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Abstract
Introduction
Materials and Me...
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ORIGINAL ARTICLE
Year : 2022  |  Volume : 23  |  Issue : 1  |  Page : 57-61
 

Knowledge regarding anesthesia and anesthesiologist among patients attending pre anesthetic check up in rural tertiary care hospital


1 Department of Anaesthesiology and critical care, Rural Medical college, PIMS, Loni, Maharashtra, India
2 Department of Anesthesiology, Shri Guru Ram Rai Institute of Medical & Health sciences, Shri Mahant Indiresh Hospital, Dehradun, Uttarakhand, India
3 Department of Periodontics and Implantology, Rural Medical college, PIMS, Loni, Maharashtra, India

Date of Submission09-Mar-2021
Date of Decision16-Apr-2021
Date of Acceptance28-Dec-2021
Date of Web Publication23-Mar-2022

Correspondence Address:
Dr. Akshaya N Shetti
Department of Anaesthesiology and Critical Care, Rural Medical College, PIMS, Loni, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/TheIAForum.TheIAForum_38_21

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  Abstract 


Introduction: Anesthesiologist plays an important role in intensive care units, trauma centers, pain clinics, and as a member of resuscitation team all over the world. Due to the lack of public awareness about anesthesia as a medical discipline, many patients assume an anesthesiologist to be an assistant of the surgeon and do not recognize the role played by the anesthesiologist in preoperative, perioperative, and postoperative periods. With the changing health-care environment and advancement in anesthesiology, the patients and general public need to be educated.
Aims and Objectives: This study aimed to assess the knowledge of patients regarding anesthesia and anesthesiologist at rural tertiary care hospital.
Design: This is a descriptive cross-sectional study done at a rural tertiary care hospital.
Materials and Methods: After approval of the institutional ethical committee, the study was conducted in the form of a questionnaire for patients coming to preanesthetic checkup outpatient department (OPD) for elective surgery.
Results: This study involves 602 (312 male; 290 females) for preanesthetic checkup OPD, of whom only 403 (67%) of them recognized anesthesiologists as doctors, while 401 (66.7%) knew that anesthesia is required prior to any surgical procedure and 209 (41.4%) of them knew anesthetists play a role in intraoperative and postoperative patient care.
Conclusion: We can conclude that there is unawareness among the rural population regarding the role played by anesthesiologists; hence, initiatives are to be taken for educating the population.


Keywords: Anesthesia, anesthesiologist, awareness, knowledge, rural population


How to cite this article:
Ahiwale PP, Singla B, Shetti AN, Mustilwar RG. Knowledge regarding anesthesia and anesthesiologist among patients attending pre anesthetic check up in rural tertiary care hospital. Indian Anaesth Forum 2022;23:57-61

How to cite this URL:
Ahiwale PP, Singla B, Shetti AN, Mustilwar RG. Knowledge regarding anesthesia and anesthesiologist among patients attending pre anesthetic check up in rural tertiary care hospital. Indian Anaesth Forum [serial online] 2022 [cited 2022 Oct 3];23:57-61. Available from: http://www.theiaforum.org/text.asp?2022/23/1/57/340483





  Introduction Top


Anesthesiology; existing from the 12th century, in the past 150 years, has been revolutionized and evolved to one of the most advanced branch in modern medicine. Anesthesiologist plays an important role in intensive care units, trauma centers, pain clinics, and as a member of resuscitation team all over the world.[1] A good anesthesiologist–patient relationship is important to reduce the anxiety of the patient.[2] The problems of image and status of anesthesiologists in eyes of the medical and lay communities are not new.[3] Due to the lack of public awareness about anesthesia as a medical discipline, many patients assume an anesthesiologist to be an assistant of the surgeon and do not recognize the role played by him in preoperative, perioperative, and postoperative periods. Many studies have been conducted, which show the poor public knowledge regarding[4],[5] anesthesia in developing and developed countries.[1],[6] With the changing health-care environment and advancement in anesthesiology, the patients and general public need to be educated.[7]

Hence, the present study was conducted to assess the knowledge and awareness of patients coming for preanesthetic checkup regarding anesthesiology and anesthesiologists.


