A
Descriptive study to Identify High Risk Families in Terms of Health and Assess their
Coping Strategies in a Selected Community of Kashmir
Shaheena Masoodi1*,
Urmila Bhardwaj2, Madhvi
Verma3
1Infection Control Nurse – SKIMS, Srinagar, Kashmir
2Associate Professor, Faculty of Nursing, Jamia Hamdard, New Delhi
3Ex Tutor, Faculty of Nursing, Jamia
Hamdard, New Delhi
*Corresponding Author Email: shaheenamasoodi@gmail.com
ABSTRACT:
Communities consist of diverse groups of families varying
in their assets, resources, problems and needs. Every community has high risk families
who need special services to help them to cope up with disease, strife, loss and
grief. Some families have individual members who are at risk due to their age or
other physiological condition. This study was conducted to identify high risk families,
to assess their coping strategies and to establish relationship between coping strategies
and risk status of families. A quantitative research approach, descriptive cross-
sectional survey research design was used. The study was conducted in Bemina Boat colony, Srinagar, Kashmir. The sample consisted
of 100 families. The data was collected through systematic random sampling by using
Aggarwal, O.P.s standardized tool, structured interview
schedule and rating scale. Obesity, malnutrition and anemia were identified by using
anthropometric observation and Hemoglobin estimation. The findings revealed that
38% of the families were high risk and 62% were in the category of low risk. Majority
of the families i.e., 91% of families had poor socio economic status, 81% had 1-2
infants, 20% of women were alone because of death of their husbands, 76% had occasional
fights within their family, 70% did not involve family members in decision making,
66% children had headache and 33% had both
lack of interest and headache, 47% children had enuresis, 13% had nail biting and
enuresis, 57% of children received late immunization, majority of the families were
not taking balanced diet, all families were not de worming their children, 22% families
had only one member suffering from diabetes mellitus and 20% had at least one person
with cardiac problem, 68% had a member with hypertension, 13% had at least one member
with a mental disorder, 3% had one member with genetic disorder, 7% had handicapped
persons, 10% had a drug addict !0 % had alcoholic in their home all families had
at least one smoker in their home. All the families had a service type of latrine
in their houses. All the families were disposing the wastes in an open space, majority
of the families were taking imbalanced diet, all the families were affected with
political turmoil, 3% of the families had experienced death of one member. Among
the population of 614, 18.72% were anemic, 4.56% of adult females were obese and
1.46% of the children were malnourished. 83% families had adequate coping strategies
and 17% had inadequate coping strategies. Out of 17% inadequate coping strategies,
high risk families’ had12% and only 5% of inadequate coping was scored by low risk
families. There was a significant relationship between risk status of families and
their coping strategies as obtained by chi square at 0.05 level of significance.
Health planners and policy makers must consider the overall development of the community
specially the poor people. Community health nurse must prepare the risk score card
for each family and designate high risk families and help them for improving their
coping.
KEYWORDS: High
risk families, coping strategies, anemia, obesity, malnutrition
INTRODUCTION:
It is well known that the course of family life is not
always smooth. In fact, everyone can count on experiencing the inevitable stresses,
strains and tough times that are a part of journey. With these changes comes the
potential for possibility that the family may be overwhelmed and lack of supportive
resources needed to deal effectively with the stressful life changes.
Carson et al (2007)[1] stated that during the
last few decades, numerous factors are affecting the Indian families in many ways,
leading to varied types of problems with challenging tasks ahead. A critical problem
in India is the discrepancy between the haves and have-nots and its widespread effect.
The economic burden on the have-nots have increased to a point that many couples
or parents have little time and energy to attend the family life. The limited availability
of educational, cultural and economic resources and the accumulation of the acute
and chronic stressors which wear people down over time, make low socio economic
status a major risk factor for family dysfunction and lack of optimal parenting.
