CARDIOVASCULAR JOURNAL OF AFRICA • Volume 33, No 4, July/August 2022 AFRICA 183 only about one-third or fewer (28%; p < 0.05) respondents in each group judged HF to be a curable disease (Fig. 3). The most important risk factors for HF for all three age groups were: hypertension, nicotine addiction, obesity and stress. The older the respondents, the less frequently they pointed to excessive physical activity (p = 0.04) and renal disease (p = 0.01) as one of the risk factors for HF. The data were not consistent as to whether respondents’ gender influenced their opinions. Only 48% of elderly respondents referred to hypercholesterolaemia and 78% pointed to both stress and lack of physical activity (Table 5). According to all three age groups of respondents, the most important source of information on diseases and healthy lifestyle was the internet. However, radio and television seemed to play a crucial role in elderly people, amounting to 44% of those respondents’ choices. On the other hand, in the middle-aged group, almost half of the respondents indicated specialists as their important source of information. Nevertheless, independent of age, the majority of people in each age group (77, 73, 78%, respectively; p = 0.21) stated that they felt they needed more information on disease and healthy lifestyle (Figs 4, 5). Discussion In our study, we analysed knowledge of the general population on heart failure: risk factors, symptoms, treatment strategies and possible sources of information on this topic. The prevalence of HF is increasing and the prognosis of survival is similar to that of cancer.16 It is paramount then that public awareness on the issue be greater, which may contribute to more effective diagnosis and quicker implementation of the desired treatment, ultimately improving patient outcomes. Therefore, we decided to design a non-standardised survey in such a way that the subjects could freely choose which part of treatment and communication should be improved. The population in our study consisted primarily of young individuals, with a mean age of 32 ± 14 years, most of whom were women (74%). In other surveys, respondents were older, with a mean age of 56 ± 15 years in the European Heart Failure Awareness Day 2011, and 58 ± 15 years in the Polish study.15,17 One of the factors influencing age distribution in our study may have been the fact that it was internet based, as opposed to a printed survey. The majority of respondents had higher education (57%), 45% were in some way involved with the healthcare system, and only 6% reported suffering from HF. The analysed study group reported a poor understanding of HF. Only 27% of respondents described their understanding of symptoms as good or very good. A similar result was shown with regard to risk factors for HF, where only 29% of participants described their understanding of the issue as good or very good. According to the SHAPE study from 2005, only 29% of respondents identified HF signs and symptoms as indicative of a severe condition.10 With regard to specific symptoms discussed in the survey, respondents in our survey indicated that as many as 84, 87 and 81%, respectively, of people in the given age groups correctly identified lower-limb oedema as a HF symptom (Table 2). These results are very different from those obtained during the HF Awareness Day in Poland in 2019, where only 50.6% of the Awareness Day participants and 32.2% of other participants indicated this symptom as indicative of HF.14 Similar results were obtained in a study from 2015 in Germany, Lithuania, Romania and Slovenia, where 52% of the respondents correctly identified Table 5. Response to the question: ‘Do the following risk factors apply to HF?’ by age group and positive answers Risk factors Young (< 40 years), % Middle aged (40–65 years), % Elderly (> 65 years), % p-value Arterial hypertension 91 91 85 0.30 Thyroid diseases 41 43 30 0.70 Diabetes 70 58 70 0.32 Nicotine addiction 84 87 89 0.90 Obesity 90 88 81 0.18 Stress 90 87 78 0.07 Excessive physical activity 31 24 15 0.04* Female gender 11 4 7 0.03* Hypercholesterolaemia 65 58 48 0.06 Renal diseases 39 32 26 0.01* Alcohol abuse 80 75 70 0.11 Lack of physical activity 88 84 78 0.16 Neoplasm/tumour 49 34 52 0.08 *Statistical significance with p < 0.05. 50 40 30 20 10 0 Patients (%) Yes No Do not know 28%* 28%* 33%* Young Middle aged Older 47%* 28%* 33%* 24%* 44%* 33%* Fig. 3. Response to the question ‘Do you think HF is curable?’ according to age group. *Statistical significance with p-value < 0.05 100 83 65 48 30 13 –5 Patients (%) Yes No Do not know 58% 54% 63% 33% 35% 26% 9% 11% 11% Young Middle aged Older Fig. 2. Response to the question ‘Do you think HF is a fatal disease?’ according to age group.
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