  Materials and Methods Top


A cross-sectional study was conducted after approval of institutional ethical committee in the preanesthetic checkup outpatient department (OPD) at a rural tertiary care hospital. The study was conducted on 602 patients of age of more than or equal to 18 years over a period of 6 months (April to September 2020) who had come to the preanesthetic checkup OPD for elective surgery. A questionnaire consisting of 10 questions [Table 1] in the local language (Marathi) was created, and the patients were interviewed over a period of 6 months. Informed written consent was obtained from the patients, and the patients who refused for consent and those mentally unfit and unable to communicate verbally with poor mental conditions were excluded from the study.
Table 1: Questionnaire

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  Results Top


This study involved 602 patients who visited the preanesthetic checkup OPD at rural tertiary care hospital. Of 602 participants, 312 (51.8%) were males and 290 (48.2%) were females, with majority of participants belonging to the age group, 234 (38.7%), of 18–40 years and 228 (37.9%) of 41–60 years. The study being carried out in a rural area, 165 (27.4%) patients of the study group were illiterate and only 205 (34%) of the patients were employed [Table 2].
Table 2: Results

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In our study, 311 (51.7%) patients had undergone previous surgical intervention and were thus aware of anesthesia, with 403 (67%) of the patients recognized anesthesiologist as a doctor. Around 401 (66.7%) patients believed that anesthesia is required for any surgical intervention, while 174 (29%) of them were clueless about it. Most of them, i.e., 322 (53.5%), were aware that anesthesiologists administer drugs to the patient, whereas 226 (37.5%) had no clue and 54 (9%) did not think so. The role of an anesthesiologist in the intraoperative and postoperative care was known to only 249 (41.4%). Around 241 (40%) patients were aware of general anesthesia and 145 (24.1%) of regional anesthesia. 226 (37.6%) people believed that there is a possible risk is associated in administering anesthesia among patients with comorbidities. 492 (81.6%) participants were not all aware about the possible complications during anesthesia. Finally, only 108 (18%) patients were aware of day-care surgeries.


  Discussion Top


Anesthesia is a specialty that deals with perioperative management of patients' surgical interventions to be carried out. Knowledge of general population regarding anesthesiology and anesthesiologist is very poor as compared to any other medical and surgical specialties. Better awareness about anesthesia and related complications by patients would help health administrators in recruiting better anesthesia-related health facilities to consumers.[8] Practicing anesthesiologists have struggled with issues relating to the status and image of the specialty. Development of anesthesiology as a specialty has facilitated advancements in surgical management and critical care. The purpose of this study was to assess the patients' awareness and knowledge about anesthesia and anesthesiologist.

In our study, 403 patients (67%) knew that anesthesiologists were doctors. This is because majority of them had already undergone some surgical intervention and were administered anesthesia. In previous studies conducted elsewhere in the world, it ranges from 50% to 88.7%.[1],[7],[9],[10] Knowledge regarding anesthesiology was low in our study as compared to other studies.[1],[11] This could be due to their lack of education as 165 (27.4%) of the participants were illiterate and 295 (49%) of them only completed their primary schooling. We could conclude that majority of the illiterate people knew anesthesiologist as a skilled assistant to surgeon, but the population with an education level of at least matriculation considered anesthesiologists for having a definitive role in operation theaters.

The source of information regarding anesthesiologist as a doctor in our study was by a virtue of reading somewhere or some relatives undergoing any surgical procedures or previous self-operative history or from the attending physician/surgeon in the patients. Till date, there has always been underutilization of our electronic and print media that has a tremendous potential to educate the general population. If the patients have beforehand knowledge through audiovisual or print media about anesthesiology, then they may have an option to enquire and choose their anesthesiologist.