According to World
health organization (2004)[2] eight risk factors (alcohol use, tobacco use, high blood pressure, high
body mass index, high cholesterol, high blood glucose, low fruit and vegetable intake,
and physical inactivity) account for 61% of cardiovascular deaths. Combined, these
same risk factors account for over three quarters of ischemic heart disease: the
leading cause of death worldwide. Although these major risk factors are usually
associated with high-income countries, over 84% of the total global burden of disease
they cause occurs in low- and middle-income countries.
According to WHO (1999) [3], Violence against
women is present in every country, cutting across boundaries of culture, class,
education, income, ethnicity and age. Studies
estimate that, from country to country, between 20 and 50% of women have experienced
physical violence at the hands of an intimate partner or family member.
World Health Organization (2008). [4, 5] Low-income
populations are most affected by risks associated with poverty, such as under nutrition,
unsafe sex, unsafe water, poor sanitation and hygiene, and indoor smoke from solid
fuels; these are the so-called “traditional risks”.
As life expectancies increase and the major causes of
death and disability shift to the chronic and non communicable, populations are
increasingly facing modern risks due to physical inactivity; overweight and obesity,
and other diet-related factors; and tobacco and alcohol-related risks. As a result,
many low- and middle-income countries now face a growing burden from the modern
risks to health, while still fighting an unfinished battle with the traditional
risks to health and the impact of these modern risks varies at different levels
of socioeconomic development. WHO also estimated 41% of pregnant women and 27% of
preschool children worldwide have anemia caused by iron deficiency.
Benard (1997)[6] identified Poverty as a factor most
likely to put youth “at risk” of drug abuse, child neglect and abuse, violence and
school failure. Millions of young people around our world are growing up in circumstances
that are far from ideal. Living in poverty is putting them “at risk” of dropping
out of school, of beginning to abuse, malnourishment, illiteracy and environmental
problems.
NEED
OF THE STUDY:
Overall morbidity rate is increasing due to the unawareness,
ignoring maintenance of health and utilizing health facilities. As many families
appear to cope well to face the challenging circumstances, such as, economic instability,
disturbed family relationships, health problems etc. However there are families
who find themselves in conflict with the system because of their behavior and attitudes
and who do not appear to be coping. Often these families are marginalized and excluded
on the basis of their behavior and socioeconomic status.
Strong M. et al.
(2006)[7] conducted a study on Socioeconomic deprivation,
coronary heart disease prevalence and quality of care and found that
participants from more deprived areas received at least equivalent, and sometimes
higher quality care for hypertension than those from less deprived areas. This differs
from previous research which has reported the expected poorer care for more deprived
populations, but agrees with other papers which have found better care in more deprived
areas. Further research using accurate
measures of individual deprivation on a larger population is needed to explain the
different findings in different studies.
Kevin M. Sweet.et al (2002)
[8] conducted a study on Identification and Referral of Families at High
Risk for Cancer Susceptibility. This cohort study consisted of 362 patients seen
at a comprehensive cancer center ambulatory clinic over a 1-year period that voluntarily
used the computer program and were a mixture of new and return patients. The computer
entry was assessed by genetics staff and then compared with the medical record for
corroboration of family history information and appropriate physician risk assessment
and found that Family history information from the medical record was available
for comparison to the computer entry in 69%. It was most often completed on new
patients only and not routinely updated. Of the 362 computer entries, 101 were assigned
to a high-risk category. Evidence in the records confirmed 69 high-risk individuals.
Documentation of physician risk assessment (i.e., notation of significant family
cancer history or hereditary risk) was found in only 14 of the high-risk charts.
Only seven high-risk individuals (6.9%) had evidence of referral for genetic consultation.
He concluded that this study demonstrates the need to collect family history information
on all new and established patients in order to perform adequate cancer risk assessment.
The lack of identification of patients at highest risk seems to be directly correlated
with insufficient data collection, risk assessment, and documentation by medical
staff.
OBJECTIVES:
1.
To identify the high risk families in terms
of health.
