKD, in terms of human suffering and financial costs, is blowing up as we move through the years of the 21st century, making it a major public health concern. The general objective was to assess the awareness, attitude and perception of Ilishan-Remo community members on chronic kidney disease.

This research was a cross-sectional survey which was carried out among 407 members of Ilishan remo community, Ogun state, Nigeria. A semi-structured instrument (questionnaire) was used for data collection. The instrument had various sections based on the conceptual framework used for the study. Data collected were analyzed using Statistical Package for Social Science (SPSS) version 21 with levels of significance set at 0.05.

There were 204 (50.1%) male and 203 (49.8%) female participants with a mean age of 29.14 ± 12.97. Overall, level of awareness of respondents on chronic kidney disease was given at 3.54 ± 1.39 (50.57%) indicating an average level which is deemed not enough. Overall, respondents’ attitude to chronic disease was good at 58.13% (8.72 ± 2.79). Overall perceived susceptibility of respondents to chronic kidney disease was determined to be low (8.64 ± 3.56) at 48% indicating respondents do not see themselves at risk of getting chronic kidney disease. Overall, respondents’ perceived severity of chronic kidney disease was good at 67.07% (10.06 ± 3.10). Overall perceived susceptibility of respondents to chronic kidney disease was determined to be low (8.64 ± 3.56) at 48% indicating respondents do not see themselves at risk of getting chronic kidney disease Overall perceived benefit of adopting chronic kidney disease-risk reduction lifestyle by respondents was good at 63.24% (13.28 ± 3.18), Overall, respondents’ perceived barrier to adopting chronic kidney disease-risk reduction lifestyle was given at above average at 55.58% (6.67 ± 2.76) indicating that difficulty in accessing care was not as pronounced, however, there is room for improvement.

Findings from this study indicated that awareness level of respondents on chronic kidney disease was average, Findings also suggested that attitude of respondents towards chronic was fairly positive. Also, it was found that respondents’ perceived susceptibility was low. In summary, this study showed that intervention towards increasing awareness needs to be focused more; relevant bodies need to organize and design an awareness program on chronic kidney disease, using all forms of media aimed at individuals with low education as findings from the study showed that individuals with lower education had low level of awareness.

Keywords: Awareness, Perception, Chronic Kidney Disease, and Ogun State

Word Count: 475

TABLE OF CONTENTS

Content         Page

Title Page. i

Certification. ii

Dedication. iii

Acknowlegdements. iv

Abstract v

Table of content …………………………………………………………………………………………….. vi

List of Tables ………………………………………………………………………………………………… ix

List of Figures…………………………………………………………………………………………………. x

Abbreviations                                                                                                                 xi

 

CHAPTER ONE:INTRODUCTION

1.1      Background to the Study. 1

1.2      Statement of the Problem.. 2

1.3      Objective of the Study. 3

1.4      Research Questions. 3

1.5      Justification for the Study. 4

1.6       Hypotheses                                                                                                      4

 

CHAPTER TWO:REVIEW OF LITERATURE

2.0      Introduction. 5

2.1      Awareness and Attitude on Chronic Kidney Disease. 6

2.2      Perception of Chronic Kidney Disease. 15

2.3      Conceptual Framework. 18

2.3.1   Health Belief Model Framework                                                                   19

2.3.2Application of the Health belief model                          20                                                    2.3.3   Perceived Suseceptibility 21

2.3.4   Perceived Severity                                                                                         21

Content         Page

2.3.5   Perceived Threat                                                                                            21

2.3.6   Perceived Benefits                                                                                         21

2.3.7Perceived Barriers                                                                      21

2.3.6Cues to Actions                                                                                  21

