2.4. Los valores y la educación
2.4.1. Definición de Valor
The crucial goal of any civilized society should be the prevention of departures from health, promotion of healthy living and protection of its citizens from ill health. In view of the findings in this study, these recommendations are made to the following bodies:
To government and health institutions
1. Efforts should be made to increase the level of awareness of cardiovascular disease risk factor and risk reduction practices through the use of other channels of information dissemination on health.
2. Dissemination of health messages in the mass media should be improved particularly those serving the rural populace.
3. Information on cardiovascular disease risk reduction measures should be improved especially in the urban areas as they heard less awareness in this area and better awareness of the risk factors.
4. Town planners should provide more space for recreational activities in the urban cities to increase physical activity and exercise among its inhabitants.
90
5. Recreational facilities should be provided by the governments as the ones provided by private agencies are often expensive and out of reach of primary school teachers.
6. Schools should have gardens and beautified with fruits in order to enhance fruit and vegetable consumption.
To communities and schools
Communities should liaise with the relevant health agencies like ministry of health to bring to them health awareness messages on cardiovascular diseases.
Schools should organize exercise for their pupils.
To families
1. Families should increase their consumption of organic foods and avoid highly processed packaged foods.
2. As families practice group prayers for their spiritual growth so also should group exercises be practiced for their health and longevity.
To individuals
Since this study has shown that age is the most significant contributor to risk of heart diseases so ageing individuals should practice cardiovascular risk reduction measures of increased exercise, consumption of fruits and smoking avoidance to help modify and reduce their risk.
91
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99 APPENDIX 1
INFORMED CONSENT:
Sir/Madam,
My name is Dr Ofoegbu Cosmas Chiedozie. I am a resident doctor in public health department of Nnamdi Azikiwe University Teaching Hospital, Nnewi doing the part two exam of National Postgraduate Medical College of Nigeria. The purpose of this consent form is to provide you with the information you need to know in deciding whether to participate in the research study titled: RURAL-URBAN COMPARISON OF CARDIOVASCULAR RISK REDUCTION MEASURES AND RISK OF CARDIOVASCULAR DISEASE AMONGST PRIMARY SCHOOL TEACHERS IN ANAMBRA STATE.
Purpose of the study:
The purpose of this study is to assess the level of awareness and practice of cardiovascular risk reduction amongst teachers in Anambra state. It will also compare the awareness and practices among teachers in rural and urban areas and their risk for cardiovascular disease.
Study procedure:
Participants in this study will be required to give a written consent before included in the study. They will complete a questionnaire and anthropometric measurements to be taken (this will require physical contact with the research assistants i.e. measurement of waist circumference as well as laboratory investigation as blood cholesterol level will be checked).
The information you give will be used solely for the study and confidential.
100 Participation:
Your participation in this study will be completely voluntary. You have the right to withdraw from the study at any time and such decision will not in any way affect you.
Confidentiality:
All information that will be obtained from you in the course of this study will remain confidential.
Study risk:
Participants will not be exposed to any harm but slight pain from needle prick in the course of this study.
Potential benefits:
For participants; they will be better informed about cardiovascular risk reduction methods.
This will serve as a motivation for its practice and translate to improved health. The risk assessment involves a medical checkup which will identify teachers with high risk for cardiovascular disease and subsequent management through referral to skilled professionals for management.
For their families; participants’ families will also benefit indirectly from the improved knowledge gotten by the participants as well as improved health.
For the health sector; the overwhelming cases of cardiovascular accidents will reduce in the long run.
For the society; we will have a healthier society, reduction in the disability adjusted life years, morbidity and mortality indices.
101 Payment of participants:
There is no financial reward for participating in this study.
Consent form
Now that you fully understand the purpose and procedure of participating in this study, are you willing to take part in this study? (a) Yes [ ] (b) No [ ]
I(Researcher) have fully explained the purpose and benefit of this study to
………. in English, Pidgin and Igbo language. She/he have been given sufficient information including risk and benefit to make an informed decision.
Signature:……… Date:………
Name: Dr Cosmas Chiedozie Ofoegbu. Phone: 08037417782
I(Participant) has read the description of the research and I understand that my participation is voluntary. I know enough about the purpose of the research study to judge that I want to take part in it. I understand that I may freely stop being part of the study at any time. I have received a copy of this consent from the additional sheet to keep for myself.
Signature:……… Date:………
Name:………. Phone:………...
WITNESS
Signature---Date--- Name---Phone number---
102 APPENDIX 11
Questionnaire
The purpose of this study is to access your awareness and practice of cardiovascular risk reduction measures. All information obtained shall be treated with confidentiality.
SECTION A: BIODATA.
1) Age at last birthday………
2) Address: urban [ ] rural [ ] 3) Sex: male [ ] female [ ]
4) Marital status: Never married [ ] Married [ ] Divorced [ ] Separated [ ] 5) Educational qualification:
FSLC [ ] TC11 [ ] OND [ ] HND [ ] NCE [ ] BSC [ ] POSTGRADUATE [ ] 6) Religion:
Roman Catholic [ ] Anglican [ ] Pentecostal [ ] Traditional religion [ ] Islam [ ] SECTION B
MEDICAL HISTORY.
1) Do you have any chronic medical condition?
A) Hypertension B) Diabetes C) Heart disease
D) Others specify……….
2) Are you on any medications
103 A) Antihypertensive
B) Antidiabetes
C) Contraceptive drugs E) Others specify
3) When last did you measure your blood pressure A) Within the last 3months
B) Within one year ago C) More than one year
D) More than three years ago
E) I cant remember ever measuring it
4) What was your last blood pressure reading………..
