A study to assess the knowledge regarding hemorrhoids

5/19/2018 A study to assess the knowledge regarding hemorrhoids

PROFORMA FOR REGISTRATION OF

SUBJECT FOR DISSERTATION

Submitted by,

Ms. Suma K.C

1styear Msc Nursing,

Medical Surgical Nursing,

Oriental College of Nursing,

Bangalore

560 010.

RAGIV GANDI UNIVERSIT! OF EA"T SCIENCES#

KARNATAKA# BANGA"ORE.

PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION


1. NAME O !"E CAN#$#A!E AN#

A##%ESS

Ms. Suma K C#

1S!&EA% M.SC. N'%S$N(

O%$EN!A) CO))E(E O N'%S$N(,

*+-5,N#MA$N,/ES! O C"O%#

%OA#,%AA$NA(A%,BAN(A)O%E. 560 010

. NAME O !"E $NS!$!'!$ON Oriental College of Nursing,

Bangalore.

. CO'%SE O !"E S!'#& AN#

S'BEC!

$ styear M.Sc. Nursing,

Medical Surgical Nursing.

+. #A!E O A#M$SS$ON O CO'%SE

10.05.010

5. !$!)E O !"E !O$C $Astudy t% assess t&e '(%)*ed+e

,e+a,di(+ &em%,,&%ids am%(+ adu*ts i(se*e-ted &%sita*s# Ba(+a*%,e )it& a

/ie) t% de/e*% a( i(0%,mati%(

b%%'*et.1

6. B%$E %ES'ME O !"E $N!EN#E#

/O%2

6.0 $ntroduction

6.1 Need for t3e study

6.1.1 State4ent of t3e role4

6. %e7ie8 of related literature

6. O9ecti7es of t3e study

6..1 Oerational definitions

6.. Assu4tions

6.. "yot3esis

6..+ Sa4ling Criteria

:$nclusion and E;clusion criteria &ES, et3ical co44ittees reort is 3ere 8it3 enclosed.

)$S! O %EE%ENCES Enclosed

RAGIV GANDI UNIVERSIT! OF EA"T SCIENCES#

1


KARNATAKA# BANGA"ORE.

PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION

1 NAME OF TE CANDIDATE AND

ADDRESS

Ms. Suma K C#

1S!&EA% M.SC. N'%S$N(

O%$EN!A) CO))E(E O N'%S$N(,

*+-5,N#MA$N,/ES! O C"O%#

%OA#,%AA$NA(A%,

BAN(A)O%E. 560 010

NAME OF TE INSTITUTION Oriental College of Nursing,

Bangalore.

COURSE OF TE STUD! AND

SUBJECT

$ styear M.Sc. Nursing,

Medical Surgical Nursing.

+ DATE OF ADMISSION 10.05.010

5 TIT"E OF TE STUD! $Astudy t% assess t&e '(%)*ed+e

,e+a,di(+ &em%,,&%ids am%(+ adu*ts

i( se*e-ted &%sita*s# Ba(+a*%,e )it& a

/ie) t% de/e*% a( i(0%,mati%(

b%%'*et.1

BRIEF RESUME OF TE INTENDED 2ORK

3.4. INTRODUCTION

D!3e only 8ay to ee your 3ealt3 is to eat 83at you dont 8ant, drin 83at you dont

lie, and do 83at youd rat3er not.F

2
http://thinkexist.com/quotation/the_only_way_to_keep_your_health_is_to_eat_what/215001.htmlhttp://thinkexist.com/quotation/the_only_way_to_keep_your_health_is_to_eat_what/215001.htmlhttp://thinkexist.com/quotation/the_only_way_to_keep_your_health_is_to_eat_what/215001.htmlhttp://thinkexist.com/quotation/the_only_way_to_keep_your_health_is_to_eat_what/215001.html


Mar !8ain.

!3ere are se7eral 7ery ainful e;eriences t3at one suffers in stillness as it

is a disco4forting toic to e e7en discussed. "e4orr3oids is suc3 a co44on

occurrence in adults ut is 7ery rarely taled aout ecause of t3e e4arrassing nature

of t3e condition. Many eole are e7en too e4arrassed to see t3eir doctor aout

3e4orr3oids. Nearly e7ery atient 7isiting t3e general or colon and rectal surgeon

8it3 anal role4s co4es in co4laining of G3e4orr3oidsG. !3ey are often assigned

la4e for urities ani, anal fissures, condylo4ata acu4inata, fistula in ano and

incontinence. !reat4ent for 3e4orr3oids is only needed if t3ey are truly sy4to4atic.

!3e 4ere resence of 3e4orr3oids is not an indication for any t3eraeutic

inter7ention.1

"e4orr3oids if untreated can otentially ose serious 4edical role4s

and can also e a sy4to4 of a igger role4. "e4orr3oids, also called piles or

D7aricose 7eins of t3e anus and rectu4F are 4asses or clu4s or Dcus3ionsF of tissues

consisting of 4uscle and elastic fiers 8it3 enlarged, ulging lood 7essels and

surrounding suorting tissues resent in t3e anal canal of an indi7idual suffering

fro4 t3e disease. Many 4yt3s e;ist regarding t3e etiology and at3o3ysiology of

internal 3e4orr3oids. !3e de7elo4ent of 3e4orr3oids 3as een attriuted to

rolonged eriods of dri7ing, sitting on cold seats or enc3es, eating sicy foods, and

doing 4anual laor. $n addition to t3is t3ere are 4isconcetions regarding t3e etiology

of 3e4orr3oids a4ong t3e lay 4e4ers of our co44unity, t3ere are e@ually

nu4erous 4isconcetions regarding t3e at3o3ysiology of 3e4orr3oids a4ong t3e

4edical co44unity.