2.
To assess
their coping strategies of families
3. To establish relationship between coping strategies
and risk status of families.
MATERIAL
AND METHODS:
Research Approach:
Quantitative Approach
Research Design:
Descriptive cross- sectional survey research
design
Attribute Variables:
Socio economic status, family organization,
family environment, child health status, adult health status, external environment,
socio- political environment, anthropometric measurement, Hb
estimation, coping strategies of familie
Population:
families residing in the urban resettlement population
of Bemina Boat Colony, Kashmir.
Sample size and sampling technique:
Systematic random sampling technique was found appropriate
to select the study subjects. Every third house was selected for the study sample.
Sample size for the present study comprised of 100.
Data Collection tool:
Structured interview schedule on:
· Socio- economic status scale for the family.
· Assessment of internal and external environment
of the family.
· Performa for anthropometric observation and
hemoglobin estimation.
· Rating scale to assess their coping strategies.
RESULTS:
The data was analyzed and presented into five
sections.
SECTION I:
This section describes the socio economic status of the
families. Frequency and percentage were computed for describing the socio economic
status of the families.
A Bar diagram showing the Percentage Distribution of
Families by their Socio- economic Status.
SECTION II:
This section describes the findings related to internal
and external family environment. Frequency and percentage were computed for describing
the various areas of risk assessment pertaining to family organization.
Table
No. 1 Frequency and Percentage Distribution of the families according to their Family
organization n= 100
|
S. No.
|
Items on Family organization
|
Frequency/
Percentage
|
|
1.
|
Number of elderly
a. None
b. 1- 2
|
54
46
|
|
2.
|
Number of infants
a. None
b. 1- 2
|
19
81
|
|
3.
|
Number of under fives
a. None
b. 1- 2
|
67
33
|
|
4.
|
Reasons of spouse alone in the family
a. Job
away from family
b. Death
c. Not
alone
|
01
20
79
|
The data presented in the above table reveals that majority
of the families i.e., 54% had no elderly and 46% had 1-2 elderly in their families.
The maximum number of families i.e., 81% had 1-2 infants and 19% had no infants.
The data also reveals that out of 100 families, 67% had no under five children and
33% had 1-2 under fives in their families. Out of 100 families, 79% of spouses were
living together, 20% of women were alone because of death of their husbands and1%
of the woman was alone because her husband was having job outside the state.
Table
No. 2 Frequency and Percentage Distribution
of the of families according to their Family Environment
|
S. No.
|
Items on Family
Environment
|
Frequency/ percentage
|
|
1.
|
Relationship with
family
a. Congenial
b. With occasional
fights
c. At times fights
but resolves easily
|
13
76
11
|
|
2.
|
Relationship with
in laws
a. Congenial
b. With occasional
fights
c. At times fights
but resolves easily
|
76
23
01
|
|
3.
|
Working status of
the spouses
a. Only one working
parent
|
100
|
|
4.
|
Family members spending
free time with each other
a. Most of the times
b. Sometimes
c. Rarely
|
21
77
02
|
|
5.
|
Punitive discipline
in the family
a. Never
b. Rare
c. Sometimes
d. Most of the times
|
04
48
48
|
|
6.
|
Having meals together
a. Most of the times
b. Sometimes
c. Rarely
|
02
62
36
|
|
7.
|
Head of the family
involves other members in decision making
a. Sometimes
b. Rarely
c. Never
|
04
26
70
|
|
8.