2.3.9   Self Efficacy                                                                                          21

CHAPTER THREE: METHODOLOGY

3.1      Research Design. 22

3.2      Population. 22

3.3      Sample size and sampling Technique. 22

3.4      Study Location23

3.5      Study Sample. 23

3.5.1   Inclusion Criteria. 23

3.5.2   Exclusin Criteria. 23

3.6      Null Hypothesis. 23

3.7      Instrumentation. 24

3.8      Validity. 25

3.9      Reliability. 25

3.10Method of Data Collection                                                                           25

3.11     Ethical Consideration26

3.11.1   Informed Consent26

3.11.2 Confidentiality   m                                                                              26

3.11.3 Anonimity27

3.11.4 Right to withdraw                                                                                          27

3.12   Post Research Benefits                                                                                  27

3.13    Method of Data Analysis                                              27

3.14 Dissemination of Results                                                                               27

Content         Page

CHAPTER FOUR: DATA ANALYSIS, RESULTS AND

DISCUSSION OF FINDINGS

4.1      Socio-Demographic Characteristics. 28

4.2      Research Questions. 30

4.2.1   Level of Awarenss of Chronic Kidney Disease                                            30

4.2.2   Level of Attitude of Chronic Kidney Disease                                               32

4.2.3   Level of Perception of Chronic Kidney Disease                                         36

4.3      Hypotheses Testing. 32

4.3.1   Hypothesis One. 52

4.3.2   Hypothesis Two. 54

4.3.3   Hypothesis Three. 56

4.3.4   Hypothesis Four 58

4.3.5   Hypothesis Five                                                                                             60

4.3.6   Hypothesis Six. 62

 

CHAPTER FIVE: SUMMARY, CONCLUSION AND                                               

RECOMMENDATIONS

5.1      Summary. 64

5.2      Conclusion. 65

5.3      Recommendations. 66

5.4      Implication of the study to Health Promotion and Education. 66

5.5     Limitation of the Study66

 

REFERENCES. 67

APPENDICES. 72

LIST OF TABLES

Table                                                                                                                           Page

  • Socio Demographic Characteristics of Respondents29
  • Descriptive Statistics of Level of Awareness on Chronic Kidney Disease 31
  • Attitude of respondents to Chronic Kidney Disease 33
    • Descriptive Statistics of Attitude of Respondents on Chronic Kidney Disease35
  • Respondents’ Perceived Susceptibility of Chronic Kidney Disease 37
    • Descriptive Statistics of Respondents’ Perceived Susceptibility of Chronic Kidney Disease 39
  • Respondents Perceived Severity of Chronic Kidney Disease    41
    • Descriptive statistics of Respondents Perceived Severity of Chronic Kidney

Disease                                                                                                                            43

  • Perceived Benefit of Adopting Chronic Kidney Disease-Risk Reduction Lifestyle

by respondents                                                                                          45

  • Descriptive statistics of Perceived Benefit of Adopting Chronic Kidney Disease-Risk Reduction Lifestyle by Respondents 47
  • Perceived Barrier to Adopting Chronic Kidney Disease-Risk Reduction Lifestyle by respondents                                                                                  49
    • Descriptive statistics of Perceived Barrier to Adopting Chronic Kidney Disease-Risk Reduction Lifestyle by Respondents 51
  • Relationship between Socio-Demographic Factors and Awareness on Chronic Kidney Disease                                                                                                                  53
  • Relationship between Socio-Demographic Factors and Attitude on Chronic Kidney                                Disease 55
  • Relationship between Socio-Demographic Factors and Perception on Chronic Kidney Disease 57
  • Relationship between Awareness and Attitude on Chronic Kidney Disease 59
  • Relationship between Awareness and Perception on Chronic Kidney Disease 61
  • Relationship between Attitude and Perception on Chronic Kidney Disease 63

 

LIST OF FIGURES

Figure                                                                                                             Page