In our study, 322 (53.5%) participants said that anesthesiologists administer drugs and 249 (41.4%) patients believed anesthesiologist monitors patients throughout operation and also looks after the postoperative period. The role of anesthesiologists after induction was not clear to many patients in previous studies.[12] This finding is in contrast to similar studies done in the Indian setting, where they answered that anesthesiologist just administers drugs once and goes away.[13],[14]

Perioperative patient monitoring is given more emphasis in anesthesiology to improve patients' safety. But in our study, majority of the population was unaware of intraoperative patient monitoring which was similar to the finding of the study by Shevde and Panagopoulos.[15] The general population needs to be educated regarding the role of anesthesiologist who is an internist of the operating room and in the perioperative patient care.

There was a lack of awareness regarding general as well as regional anesthesia in most of the patients in our study, which is in contrast to the study conducted by Mathur et al.[13] where in majority of the people were aware regarding these anesthetic techniques. This was similar to findings of a study which was conducted by Naithani et al,[16] and Gurunathan and Jacob.[17] Knowledge regarding general anesthesia is still more as compared to regional anesthesia in regard to drugs administered intravenously that makes patients fall asleep. Inhalational anesthetic agents, other routes of drug delivery system, local anesthetics, and all different types of regional anesthesia are hardly known by the patients. Thus, appropriate debriefing of the patient and relatives prior to administration of anesthesia may help in educating them as well as alleviating anxiety.

During anesthesia, conditions such as hypertension, diabetes, asthma, and other comorbidities as well as addictions like smoking or alcohol consumption are likely to affect different parameters of the patient; only 226 (37.6%) patients were aware regarding this which was almost similar to the results of Singh et al.[18] stating less than two-third of participants knew that concomitant diseases, smoking, and alcohol increase the risk of anesthesia.

Majority (81.6%) of patients were unaware of complications of anesthesia such as postoperative pain, delayed recovery from anesthesia, need for postoperative ventilation, bronchospasm, hypotension, postdural puncture headache, spinal hematoma, paraplegia, and local anesthetic toxicity. The most important concern is awareness during anesthesia and failure to gain consciousness followed by intra and postoperative pain. Better knowledge about various anesthesia techniques and their possible complications in various conditions of patients may reduce the number of medicolegal litigations. A good communication with the physician as judged by the patient is associated with a lower incidence of malpractice litigation.[19] Well-informed patients can select their anesthesiologists which can help in improving the perioperative care which, in turn, will reduce the morbidity.[20]

Information that increases public awareness of the role of anesthesiologist will contribute toward improving the image of anesthesia.[10] The education of other health-care professionals may be enhanced by publishing papers in their journals and by participating in multidisciplinary hospital committees.[3] A task force on public education and information by the American Society of Anesthesiologists recommended that public education programs should take place at the grassroot level and have appointed a manager of state programs to facilitate this endeavor.[7] A similar initiative if taken in our country will definitely strengthen our endeavor to improve anesthesiologist's image among the general population. The involvement of electronic and print media in educating the general population, irrespective of their educational status, can have a strong impact on our effort in educating them.

The above study highlights the importance of attending the preanesthetic checkup clinic where the patients can be educated about anesthesia, various techniques of administration such as labor analgesia, regional anesthesia, an day-care anesthesia with their benefits, complications, adverse effects, and also at the same time obtaining a well-informed consent about anesthetic risks.

Limitation of the study

The study was done for a short period of time, and hence, a small sample was studied. Furthermore, the study was carried out in a rural section where majority of the people are not very well educated, thus extrapolating the results at national or global level is not optimal.