|
Family members being
abused physically
a. Never
b. Rarely
c. Sometimes
|
93
03
04
|
Data in the table 2 indicates that majority of the families i.e., 76%
had occasional fights within their families, 13% had congenial relationship and
11% had fights that resolved easily. Majority of women i.e., 76% had congenial
relationship with their in-laws, 23% with occasional fights and 1% had fights
that resolved easily. All families had only one working spouse. Majority of the
families i.e., 77% responded that they sometimes spend free time with each
other, 21% said most of the times and 2% very rarely. Data also reveals that
48% had very rare punitive discipline, 48% families sometimes used punitive
discipline and 4% of the families had no punitive discipline within their
families. Maximum number of the families i.e., 62% sometimes had meals
together, 36% very rarely and 2% had most of the times. Majority of the family
heads i.e., 70% did not involve family members in decision making, 26% involved
them rarely and only 4% involved them sometimes in decision making. 93% of the
family members were not abused physically, 3% were abused rarely and 4% were
abused only sometimes. Maximum number of the families i.e., 61% sometimes
had meals together, 37% very rarely and 2% most of the times.
Table No.3 Frequency and Percentage Distribution of families
according to their child health Status n=100
|
S. No.
|
Items on Child Health Status
|
Frequency/Percentage
|
|
1.
|
No. of children having the symptoms
of lack of interest, remaining sad and headache
b. One of them is present
c. Two of them is present
d. three of them is present
|
66
33
01
|
|
2.
|
No. of children having the traits
like, nail biting, enuresis and academic problems
a. None of the above
b. One of them is present
c. Two of them is present
|
40
47
13
|
|
3.
|
Children below 5years of age not covered full immunization
a. None
b. Covered all but late
c. Incomplete immunization
d. Received no immunization
|
23
57
13
07
|
|
4.
|
Children frequently suffering from diarrhea
a. None
b. One
|
84
16
|
|
5.
|
Children frequently suffering from ARI
a. None
b. One
c. Two
|
29
36
35
|
|
6.
|
Daily diet of the family
a. Veg., Dal/meat, rice/chapatti, curd, fruits
and salads
b. Veg., Dal/meat, rice/chapatti and curd
c. Veg. and Dal and rice/chapatti
d. Veg. and rice/chapatti
|
01
45
05
49
|
|
7.
|
De-worming of children
a. Never
|
100
|
Data in the above table
reveals that majority of the children i.e., 66% had headache, 33% had lack of
interest and headache and 1% was remaining sad and also had lack of interest
and headache. Majority of the children i.e., 47% had enuresis, 13% had nail
biting and enuresis and 40% were not having any trait. Among 100 families, 57%
of the children below 5 years of age received all immunization but late, 23%
received all in time, 13% received incomplete and 7% received no immunization
at all. Data also revealed that in 84% families, no child was suffering from
diarrhea frequently and in 16% of families, only one child was suffering from
the same. In 36% of families, only one child was suffering from ARI, in 35% of
families two children were suffering from ARI and in 29% of families, none of
the children was suffering from ARI frequently. The maximum number of families,
i.e., 49% of the daily family diet contained Vegetable and rice, 45% Veg., Dal/meat, rice and curd, 5% Veg. and Dal
and rice, 1% Veg., Dal/meat, rice, curd, fruits and
salads. None of the families were de worming their children.
Data in the above
table reveals that majority of the children i.e., 66% had headache, 33% had
lack of interest and headache and 1% was remaining sad and also had lack of
interest and headache. Majority of the children i.e., 47% had enuresis, 13% had
nail biting and enuresis and 40% were not having any trait. Among 100 families,
57% of the children below 5 years of age received all immunization but late,
23% received all in time, 13% received incomplete and 7% received no
immunization at all. Data also revealed that in 84% families, no child was
suffering from diarrhea frequently and in 16% of families, only one child was
suffering from the same. In 36% of families, only one child was suffering from
ARI, in 35% of families two children were suffering from ARI and in 29% of
families, none of the children was suffering from ARI frequently. The maximum
number of families, i.e., 49% of the daily family diet contained Vegetable and
rice, 45% Veg., Dal/meat, rice and curd, 5% Veg. and Dal and rice, 1% Veg., Dal/meat,
rice, curd, fruits and salads. None of the families were de worming their
children.
Table
No. 4. Frequency and Percentage Distribution of the families according to the
adult health n=100
|
S.