  1. The Health Belief Model            19
  2. Application of the Health Belief Model 20

ABBREVIATIONS

ANOVA: Analysis of Variance

BUHREC: Babcock University Health Research Ethics Committee

CKD: Chronic Kidney Disease

ESRD: End-Stage Renal Disease

HBM: Health Belief Model

RRT: Renal Replacement Therapy

SPSS:Statistical Package for Social Science

US: United State

WHO: World Health Organization

CHAPTER ONE

INTRODUCTION

  • Background to the Study

In most developed countries, chronic diseases like diabetes and hypertension are presenting high rate of prevalence, posing significant burdens on those who are diagnosed, and making increase in the costs of healthcare systems. Chronic kidney disease is said to be exhibiting similar trends as diabetes and hypertension, though it is not well known like diabetes and hypertension (Arogundade & Barsoum, 2008). Chronic kidney disease (CKD) is a permanent and progressive damage of kidney function, which results in the weakening and worsening of renal function or end-stage renal disease (ESRD). ESRD represents the end of the continuum of CKD. It is an overwhelming medical, social and economic problem for the patients, their families, and the country as a whole (Olugbenga, Ayodele, & Olutayo, 2010). No fewer than 24 million Nigerians are suffering from Chronic Kidney Disease which represents 14.2 per cent of the populace; also one in every seven individual in Nigeria has a degree of Chronic Kidney Disease or the other (Effa, 2016). About 20 per cent of deaths in Nigerian Hospitals are linked to kidney disease. Approximately about 50 per cent of patients do not recognize the origin of their kidney disease for the reason that it was reported late in the hospital for treatment (Oluseyi, Ayodeji, Enajite, Oladimeji & Ifedayo, 2016). The increase in the prevalence of CKD in developed and developing countries has occasioned a transformed interest in global CKD prevention because it is now considered a threat (Arogundade & Barsoum, 2008).  It is vital to identify and detect the disease early, though, for developing countries, if detected early is very important to deter mortality, because the bulk of the victims cannot afford the charges of management and treatment at the last stage of the disease.

Kidney disease can occur at any age and can affect any races and studies have revealed that African, Americans, Hispanics, American Indians and those from South Asian origin (those from India, Bangladesh, Sri Lanka or Pakistan) are at a greater risk of coming down with CKD. This threat is owed to high rates of diabetes and high blood pressure in these populations (Couser, Remuzzi, Mendis, & Tonelli, 2011). blood test and urine test are adequate to detect CKD and if still at early stage, low cost management and treatments can slow the development of the disease, decrease the possibility of heart attacks and strokes and thereafter improving the quality of life (World Kidney Day: Chronic Kidney Disease; 2015)

Significantly CKD has a strong influence on morbidity and fatal outcomes. Chronic kidney disease was ranked 27th in the list of causes of total number of deaths worldwide in 1990, but later rose to 18th in 2010 according to the global burden of disease study. (Jha, Garcia-Garcia, & Iseki, 2013). But among over 300 sources accounted for in the global burden of disease, contemporary study reveals that CKD is the 15th and 20th prominent cause of years lived with disability (Global Burden of Disease Study; 2013), and disability-adjusted life years (Murray, Barber, & Foreman, 2013).