  Conclusion Top


Our study portrays ignorance and unawareness regarding anesthesiology and anesthesiologist's role among rural patients. It is important to educate the patients and the relatives of the rural population. We initiated to educate the people coming for preoperative checkup regarding the role of anesthesiologist and different types of anesthesia information using 5 min of video presentation in the local language.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Swinhoe CF, Groves ER. Patients' knowledge of anaesthetic practice and the rôle of anaesthetists. Anaesthesia 1994;49:165-6.  Back to cited text no. 1
    
2.
Simpson M, Buckman R, Stewart M, Maguire P, Lipkin M, Novack D, et al. Doctor-patient communication: The Toronto concensus statement. BMJ 1991;303:1385-7.  Back to cited text no. 2
    
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Armitage EN. The public image of the speciality [letter]. Anaesthesia 1978;33:64-5.  Back to cited text no. 3
    
4.
Chew ST, Tan T, Tan SS, Ip-Yam PC. A survey of patients' knowledge of anaesthesia and perioperative care. Singapore Med J 1998;39:399-402.  Back to cited text no. 4
    
5.
Khan F, Hassan S, Zaidi A. Patient's view of the anaesthetist in a developing country. J Pak Med Assoc 1999;49:4-7.  Back to cited text no. 5
    
6.
Jathar D, Shinde VS, Patel RD, Naik LD. A study of patients' perception about the knowledge of anaesthesia and anaesthesiologist. Indian J Anaesth 2002;46:26-30.  Back to cited text no. 6
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Klafta JM, Roizen MF. Current understanding of patients' attitudes toward and preparation for anesthesia: A review. Anesth Analg 1996;83:1314-21.  Back to cited text no. 7
    
8.
Harms C, Young JR, Amsler F, Zettler C, Scheidegger D, Kindler CH. Improving anaesthetists' communication skills. Anaesthesia 2004;59:166-72.  Back to cited text no. 8
    
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Hume MA, Kennedy B, Asbury AJ. Patient knowledge of anaesthesia and peri-operative care. Anaesthesia 1994;49:715-8.  Back to cited text no. 9
    
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Keep PJ, Jenkins JR. As others see us: The patients' view of the anaesthetists. Anaesthesia 1978;33:43-5.  Back to cited text no. 10
    
11.
Ismaeil WE. Awareness of the public about anesthesia and anesthesiologists in Egypt. Ain Shams J Anesthesiol 2011;4-2:25-33.  Back to cited text no. 11
    
12.
Khara BN, Rupera KB, Gondalia KR, Kamat HV. Knowledge about anesthesia and perception about anesthesiologists among patients at a rural tertiary care hospital: A cross sectional survey. Natl J Med Res 2013;3:371-3.  Back to cited text no. 12
    
13.
Mathur SK, Dube SK, Jain S. Knowledge about anaesthesia and anaesthesiologist amongst general population in India. Indian J Anaesth 2009;53:179-86.  Back to cited text no. 13
[PUBMED]  [Full text]  
14.
Pandya K, Mehta KH, Patel KD. Awareness regarding anaesthesiology and anaesthesiologists among general population in developing country – A cross sectional survey. Natl J Community Med 2016;7:515-8.  Back to cited text no. 14
    
15.
Shevde K, Panagopoulos G. A survey of 800 patients' knowledge, attitudes, and concerns regarding anesthesia. Anesth Analg 1991;73:190-8.  Back to cited text no. 15
    
16.
Naithani U, Purohit D, Bajaj P. Public awareness about anaesthesia and anaesthesiologist. A survey. Indian J Anaesth 2007;51:420-6.  Back to cited text no. 16
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17.
Gurunathan U, Jacob R. The public's perception of anaesthesiologists – Indian attitudes. Indian J Anaesth 2004;48:456-60.  Back to cited text no. 17
    
18.
Singh T, Sharma S, Banerjee B, Garg S. Knowledge regarding anesthesiologist and anesthesiology among patients and attendants attending a rural hospital of New Delhi. J Educ Health Promot 2018;7:12.  Back to cited text no. 18
    
19.
Adamson TE, Tschann JM, Gullion DS, Oppenberg AA. Physician communication skills and malpractice claims. A complex relationship. West J Med 1989;150:356-60.  Back to cited text no. 19
    
20.
Irwin MG, Fung SK, Tivey S. Patients' knowledge of and attitudes towards anaesthesia and anaesthetists in Hong Kong. Hong Kong Med J 1998;4:16-22.  Back to cited text no. 20
    



 
 
    Tables

  [Table 1], [Table 2]



 

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