3


!3e 4isconcetions related to 3e4orr3oids 3a7e een eretuated

t3roug3out 4any surgical te;ts. "e4orr3oids are art of t3e nor4al anato4y 8it3in

t3e anal canal and are elie7ed to e i4ortant in 4aintaining continence. /3en an

indi7idual coug3s, strains or sneeHes, t3ese firo 7ascular cus3ions engorge and

4aintain closure of t3e anal canal in order to re7ent leaage of stool in t3e resence

of increased intrarectal ressure. !3erefore, surgical re4o7al 4ay result in 7arying

degrees of incontinence articularly in indi7iduals 8it3 4arginal reoerati7e control

aout 83ic3 4ost eole are una8are.

"e4orr3oids are of t8o tyesI t3e one 83ic3 is laced inside is na4ed as

$nternal "e4orr3oids and is structured 9ust under t3e tissue t3at lines t3e inside of t3e

rectu4. !3ey are not noticeale till t3ey eco4e ig and 8ill 4ae t3e4 to collase

and 9ut out t3roug3 t3e anus. On t3e ot3er 3and, t3e 7ein t3at for4s outside t3e rectu4

and surround t3e anus is called t3e E;ternal "e4orr3oids. !3e 4ain causes t3at utter

into t3is ainful osition, is 3ereditary, ostoning of 7isits to toilet.

1

Nearly1 4illion ne8 cases are reorted annually in ' S , += er 1000 and

increases 8it3 age ,age grou of +5>65yrs,it is esti4ated t3at 50>5J 0f eole

around t3e 8orld 3a7e 3e4orr3oids. $n $ndia =5J of t3e oulation is esti4ated.

A4ong t3is al4ost 3alf 4illion oulation are e;eriencing conditions t3at are

related to 3e4orr3oids. 'sually, 4any are not a8are t3at t3ey 3a7e t3e sy4to4s

associated to t3is condition. 1

A %etrosecti7e Study 8as conducted regarding E7aluation of %uer

Band )igation as a !reat4ent of "e4orr3oids at Srinagar, o7er a eriod of one year

on outatient asis. $n t3is study fifty cases 8ere su9ected to t3is treat4ent, 4a9ority

:=0J< of 8ere grade and in t3e age range of 1 to =0 years 8it3 J in t3e 1>0

4


year age grou. !3e results of t3e treat4ent 8ere e;cellent or good in K0J cases,

fair in +J and oor in +J, 8it3 failure after co4letion of treat4ent in J of cases.

Moreo7er, t3e enefits of t3is 4et3od of treat4ent 8ere far etter t3an ot3er

4odalities of treat4ent. !3ese oser7ations confir4 t3e fact t3at 3e4orr3oids can

recur e7en after e;ert surgical treat4ent and a large nu4er of atients insist on

undergoing and ligation rat3er t3an 3e4orr3oidecto4y.+

"e4orr3oid leeding s3ould e considered se7ere only if you start losing a

lot of lood and you get diHHy and 8ea. E7en t3oug3 3e4orr3oids are usually t3e

4ost co44on reason for your rectu4 to leed, one s3ould still see a doctor if 3e or

s3e 3a7e t3is sy4to4. !3ere are lots of ot3er serious conditions suc3 as ulcerati7e

colitis, anal fissures, olys and certain tyes of cancers t3at 8ill cause rectal

leeding, 83ic3 is 83y it is crucial t3at one eli4inate t3e ossiilities 8it3 t3e

doctor.5

"e4orr3oids are t3e arteries sulying lood to t3e anal canal descend

into t3e canal fro4 t3e rectu4 ao7e and for4 a ric3 net8or of arteries t3at

co44unicate 8it3 eac3 ot3er around t3e anal canal. Because of t3is ric3 net8or of

arteries, 3e4orr3oid lood 7essels 3a7e a ready suly of arterial lood. !3is e;lains

83y leeding fro4 3e4orr3oids is rig3t red arterial lood rat3er t3an dar red

7enous lood, and 83y leeding fro4 3e4orr3oids occasionally can e se7ere. One of

t3e 4ost o7ious signs of 3e4orr3oids occurs 83en one erson leed 83ile 3a7ing a

o8el 4o7e4ent and a lot of ain 8it3 t3is, 83ic3 8ill 3aen if one 3a7e

3e4orr3oids.6

E7en t3oug3 a recise definition of 3e4orr3oids does not e;ist, t3ey can

e descried as 4asses or clu4s Gcus3ionsG of tissue 8it3in t3e anal canal t3at

5


contain lood 7essels and t3e surrounding, suorting tissue 4ade u of 4uscle and

elastic fiers. !3e anal canal is t3e last four centi4eters t3roug3 83ic3 stool asses as

it goes fro4 t3e rectu4 to t3e outside 8orld. Most eole t3in 3e4orr3oids are

anor4al, ut t3ey are resent in e7eryone. $t is only 83en t3e 3e4orr3oid cus3ions

enlarge 3e4orr3oids can cause role4s and e considered anor4al or a disease.