No.
|
Items
on Adult Health Status
|
Frequency
and Percentage
|
|
1.
|
Family
member suffering from Diabetes Mellitus
a. None
b. One
|
78
22
|
|
2.
|
Family member suffering from cancer
a. None
b. One
|
99
01
|
|
3.
|
Family
member suffering from heart disease
a. None
b. One
|
80
20
|
|
4.
|
Family
member suffering from hypertension
a. None
b. One
c. Two
d. Three and more than three
|
32
45
22
01
|
|
5.
|
Family member having mental disorders
a.
None
b. One
|
87
13
|
|
6.
|
Family
member having genetic disorders
a. None
b. One
|
97
03
|
|
7.
|
Handicapped
persons in the family
a. None
b. One
|
93
07
|
|
8.
|
Drug
addicts in the family
a. None
b. One
|
90
10
|
|
9.
|
Alcoholics
in the family
a. None
b. One
|
90
10
|
|
10.
|
Smokers
in the family
a. One
b. Two
c. Three and more than three
|
53
35
12
|
The above data in
the above table reveals that 78% families did not have any member suffering
from diabetes mellitus. 22% had only one member suffering from diabetes
mellitus. Only 1% of the family had cancer and rest of the families i.e., 99%
did not complain for the same. 20% families had only one person in their
families with cardiac problem and rest did not have any such disease. 45%
families had one member with hypertension, 22% two, 1% three and 32% did not
have any member with hypertension. 87% of families did not have any member
suffering with mental disorder and 13% had only one member having mental
disorder. Majority of families i.e., 97% did not have any member with genetic
disorder and 3% families had only one member with genetic disorder. 93% of
families did not have any handicapped person and 7% had only one member. 10%
families had only one drug addict in their home and 90% did not have. 10%
families had only one alcoholic in their home and 90% did not have. Among 100
families, 53 had only one smoker in their home, 35% had two and 12% had three
and more smokers in their family.
Figure 2: A Doughnut Diagram showing Percentage
Distribution of the family members with Drug addicts.
Figure
3: A Cylindrical Diagram showing Percentage Distribution of the family members
with Alcoholics
Table
No. 5. Frequency and Percentage Distribution of the families according to their
External environment n=100
|
S.
No.
|
Items
of External Environment
|
Frequency
/Percentage
|
|
1.
|
Type
of house
a. Pucca with 2 rooms or more, kitchen and
bathroom
b. Semi Pucca
with 2 rooms, kitchen and bathroom
c. Pucca with 2
rooms, no kitchen, no bathroom
d. Kacha with
one room, no kitchen, no bathroom
|
85
02
10
03
|
|
2.
|
Kind
of ventilation in the house
a. Two windows in a room
b. One window in a room
c. No window, only a door
|
06
93
01
|
|
3.
|
Kind
of drinking water in family
a. Boiled/ Chlorinated water
b. Untreated tap water
|
18
82
|
|
4.
|
Kind
of latrine in the house
Service type
|
100
|
|
5.
|
Disposal
of refuse
a. Open space
|
100
|
|
6.
|
Kind
of drainage system in the house
c. Closed inside and open outside
|
100
|
|
7.
|
Having
rodents and arthropods in the house
a. None of the above
b. One of them is present
c. Two of them is present
|
03
43
54
|
Data in the table
5 reveals that among 100 families, 85% had Pucca
house with 2 rooms or more, kitchen andbathroom, 2%
Semi Pucca with 2 rooms, kitchen and bathroom, 10% Pucca with 2 rooms, no kitchen, no bathroom and 3% had Kacha with one room, no kitchen, no bathroom. 6% families
had two windows in a room, 93% had one window in a room, and 1% had no window,
only a door. Majority of families i.e., 82% were drinking tap water directly
and 18 % boiled water. All the families had a service type of latrine in their
houses. All the families were disposing the wastes in an open space. All the
families (100%) had closed inside and open outside drainage system. Majority of
the families i.e., 54% had rodents and arthropods in their houses, 43% had only
arthropods in their houses and 3% only had none of them present.