  • Statement of the Problem

CKD is a predominant and possibly rising disease across sub-Saharan Africa with threats that comprises both communicable and non-communicable diseases.  African countries extremely depend on external resources for health care financing (12% compared to global average of 0.4%) (John, Bocheng, Scott, & Nicole, 2014). Most of this is still dedicated to specific diseases such as malaria, HIV and TB. CKD and other Non-Communicable disease not on the radar.  Communicable diseases continues to be the principal cause of death in Africa but behavioral diseases like chronic kidney and heart diseases are becoming more prominent (Guest & Peter, 2015). Health complications or circumstances turn out to be public health concerns when four criteria are met (Levey, Atkins, & Coresh, 2007). First, if the burden of the disease is high (i.e., many people are affected, and then it has been on the increase lately, and possibly will escalate in the future). This burden is proven in terms of mortality, morbidity, quality of life, and cost and also poses as a risk by the public. Secondly, the problem is spread unfairly (i.e. it affects mainly minorities and disadvantaged persons to a larger degree). Third, there is indication that protective approaches, that target economic, political, and environmental features that affect a populace’s health could considerably diminish the burden of the condition; and fourth, evidence shows that such protective approach do not yet exist (Couser, Remuzzi, Mendis, & Tonelli, 2011). Not less than 24 million Nigerians are suffering from Chronic Kidney Disease which symbolizes 14.2 per cent of the populace; also one in every seven individuals in Nigeria has one degree of Chronic Kidney Disease or the other (Effa, 2016).  About 20 per cent of deaths in Nigerian Hospitals are initiated by kidney disease. Almost about 50 per cent of patients do not know the cause of their kidney disease because it was informed late in the hospital for treatment (Ulasi,& Ijoma 2010). Also CKD is the 15th and 20th prominent cause of years lived with disability (Global Burden of Disease Study, 2013), and disability-adjusted life years (Murray, Barber, & Foreman, 2013). Moving through the years of the era of the 21st century, the burden of CKD, in association with the suffering and financial implications, is becoming alarming thereby making it a major public health concern. It is preventable and the inception can be deferred as well as slow down its progression. Regrettably, the application of this knowledge, which can drastically reduce the weight and menace of CKD, is inadequate and unsatisfactory. Efficiently addressing this major health issue will require a broad public health approach (Couser, Remuzzi, Mendis, & Tonelli, 2011). Hence the research work sought to propose practical solutions to the gap in awareness and perception of Ilishan Remo community members on chronic kidney disease.

  • Objectives of the Study

The general objective of this study is to assess the awareness, attitude and perception of Ilishan-Remo community members on chronic kidney disease. The specific objectives are to:

  1. Assess the level of awareness of Ilishan Remo community members on chronic kidney disease.
  2. Determine the attitude of Ilishan Remo community members on chronic kidney disease.
  3. Identify the perception of Ilishan Remo community members on chronic kidney disease.
    • Research Questions
  1. What is the level of awareness among Ilishan-Remo community members on chronic kidney disease?
  2. What is the level of attitude among Ilishan-Remo community members on chronic kidney disease?
  3. What is the level of perception of chronic kidney disease among Ilishan-Remo community members?

 Justification for the Study

Communicable diseases continue to remain the prime cause of death in Africa but behavioral diseases like chronic kidney and heart diseases are becoming more prominent.Not less than 24 million Nigerians are suffering from Chronic Kidney Disease which symbolizes 14.2 per cent of the populace; also one in every seven individuals in Nigeria has one degree of Chronic Kidney Disease or the other (Effa, 2016).  About 20 per cent of deaths in Nigerian Hospitals are initiated by kidney disease. Almost about 50 per cent of patients do not know the cause of their kidney disease because it was informed late in the hospital for treatment (Oluseyi, Ayodeji, Enajite, Oladimeji & Ifedayo, 2016). This study uncovered the awareness and perception of Ilishan Remo community members on chronic kidney disease and its management, which may provide valuable information that will together with the community’s inputs help to improve applicable and operative health education approaches to increase community awareness and perception of chronic kidney disease in order to prevent or limit the progression and better manage kidney dysfunction in future.

  • Hypotheses
  1. H1:  There is a significant relationship between socio-demographic factors and awareness of Ilishan Remo community members on chronic kidney disease.
  2. H2: There is a significant relationship between the socio-demographic factors and the attitude of Ilishan Remo Community members on chronic kidney disease.
  3. H3: There is a significant relationship between the socio-demographic factors and the perception of Ilishan Remo Community members on chronic kidney disease.
  4. H4: There is a significant relationship between the awareness and the attitude o of Ilishan Remo community members on chronic kidney disease.
  5. H5:  There is a significant relationship between awareness and the perception of Ilishan Remo Community members on chronic kidney disease.
  6. H6:There is a significant relationship between attitude and perception of Ilishan remo community members on chronic kidney disease.

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