Ma9ority of eole 83o suffer fro4 3e4orr3oids tend to ignore t3is condition. But no

4atter 3o8 one try to disregard it, t3e sy4to4s are still felt and it is getting 8orse

day y day. "e4orr3oids s3ould not e considered a taoo su9ect esecially no8 t3at

t3ere are 4any re4edies disco7ered in curing 3e4orr3oids. !3ese treat4ents 4ay range

fro4 4edical to natural re4edies. And 4any are una8are of t3ese sfacts.6

3.5. NEED FOR TE STUD!

"e4orr3oids, or iles, are one of 4aninds 4ost co44on and nagging

disorders. By t3e4sel7es, 3e4orr3oids are rarely serious, ut t3ey can e e;tre4ely

trouleso4e. $n so4e instances, t3ey 4ay 4as a 4ore serious disorder, suc3 as colon

or rectal cancer. !3erefore, 3e4orr3oids re@uire t3e roer diagnosis and treat4ent y

a 3ysician. "e4orr3oids t3at cause role4s are found e@ually in 4en and 8o4en,

and t3eir re7alence eas et8een +5 and 65 years of age.=

S8elling in t3e anal or rectal 7eins causes 3e4orr3oids. !3e factors t3at

4ay cause t3is s8elling are c3ronic constiation or diarr3ea, straining during o8el

4o7e4ents, sitting on t3e toilet for long eriods of ti4e, lac of fier in t3e diet,

eing o7er8eig3t, 8eaening of t3e connecti7e tissue in t3e rectu4 and anus t3at

occurs 8it3 age and regnancy in 83ic3 increasing ressure in t3e ado4en.

6
http://www.hemroidshemorrhoids.com/hemorrhoidscure.htmlhttp://www.hemroidshemorrhoids.com/hemorrhoidscure.html


E;cessi7e straining, ruing, or cleaning around t3e anus 4ay 4ae

sy4to4s, suc3 as itc3ing and irritation, 8orse. "e4orr3oids are not dangerous or

life t3reatening as sy4to4s usually goes a8ay 8it3in a fe8 days, and so4e eole

8it3 3e4orr3oids ne7er 3a7e sy4to4s. But t3ere are ti4es t3at one 4ust see out

4edical attention for 3e4orr3oids. Before taing any o7er t3e counter 4edications for

3e4orr3oids, one s3ould consult a doctor if 3e or s3e is taing anticoagulants.

Bleeding regularly s3ould e c3eced out y a 3ysician as soon as ossile. Certain

lifestyle c3anges can e eneficial to a7oiding future role4s 8it3 3e4orr3oids.

!3is includes drining 4ore 8ater, eating 4ore fier, reducing 8eig3t if one is

o7er8eig3t and e;ercising 4ore. All of t3ese can 3el control and re7ent t3e

sy4to4s of 3e4orr3oids.K

/it3 roer treat4ent, 3e4orr3oids 4ay start to i4ro7e o7er a fe8 days to

a 8ee. $n four to si; 8ees, t3e Glu4G fro4 an e;ternal 3e4orr3oid s3ould decrease

in siHe. /3en 3e4orr3oids eco4e ersistent or 7ery ainful, ot3er treat4ents 4ay e

necessary. Most of t3ese treat4ents 3a7e co4lications, and 4ost doctors try to a7oid

t3e4, and use t3e4 only as a last resort. !3ey are Clot re4o7al, %uer and ligation,

Sclerot3eray, $nfrared coagulation, 3e4orr3oidecto4y. 2eeing t3e anal area clean,

SitH at3s :sitting in 8ar4 8atert3e>counter 8ies 83ic3 is a natural

astringent, crea4s, gels, and suositories t3at are also sold o7er>t3e>counter 4ay

3el reduce s8elling and ro7ide relief fro4 sy4to4s and 3els in re7enting

3e4orr3oids. K

Most 3e4orr3oids are considered 4ild, and sy4to4s are often relie7ed y

a fe8 c3anges in diet and lifestyle. One goal of treat4ent is to ensure t3at stool s3ould

7


is soft and easily assed. t3is can e easily ac3ie7ed y c3anges in life style 83ic3

include increasing fier in t3e diet 8ill 3el stool to e 4ore easily assed 8it3out

straining, drining 4ore 8ater.10

An article regarding t3e use of s@uatting tye of defecation and incidence of

3e4orr3oids reorted, "e4orr3oids are an e;tre4ely co44on role4, esecially in

/estern countries. A lifeti4e incidence of 50>5J 3as also een reorted gloally.