5) Have you ever measured your weight Yes [ ] No [ ]
6) What was your last weight……….
7) Have you ever measured your blood cholesterol Yes [ ] No [ ] Not Aware [ ]
8) Last menstrual period (for females).
A) This month B) Last month C) Two months ago D) Up to three months E) More than three months AWARENESS
7) Have you heard of cardiovascular risk reduction? Yes [ ] No [ ]
104 8) If yes, where?
Radio/TV [ ] friend [ ] neighbor [ ] newspaper [ ] health campaign [ ] school [ ] 9) What are the cardiovascular risk reduction methods?
Exercise [ ] Exercising at least thirty (30) minutes every day [ ] Smoking avoidance [ ] Reduction of alcohol intake [ ] Consumption of fruits and vegetable [ ] Consumption of up to five (5) servings of fruits a day[ ] Avoidance of fried food [ ] Weight reduction [ ] Regular blood pressure check [ ] Blood sugar check [ ] Regular blood cholesterol check [ ] Regular medical checkup[ ]
10) Where is weight/fat deposition most dangerous A) Arm
B) Head C) Waist D) Chest E) Legs
F) I don’t know
11) What is the cut off point for blood pressure reading for hypertensive?...
PRACTICE
12) Do you smoke? Yes [ ] No [ ]
If yes how many sticks per day...
13) Do you exercise? Yes [ ] No [ ] If yes how often?
A) Daily
105 B) 3 times weekly
C) Weekly D) Sparingly E) Never.
14) What cardiovascular risk reduction method do you practice?
Exercise [ ] Exercising at least thirty (30) minutes every day [ ] Smoking avoidance [ ] Reduction of alcohol intake [ ] Consumption of fruits and vegetable [ ] Consumption of up to five (5) servings of fruits a day[ ] Avoidance of fried food [ ] Weight reduction [ ] Regular blood pressure check [ ] Blood sugar check [ ] Regular blood cholesterol check [ ] Regular medical checkup[ ]
15) Do you eat fruits/vegetables A) Hardly
B) Daily C) Weekly
D) More than once daily E) Up to five times a day
16) Do you drink alcohol? Yes [ ] No [ ] If yes what quantity per day……….
SECTION C
Anthropometric/ laboratory measurements BMI:
< 18.50 [ ] 18.50-24.99 [ ] 25.00-29.99 [ ] 30.00-34.99 [ ] 35.00-39-99 [ ] ≥40.00 [ ]
106 Waist Circumference
Men………below 102cm [ ] above 102cm [ ] Women………below 88cm [ ] above 88cm[ ] Blood Pressure/mmHg
< 130/85 [ ] 130/85-139/90 [ ] 140/90-159/99 [ ] 160/100-179/109 [ ] >180/110 [ ] Blood sugar reading……….
Blood cholesterol reading………
SECTION D
Global Risk Assessment Scoring using multiple risk factors.
Risk Factor
Risk Points Men Women Age, y
<34 −1 −9
35–39 0 −4
40–44 1 0
45–49 2 3
50–54 3 6
55–59 4 7
60–64 5 8
65–69 6 8
70–74 7 8
Total cholesterol, mg/dL
<160 −3 −2
169–199 0 0
200–239 1 1
240–279 2 2
≥280 3 3
HDL cholesterol, mg/dL
<35 2 5
35–44 1 2
45–49 0 1
50–59 0 0
107 Risk Factor
Risk Points Men Women
≥60 −2 −3
Systolic blood pressure, mm Hg
<120 0 −3
120–129 0 0
130–139 1 1
140–159 2 2
>160 3 3
Diabetes
No 0 0
Yes 2 4
Smoker
No 0 0
Yes 2 2
Adding up the points
Age……….
Cholesterol……….
HDL-C………..
Blood pressure………
Diabetes………..
Smoker………
Total points……….
Percentage risk………
108 Appendix III
Scoring for responses in awareness and practice section of the questionnaire
Overall awareness scoring -1 0 1 2
Have you heard about cardiovascular heart disease
Yes X
No X
If yes, what is your source of information
Radio/Tv X
Friend X
Neighbor X
Newspaper X
Health company/Health worker X
School X
Which of these is a risk for developing heart disease Consumption of fatty food
Yes X
No X
Consumption of highly processed fatty foods
Yes X
No X
Consumption of fruits and vegetables
Yes X
No X
Increased alcohol intake
Yes X
No X
Is smoking a risk for developing heart disease
Yes X
No X
Risk of developing heart disease can be
I don’t know X
Exercise
Yes X
No X
Lack of exercise
Yes X
No X
Physical inactivity
Yes X
No X
Overweight
Yes X
No X
Stress
Yes X
No X
Where is weight/fat deposition most dangerous
109
I don’t know X
Arm X
Head X
Yes No
Waist X
Yes No
Chest X
Yes No
Legs X
Yes No
Which of these can reduce the risk of heart disease I don’t know
Yes No Exercise
Yes X
No X
Exercising at least thirty minutes a day
Yes X
No X
Smoking avoidance
Yes X
No X
Reduction of alcohol intake
Yes X
No X
Consumption of fruits and vegetables
Yes X
No X
Consumption of up to five servings of fruits a day
Yes X
No X
Avoidance of fried foods
Yes X
No X
Weight reduction
Yes X
No X
Regular blood pressure check
Yes X
No X
Regular blood sugar check
Yes X
No X