Table
No. 6. Frequency and Percentage Distribution of the families according to their
socio political environment n=100
|
S.
No.
|
Political
turmoil
|
Frequency/
Percentage
|
|
1.
|
No.
family members got affected with the present turmoil
a. More than three
|
100
|
|
2.
|
No.
of family members being disabled
a. None
b. One
|
97
03
|
|
3.
|
No.
of persons died with the present turmoil
a. None
b. One
|
97
03
|
|
4.
|
No.
of children lost their parents
a. None
b. One
c. Two
d. More than three
|
97
0
02
01
|
Data in the table
6 reveals that100 % of the family members got affected with political turmoil.
3% of the families had only one member being disabled with the political
turmoil and 97% were normal. Only few of them were injured but they recovered
soon. Out of 100, 3% of the families had experienced death of one member. Among
2% of the families, two children had lost their parents (father) because of the
socio political turmoil and in 1% family, three children had lost their parent
and 97% children were living with their parents.
SECTION III:
This section describes the sample characteristics in terms
of malnutrition, obesity and anemia of the family members. Frequency and percentage
were computed for describing anthropometric observation and hemoglobin estimation
of the total population.
Table No. 7 Frequency
and Percentage Distribution of Anthropometric Observation and Hemoglobin Estimation
of the total population.
nt=614*
|
S.
no.
|
Nutritional
Status
|
Frequency
|
Percentage
|
|
1.
|
Malnutrition among children
|
09
|
1.46
|
|
2.
|
Obesity among adults
|
28
|
4.56
|
|
3.
|
Anemia with Hb<8gm.
|
115
|
18.72
|
* nt= Total population in 100 Families i.e., 614
Data in the table 7 reveals
that among the population of 614, 1.46% of the children are malnourished, 4.56%
are obese and 18.72% are anemic.
Table No. 8. Mean, Rank Order and
standard Deviation of the Risk scores obtained by the Families. n=100
|
Areas
of Risk
|
Minimum
possible score
|
Maximum
possible score
|
Range
of obtained scores
|
Standard
deviation
|
Mean*
|
Rank
order
|
|
Socio Economic Status
|
06
|
91
|
18-37
|
2.70
|
30.19
|
I
|
|
External environment
|
07
|
28
|
13- 19
|
1.44
|
55.64
|
II
|
|
Child Health
|
07
|
28
|
7-23
|
1.56
|
71.78
|
III
|
|
Family Environment
|
08
|
32
|
18- 28
|
1.81
|
73.15
|
IV
|
|
Socio political turmoil
|
04
|
16
|
9- 13
|
0.66
|
80.31
|
V
|
|
Nutritional Factors namely anemia, obesity
and malnutrion
|
03
|
12
|
8-12
|
1.13
|
87.25
|
VI
|
|
Family Organization
|
04
|
16
|
10-16
|
1.65
|
87.93
|
VII
|
|
Adult health
|
10
|
40
|
30- 39
|
2.062
|
91.6
|
VIII
|
Mean* = Total scores divided by maximum possible scores
in that area was taken as a mean because the scores of the areas vary.
The data in the table 8 shows that the mean score of
socio economic status of families was lowest i.e., 30.19, as low score was
given to the high risk. That indicated the highest risk area out of eight
areas. External environment came at the 2nd rank and child health
ranked at 3rd position
followed by family environment, socio political, nutritional factors namely
anemia, obesity and malnutrion, family organization
and the least rank i.e., 8th was given to the adult health.
Table No.9. Frequency and
Percentage distribution of families by their risk assessment.
n=100
|
Risk
Status
|
Frequency/Percentage
|
|
High
Risk
|
38
|
|
Low Risk
|
62
|
High Risk score= Score of 157 and less
Low Risk score = Score of 158 and more
The data in the above table indicates that out of 100
families, majority of the families i.e., 62% were low risk and only 38% of the
families were high risk.