Considering t3e 8idesread ain and suffering as 8ell as 4edical e;ense in7ol7ed, it

is surrising t3at t3ere 3as een so little researc3 into t3e 4et3ods of re7enting

3e4orr3oids. "e4orr3oids are 7ery rare in nations 83ere eole s@uat to defecateI it

8as found t3at atients and e7en 4edical ersonnel are usually 3esitant to discuss

toics suc3 as anal incontinence. !3is delays t3e rocess of a8areness to t3e ulic

regarding 3e4orr3oids and its re7ention.11

$t is esti4ated t3at aout =5 ercent of eole 8ill 3a7e 3e4orr3oids at

so4e oint in t3eir li7es. "e4orr3oids are 4ost co44on a4ong adults ages +5 to 65

and also co44on in regnant 8o4enI t3ey eco4e large and cause role4s in only

+J of t3e general oulation. "e4orr3oids t3at cause role4s are found e@ually in

4en and 8o4en, and t3eir re7alence eas et8een +5 and 65 years of esecially

8it3 4ild 3e4orr3oids.1

Se7enty ercent of $ndian oulation li7es in 7illages 83ere t3e do4inant

4ode of defecation still is s@uatting in t3e fields. $n cities also, y and large, s@uatting

tye of latrine seats 3a7e do4inated t3e scenario in $ndian set>u till recently. !3us,

esides t3e role of edestal latrines in t3e etiology of 3e4orr3oids, t3ere is also an

issue of aest3etics and culture for $ndians. 1

8


"e4orr3oid leeding s3ould e considered se7ere if one start losing a lot

of lood and you get diHHy and 8ea. E7en t3oug3 3e4orr3oids are usually t3e 4ost

co44on reason for your rectu4 to leed, one s3ould still see a doctor if 3e or s3e

3a7e t3is sy4to4. !3e effort to consult a doctor does not occur due to 3esitation.

!aing o7er t3e counter 4edication to deal 8it3 t3e ain, and can usually treat

3e4orr3oids y i4ro7ing t3e diet, drining lots of 8ater, and getting 4ore e;ercise.

$f t3ese stes 3el control t3e sy4to4s, sticing 8it3 t3e lifestyle c3anges 8ill 3el

you a7oid future role4s. $f one finds t3at t3ese lifestyle c3anges arent enoug3, 3e

or s3e 4ust 7isit a doctor 83o 4ay rescrie a stronger 4edication. One 4ay need a

stronger 4edication or rocedure to alle7iate t3e sy4to4s. 5

Nearly 3alf of t3e 8orlds oulation 8ill e;erience so4e for4 of

3e4orr3oids > esecially 83en t3ey reac3 t3e golden age of fifty. $n 4any cases, t3e

3e4orr3oid is a 3ar4less or acute condition t3at does not affect nor4al daily life. But

one s3ould see to re7ent t3e occurrence of constiation so t3at a s4oot3 assage of

stool during o8el 4o7e4ent is e;erienced.1

As suc3 3e4orr3oids is a toic t3at an indi7idual 3esitate to e;ress aout

and t3is result in 4ost cases 3idden signs and sy4to4s t3at later lead to

co4lications lie rectal cancer. At t3e sa4e ti4e 3e4orr3oids can e re7ented

easily y certain life style 4odifications and fe8 co4ro4ises in daily acti7ities of an

indi7idual. And no8 dayLs ne8 etter treat4ent 4et3ods are de7eloed for treat4ent

of 3e4orr3oids 83ic3 also re7ent its recurrence. !3e researc3er 3ad co4e across a

ca4e of 3e4orr3oids during clinical e;erience t3at 8as co4licated due to atientLs

reluctance to sea out t3e co4laints and to get treated. 2no8ing aout t3e ulic

9


reluctance and t3eir una8areness t3e researc3er felt t3e need to 4ae ulic, a8are of

t3e causes, co4lications and treat4ent, 4ainly re7ention of 3e4orr3oids.

3.6.REVIE2 OF "ITERATURE

Re/ie) %0 *ite,atu,e is -ate+%,i7ed u(de, t&e 0%**%)i(+ &eadi(+s.

%e7ie8 of literature ro7ides t3e asis for future in7estigations, 9ustifies

t3e need for relications, 9ustifies t3e need for relication, and t3ro8s lig3t u. On

feasiility of t3e study and indicates constrains of data collection and 3el to elate

findings of one anot3er.

1. %e7ie8 related to t3e incidence of 3e4orr3oids.

. %e7ie8 related to adults no8ledge regarding 3e4orr3oids.

. %e7ie8 related to 4anage4ent of 3e4orr3oids.

Re/ie) ,e*ated t% t&e i(-ide(-e %0 &em%,,&%ids.

$n $ndia aro;i4ately +0,=, eole are reorted to 3a7e

3e4orr3oids. 1 4illion ne8 cases are reorted annually , += er 1000 and increases

8it3 age ,age grou of +5>65yrs,it is esti4ated t3at 50>5J 0f eole around t3e

8orld 3a7e 3e4orr3oids and in $ndia =5J of t3e oulation is esti4ated. Current

statistics suggest t3at al4ost 3alf of eole in t3eir fifties 3a7e iles. Age is not t3e

only factor t3oug3, and 3e4orr3oids can affect eole of any age grou or gender.1+

A study conducted in 'nited States, regarding t3e incidence and

re7alence of 3e4orr3oids, it is found t3at aro; 1 in 6 or . ercent or 10.+

4illion eole 3a7e 3e4orr3oids in 'nited States of A4erica. $n t3e 'S, aout +.+J

10


of t3e general oulation 3as 3e4orr3oids 83ic3 occur 4ore often in Caucasians

fro4 rural areas and in t3ose 8it3 3ig3er socio>econo4ic status. re7alence of

3e4orr3oids increases 8it3 age and eas in eole aged +5>65 years. According to

t3e sa4e statistics :1K>=< t3e Mortality? 1= deat3s, "ositaliHations? 16, 000,

3ysician office 7isits? .5 4illion, rescritions? 1.5 4illion, #isaility? 5,000

eole.1+

According to an article ulis3ed regarding sy4to4s of 3e4orr3oids in

'.S, t3e nu4er of eole li7ing 8it3 3e4orr3oids in t3e 'SA rose to 1 4illion

out of a total oulation of aout K 4illion, 83ic3 is a re7alence rate of +.+J.