SECTION IV:
This section describes the families according to their
coping strategies. mean, median and
standard deviation of coping strategies scores of families were computed for
describing coping strategies of
families.
Table no.10 Mean, median and standard
Deviation of Coping Strategies Scores of Families n=
100
|
Variable
|
Minimum
possible score
|
Maximum
possible score
|
Range
of obtained scores
|
Mean
|
Median
|
Standard
deviation
|
|
Coping strategies
|
0
|
40
|
29-37
|
32.44
|
33
|
2.124
|
Data in the table 10 shows that the mean score of the
coping strategies of high risk was found to be 32.44, median was 33 with the
standard deviation 2.124. The close value of the mean and median indicates the
distribution to be normal one.
SECTION V:
This section describes the findings related to
relationship between risk status of families and their coping strategies.
To determine the relationship between the risk status of
families and coping strategies, Chi square was used to determine whether the selected
variable is independent or related.
Table no. 11 Relationship between
Risk Status of the Families and their Coping Strategies by Chi Square n=100
|
Selected
Variable
|
High
Risk
|
Low
Risk
|
X2
|
|
Adequate Coping
|
26
|
57
|
9.23*
|
|
Inadequate Coping
|
12
|
5
|
X2 (1) = 3.84, p <0.05, *Significant
at 0.05 level
The data in table 11 shows that the calculated value is
(9.23), which is more than the table value of 3.84 at the df
(1). This shows that the chi square value is significant at 0.05 level. Therefore,
it indicates a significant relationship between the risk status of families and
coping strategies.
DISCUSSION:
The present study dealt with the high risk families and
their coping strategies in terms of health and findings revealed that only 38% of
the families were high risk even though their socio-economic status was poor.
· The findings also revealed that the adult population
was smokers. Subramanian SV.et al. (2004) [9] conducted a study on “Patterns and distribution of tobacco consumption in India”.
The findings revealed that the smoking and chewing tobacco are systematically
associated with socioeconomic markers at the individual and household level. Individuals
with no education are 2.69 times more likely to smoke and chew tobacco than those
with postgraduate education. Households belonging to the lowest fifth of a standard
of living index were 2.54 times more likely to consume tobacco than those in the
highest fifth. Scheduled tribes and scheduled castes were more likely to consume
tobacco than other caste groups.
· The external environment of the families was
very poor. These families had outside open drainage system with service type of
latrines. Therefore, the people living in this locality are more vulnerable to diseases.
Chauke LK.et al. (2000) [10] conducted a study
on” investigation of sanitation and hygiene
practices in selected rural areas of the Northern Province, South Africa”. The
research findings indicated the following shortfalls poor household socio-economic
status, water scarcity with 14% relying on rivers and 12.1% using unprotected wells
without hand pumps while no house connections were found. Hygiene practices were
found to be bad in terms of water collection and storage. Sanitation facilities
and practices were also poor with 88.3% of the population still relying on unimproved
pit latrines and children less than 5 years defecating outside the latrines, whilst
10.7% of the population still uses the bush. Poor waste management was also found
to be a recurring problem.
·
The study
findings indicated that the majority of the families i.e., 63% were known cases
of hypertension including adult females. Das SK. et al (2005) [11] conducted
a study on “prevalence of hypertension in an urban community of India”. It was found
that men showed higher prevalence of both systolic and diastolic hypertension in
young age and higher prevalence of diastolic hypertension in women after 40 years
may be related to increasing family stress and obesity which is common in middle
aged woman. There was also a significant correlation between hypertension with higher
age, sedentary activity, smoking and body mass index.
CONCLUSION:
Health planners and policy makers must consider that overall
development of the community specially the poor people. Community health nurse must
prepare the risk score card for each family and designate high risk families and
help them for improving their coping.
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