Aout a 4illion ne8 cases of 3e4orr3oids are disco7ered yearly. !3e s3ocing trut3

3o8e7er is t3at of all t3ese large nu4er of 3e4orr3oid cases, aout 3alf to t3ree

4illion cases er annu4 do not see roer treat4ent. So to conclude t3at t3ere are

aout 10 4illion eole 8it3 3e4orr3oids aying little of no attention to t3eir

sy4to4s.

11

A study 8as conducted regarding t3e re7alence of 3e4orr3oids, in

83ic3 t3e clinical records of 5 atients 8ere re7ie8ed. i7e 3undred ninety four

3ad sy4to4s of 3e4orr3oids and +1 3ad no sy4to4s asy4to4atic grou.

Eig3t>si; er cent of t3e entire grou, er cent a4ong t3e sy4to4atic grou and

er cent a4ong t3e asy4to4atic grou 3ad 3e4orr3oids. $t 8as felt t3at if t3e

re7alence rate of 3e4orr3oids in t3e sy4to4atic and asy4to4atic grous is

si4ilar or close to si4ilar in e7ery age, it is liely t3at a certain nu4er of eole

8ill 3a7e 3e4orr3oids in e7ery age grou irresecti7e of t3e resence or asence of

sy4to4s.15

A study 8as conducted regarding sy4to4atic 3e4orr3oids its

11


co4lications and co4lications of oerati7e t3eray o7er a eriod of 66>4ont3.

O7er 1,000 atients resented to t3e ractice 8it3 leeding, t3ro4osis, or

rolased. And K. ercent of atients re@uired oerati7e t3erayI conser7ati7e

t3eray 8as gi7en to +5. ercent of atients, 83ile ruer and ligation 8as

erfor4ed on ++. ercent of atients. !3e study retrosecti7ely re7ie8ed t3e

co4lications and lengt3 of stay for a suset of atients undergoing oerati7e

t3eray during t3e 66>4ont3 study eriod. !3e study concluded t3at o7er K0

ercent of sy4to4atic 3e4orr3oids can e treated conser7ati7ely or 8it3 ruer

and ligation, and as surgery is reser7ed for only t3e 4ost se7ere cases,

co4lication rates 4ay not decrease.16

An article ulis3ed reorted t3e Su44er, 3ig3 incidence of

3e4orr3oids. Su44er is a eriod of 3ig3 incidence of 3e4orr3oids, ecause t3ere

are 4any relations3is 8it3 t3e 8ater.1=

Re/ie) ,e*ated t% adu*t8s '(%)*ed+e ,e+a,di(+ &em%,,&%ids.

According to an article, 3e4orr3oids 3a7e een identified as one of t3e

4ost co44on ail4ents e7en recorded in adults. $t is 7ery 3ard to find an adult 83o

3as ne7er een diagnosed of t3is ail4ent at one ti4e or t3e ot3er in a lifeti4e. A

3andful of eole are e7en li7ing 8it3 3e4orr3oids, 4anaging it year after year,

ecause t3ey 3a7e no no8ledge of 3o8 to treat or get rid of it. !3e sufferer 8ill

usually de7elo an internal 3e4orr3oid 4ostly due to constiation. "o8e7er, 4ost

12


eole do not e7en no8 83at is 8rong and so t3ey ee on 8it3 t3eir lifestyle and

4ore 3ar4 is done to t3e already in9ured rectu4.1

An article regarding 3o8 do you (et 3e4orr3oids lot of eole dont e7en

no8 t3ey 3a7e 3e4orr3oids. !3e rectu4 is not an area one can readily see.

So4eti4es one dont no8 3e or s3e 3as 3e4orr3oids until lood in t3e toilet 8ater

after a o8el 4o7e4ent, or 3a7ing ain or disco4fort in t3e rectu4, or feel of e;tra

tissue around t3e rectu4 are noticed. Constiation is not t3e only 8ay you can get

3e4orr3oids. Ot3er additional 8ays include alco3olis4, eing regnant and not

eating enoug3 fier, doing daily 3ea7y lifting , eating e;cessi7e rocessed foods ,

>ostoning a o8el 4o7e4ent, 3a7ing a 8ea li7er, eing o7er8eig3t, Sitting in a

c3air at 3o4e, at 8or, in a car, or in a truc for long eriods.1K

According to an article !reat4ent for 3e4orr3oids>5 critical Action &ou

Must !ae, 4ore t3an +0 ercent of t3e adult oulation suffers fro4 t3e iles in t3eir

lifeti4e, yet not 4any eole no8 t3e reason t3eyLre 3a7ing a 3e4orr3oids or t3e

roer care for 3e4orr3oids. !3ere are co44on 4istaes t3at eole 4ae 83en t3ey

try to sol7e t3e role4s on 3e4orr3oids. $f one 8ants to a7oid t3ose 4istaes t3at a

lot of eole are 4aing, t3en one s3ould tae t3ese critical actions for 3e4orr3oid

treat4ents.0

According to anot3er article, al4ost e7eryone gets 3e4orr3oids at so4e

ti4e. $ts ainful, aggra7ating role4 t3at no one see4s to tal aout. And t3e reason

83y no one 8ants to tal aout is t3at it is e4arrassing and considered as t3e t3ing

eole donLt lie to discuss. And all t3e secrecy is roaly t3e reason 4ost eole

dont no8 83at to do for t3e4 and t3eyre e4arrassed to as. "e4orr3oids occur

13
http://www.cdhcc.com/category/hemorrhoid-treatments/http://www.cdhcc.com/category/hemorrhoid-treatments/http://www.cdhcc.com/category/hemorrhoid-treatments/http://www.cdhcc.com/category/hemorrhoid-treatments/


uni7ersally in adults and c3ildren and 3alf of all eole all o7er t3e age of 50 li7e 8it3

t3is ainful nuisance. !o conclude if one follo8 re7enti7e 4easures roerly it 8ill

ee oneself free fro4 t3is ainful and e4arrassing situation. 1

Re/ie) ,e*ated t% ma(a+eme(t %0 &em%,,&%ids.

A study 8as conducted on Staled 3e4orr3oidecto4y 7s. closed

diat3er4y>e;cision 3e4orr3oidecto4y 8it3out suture>ligation? a case>controlled trial.

A series of 10 atients 3ad indication for staled 3e4orr3oidecto4y in 83ic3 :=6e;cision 3e4orr3oidecto4y. %esu4tion of acti7ities occurred after

K days after staling and 1+ days after diat3er4y surgery. !3e result s3o8ed t3at t3ere

8as no difference regarding co4lications during t3e follo8>u, after one year, +5

:0.+J< atients in t3e staled grou and 1 :=.J< in t3e diat3er4y grou 8ere

asy4to4atic, and none of t3e atients needed a second oeration and t3ere 8as no

fecal incontinence. !3e study concluded t3at staled 3e4orr3oidecto4y selecti7ely

indicated is less ainful, not associated to greater 4oridity and 3as t3e sa4e long>

ter4 efficacy 83en co4ared to closed diat3er4y e;cision 8it3out suture>ligation.

A study 8as conducted on suture less closed 3e4orr3oidecto4y? a ne8

tec3ni@ue. !3e study 8as to co4are a ne8 tec3ni@ue of radical 3e4orr3oidecto4y

using an electro t3er4al de7ice originally de7ised to seal 7essels in ado4inal

oerations, 8it3 t3e con7entional oen Milligan>Morgan rocedure erfor4ed 8it3

diat3er4y. Bot3 carry riss of ostoerati7e leeding, urinary retention, and late anal

stenosis and con7alescence is si4ilarly long and difficult after ot3 oerations. $n t3e

study grou :n +0


ti4e off 8or 8ere significantly s3orter in t3e study grou and t3ere 8ere also fe8er

ostoerati7e co4lications in t3is grou. !3is ilot study s3o8s t3at suture less

closed 3e4orr3oidecto4y is a ne8 tec3ni@ue t3at is si4le and safe, significantly

s3ortens t3e oeration, and is follo8ed y a significantly easier and s3orter reco7ery.

A study 8as reorted, on t3e c3allenge to t3e 4edical fraternity in ter4s of

finding satisfactory cure of t3e disease 2s3ar Sutra )igation :2S) t3eyre e4arrassed to as. $ts surrising t3at 3e4orr3oids occur

uni7ersally in adults and c3ildren.$n fact, 3alf of all eole all o7er t3e age of 50 li7e

8it3 t3is ainful nuisance. "e4orr3oids are 7ery si4ilar to 7aricose 7eins in t3e legs >

t3ey are s8ollen, tender 7eins eit3er inside t3e rectu4 or outside t3e around t3e rectal

area. !3e 7eins get s8ollen and tender fro4 too 4uc3 ressure 83ic3 4ay e fro4

15


t3e strain of constiation, diarr3ea or regnancy, or it co4es fro4 disorders suc3 as

oesity and li7er disease. !3e treat4ent of 3e4orr3oids egins 8it3 si4le ad7ice?

GNo strain, no ainG 83ic3 signifies fe8 c3anges in life style of an indi7idual.!3is

include sto straining 83en you go to t3e at3roo4,eat 4ore fier to a7oid

constiation and 3ard stools, drining lots of li@uids to soften your stools, staying

a8ay fro4 caffeine and alco3olic e7erages, a7oid using la;ati7es t3at contain

ingredients ot3er t3an si4le stool softeners. !o conclude if one follo8 re7enti7e

4easures roerly it 8ill ee oneself free fro4 a ainful and e4arrassing

situation.5

A study 8as conducted regarding t3e re inter7entions after co4licated or

failed staled 3e4orr3oidoe;y. !3e ai4 of t3e study 8as to analyHe t3e causes for

and t3e outco4e of reinter7ention follo8ing eit3er se7erely co4licated or failed

staled 3e4orr3oidoe;y. !3e study 8as conducted in a total of ri4ary staled

3e4orr3oidoe;ies and 65 reinter7entions after staled 3e4orr3oidoe;y 8ere

erfor4ed y t3e aut3ors in fi7e centers de7oted to colorectal surgery. After t3e

reinter7ention, roctoscoy 8as erfor4ed in 61 atients :K ercent< and 4edian

follo8>u of 5.5 4ont3s t3e reoeration rate after staled 3e4orr3oidoe;y 8as 11

ercent. !3e study reorted t3at reinter7ention 8as associated 8it3 a 3ig3 leeding

and soiling rate, ut 8as effecti7e in treating ain and ot3er sy4to4s in t3e 4a9ority

of atients.6

3.6.5. STATEMENT OF TE PROB"EM

16


DA study to assess t3e no8ledge regarding 3e4orr3oids a4ong adults in selected

3ositals, Bangalore 8it3 a 7ie8 to de7elo an infor4ation oolet.F

3.9. OBJECTIVES OF TE STUD!

1. !o assess t3e no8ledge regarding 3e4orr3oids a4ong adults.

. !o find out t3e association et8een no8ledge regarding 3e4orr3oids and selected

de4ogra3ic 7ariales.

. !o de7elo an infor4ation oolet for adults regarding 3e4orr3oids.

3.9.5. OPERATIONA" DEFINITIONS

K(%)*ed+e:%efers to t3e le7el of understanding of adults regarding 3e4orr3oids as

assessed y t3eir resonses to t3e ite4s of no8ledge @uestionnaire.

em%,,&%ids:$t is a disease condition in 83ic3 t3e 7eins around t3e anus or lo8er

rectu4 gets infla4ed and s8ollen, caused due to se7eral factors lie 3ereditary.

8eig3tlifting, i4roer diet, constiation, rolonged sitting and standing and 7igorous

e;ercises.

I(0%,mati%( b%%'*et: $t is organiHed infor4ation regarding t3e 4eaning, causes,

sy4to4s, co4lications, recautions, re7ention and 4anage4ent of 3e4orr3oids.

Adu*ts: %efers to ot3 4en and 8o4en of age 0>60yrs, 83o are attending O# and

inatient deart4ent in selected 3ositals Bangalore.

17


3.9.6. ASSUMPTION

$t is assu4ed t3at adults 4ay 3a7e so4e no8ledge regarding 3e4orr3oids.

3.9.9. !POTESIS

!3ere 8ill e significant association et8een no8ledge regarding

3e4orr3oids and selected de4ogra3ic 7ariales.

3.9.9. SAMP"ING CRITERIA

INC"USION AND E;C"USION CRITERIA

INC"USION CRITERIA

1. Adults 83o are a7ailale at t3e ti4e of data collection.

. Adults 83o are 8illing to articiate in t3e study.

. Adults 83o are ale to understand and read englis3 or annada.

E;C"USION CRITERIA

1. Adults 83o are diagnosed 8it3 3e4orr3oids

. Adults 83o are 3a7ing re7ious source of infor4ation aout 3e4orr3oids.

MATERIA"S AND METODS

18


60 yrs of

age attending O# and in atient deart4ent in selected 3ositals, Bangalore.

. T%%* 0%, data -%**e-ti%(? Structured no8ledge @uestionnaire.

>. Met&%d %0 data a(a*ysis a(d i(te,,etati%(?

!3e data 8ill e analyHed y using descriti7e and inferential statistics.

!3e in7estigator 8ill use aroriate statistical tec3ni@ues for data

analysis and resent data in t3e for4 of tales, gra3s and diagra4s.

#e4ogra3ic 7ariales 8ill e analyHed y fre@uency and ercentage

distriution.

)e7el of no8ledge 8ill e assessed y 4ean and standard de7iation.

C3i> s@uare test 8ill e used to deter4ine t3e association et8een t3e

no8ledge and selected de4ogra3ic 7ariales.

>i.Du,ati%( %0 study ? + 8ees.

>ii. Va,iab*es

19


%esearc3 7ariale ? 2no8ledge of adults regarding 3e4orr3oids.

#e4ogra3ic 7ariales? Age, se;, education status,

Socio econo4ic status, occuation.

>iii. P,%?e-ted %ut-%me ? !3e study 8ill e successful in i4ro7ing t3e no8ledge

of adults regarding 3e4orr3oids and 3el t3e4 to tae re7enti7e 4easures.

=..D%es t&e study ,e=ui,e a(y i(/esti+ati%(s %, i(te,/e(ti%( t% be -%(du-ted %(

atie(ts %, %t&e, &uma( bei(+s %, a(ima*s@

NO, t3e study doesnLt re@uire any in7estigations or inter7ention.

=.+.as et&i-a* -*ea,a(-e bee( %btai(ed 0,%m y%u, i(stituti%(@

&ES, et3ical clearance reort is 3ere 8it3 enclosed.

. "IST OF REFERENCES

1. !otal 3ealt3 tis."e4orr3oids.2i7a 4icrofinance.0 Marc3 010.

A7ailale fro4 '%)?3tt?--total3ealt3tis.org-010-0-03e44orr3oids>

$ntroduction-

. (olla4aully NaHi4a.#isco7ering !rut3 aout 83at causes a "e4orr3oid.

A1articles.10t3 No7e4er 010I '%) A7ailale fro4

? 3tt?--888.a1articles.co4-article11011=.3t4l .

. Catalo reter4 #. "e44orr3oids.A4erican Society of Colon %ectal

Surgeons :ASC%S


-888.ind4edica.co4- ournals.39ournalidissueid1=articleid

10=articleid10=actionarticle.

5. #o &ou !3in &ou "a7e "e44orr3oids ree online article directory. More

More ree $nfor4ation. A7ailale fro4 '%) ?3tt?--888.4oreinfor4ation

.co4-Art-15--#o>&ou>!3in>&ou>"a7e>"e44orr3oids.3t4l.

6. Mars ay ./."e44orr3oids :$)ES

1==KK+>1=.3t4l

11. (enga Bello. "o8 !o #etect "e44orr3oids.Article Snatc3.co4 Sy4to4s of

"e44orr3oids.A7ailale fro4 '%)?3tt?--888.article snatc3.co4-Article-

Sy4to4s>of>"e44orr3oids>"o8>!o>#etect>"e44orr3oids>Early115550.

21
http://ibdcrohns.about.com/cs/related%20conditions/a/faqhemmorrhoid.htmhttp://ibdcrohns.about.com/cs/related%20conditions/a/faqhemmorrhoid.htm


1.Sing3 A4ar9eet.#o /e %eally Need to edestal !ye of )atrines in $ndia.$ndian

ournal of Co44unity Medicine.00=>10,001>1.I+.A7ailale

fro4 '%) ?3tt?--888.ind4edica.co4-9ournals.39ournalid=issued

10articleid1KKactionarticle.

1.Buller A Ant3ony./3at E7ery Sufferer S3ould 2no8 Aout "e44orr3oids.

EHineRrticles.Article.A7ailale fro4'%)?3tt?--

eHine articles.co4-83at>e7ery>sufferer>S3ould>no8>Aout>"e4orr3oid

50=+=.

1+. Statistics y country for "e44orr3oids./rong diagnosis.N$" ulication

NoIK+>1++=,N$##2,1KK+.A7ailale fro4 '%) ?3tt?--888.8rongdiagnosis

.co4-3-3e4orr3oids-stats>country>3t4.

15..A."aas,"aas.(. et al.!3e re7alence of "e44orr3oids."e44orr3oids1K

uly I 6:=K.A7ailale fro4 '%)?3tt?--888.t3e doctors

.co4-diseases-3e4orr3oids.3t4.

16. Bleday %onald, uan..enna et al.Sy4to4atic 3e4orr3oids? current incidence

and co4lications of oerati7e t3eray. 5I 5I+==>+1.

A7ailale fro4 '%) ?3tt?--888.singerlin.co4-content-455++10

I =0=5-singer lin.

1=. Berg CraigI #SC$, erry E BlodeI M#I AC."ealt3 Benefits of t3e National

S@uatting osition. NatureLs latfor4 t3e Basis for a 3ealt3ier life. May 1

010? A7ailale fro4 '%) ?3tt?--888.natureslatfor4.co4-"e44orr3oids

.3t4l

1. A@oole !e4itoe.!reat4ent for e;ternal "e4or3oids.EHine articles. A7ailale

fro4 '%)?3tt?--eHinearticles.co4-!reat4entorE;ternal"e4orr3oids

22
mailto:[email protected]:[email protected]


id511+.

1K. %udy Sil7a. "o8 do you (et "e4orr3oids EHinearticles.co4. A7ailale fro4

'%)?3tt?--eHinearticles.co4-"o8>#o>&ou>

(et> "e4orr3oids5-idK5=.

0. !reat4ent for "e4orr3oids.!reat4ent for "e4orr3oids>5 critical Action &ou

Must !ae.anuary 0t3,010IA7ailale fro4 '%)?

3tt?--888.cd3cc.co4-.

1. 2ao $rsan.!3e DNo ain, No strainF 8ays to re7ent 3e4orr3oids. EHine articles.

A7ailale fro4 '%)?3tt?--eHinearticles.co4-!3eNo>ain,>No strain>/ays

>to>re7ent>"e4orr3oidsid+1006K.

. S.E.Arau9o,de Caratto .Staled 3e4orr3oidecto4y 7s closed diat3er4y>

E;cision 3e4orr3oidecto4y 8it3out suture>ligation? a case trial.

u4ed.00= #ece4er, 5+:0B.

A7ailale fro4 '%)?3tt?--888.nci.nl4.ni3.go7-u4ed--1656+.

. .Sayfan, Becer .A, 2ottun.).#eart4ent of Surgery, $srael.Suture closed

"e4orr3oidecto4y? a ne8 [email protected] uly I+I:1==,year010,7olu4e1,sage=,

eage1,aulastsing3,tye0.

23


5. 2ao $rsan.!3e DNo ain,No strainF 8ays to re7ent 3e4orr3oids.EHine articles.

A7ailale fro4 '%)?3tt?--eHinearticles.co4-!3eNo>ain,>No strain>/ays

>to>re7ent>"e4orr3oidsid+1006K.

6. ).Brusciano, S.M.Ayaace et.al.%e inter7entions After Co4licated or ailed

Staled "e4orr3oidoe;y.#isease of t3e colon %ectu4. +I

1+6>151.A7ailale fro4 '%) ?3tt?--888.sringerlin.co4-content

-nu;uucy@8u8@-.

. Si+(atu,e %0 t&e -a(didate :

54. Rema,'s %0 t&e +uide :

55. Name a(d desi+(ati%( i( b*%-' *ette,s :

55.5 Guide :

55.6 Si+(atu,e :

55.9 ead %0 t&e dea,tme(t :

24


55. Si+(atu,e :

56.5 Rema,'s %0 -&ai,ma( ,i(-ia* :

56.6 Si+(atu,es :

25

A study to assess the knowledge regarding hemorrhoids

Documents

Transcript of A study to assess the knowledge regarding hemorrhoids