The Assessment of Knowledge in Sample of Iraqi Patients with Ankylosing Spondylitis

Abstract

Ankylosing spondylitis (AS) is a chronic inflammatory disease of the sacroiliac joints and spine that may be associated with a variety of extra-spinal lesions. Knowledge acquisition is a complex procedure and depends on patient intelligence, level of education, motivation teaching style and content. Different models have been identified to increase level of knowledge, with educational courses and information booklets among the most common. The aim of the present study is to assess a level of knowledge in sample of Iraqi patients with ankylosing spondylitis, by a self-administered questionnaire. This is a cross-sectional study including 200 Iraqi patients with AS, who have access to the Rheumatology Unit in Baghdad Teaching Hospital. AS Data collection were taking place between November 2017 and September 2018. Socio demographic data were reported including age, residence, marital status, smoking, educational level, occupation and disease diagnosis duration. Patients had undergone an interview with a physician to assess their level of knowledge by a questionnaire, which included 4 knowledge areas: Area A includes general knowledge about AS, comprising etiology, symptoms musculoskeletal and extra musculoskeletal, and laboratory blood tests. Area B includes immuno-genetics test (HLA.B27 antigen) and inheritance. Area C includes general management, including pharmacological treatment and its side effects, physical therapy and exercise (exercise type & proper duration and its role in treatment). Area D includes joints protection, pacing and priorities. The clinical and demographic data analyzed using descriptive statistics. The mean total questionnaire score is 16.28 SD +- 2.49, range (2 – 26). There is no significant statistical association between the mean total score and the gender (P value = 0.14), age (P value 0.93), marital status (P value 0.73), smoking (P value 0.65), residence (P value 0.56), and BMI (P value 0.23), While there is a highly significant statistical relationship between mean total score and the level of education (P value 0.0004), and occupation (P value 0.0026). For Area A, the mean achieved score is 3.63 +- SD 1.61, maximum possible score is 8. For Area B, the mean achieved score is 0.26 +-SD 0.51, the maximum possible score is 2. For Area C, the mean achieved score is 9.53 +- SD 2.42, maximum possible score is 15. Area D, the mean achieved score is 2.87 +- SD 1.06, the maximum possible score is 4. The study showed that AS Iraqi patients have low level of knowledge, unawareness and wrong thoughts about specific aspects of their disease, which may reinforce the recommendation of this study.

Characteristics of Ankylosing spondylitis patients in Kurdistan region of Iraq

“…The male-to-female ratio was 5.2:1 compared to the highly different one in our study; the male: female ratio: was 13.43:1. 7 A study conducted in Baghdad reported similar findings in terms of age (36.89 years) with a 10.11:1 male: female ratio 12 and that one conducted in the Kurdistan Region of Iraq. 9 The male: female ratio reported in this study is a little bit different, despite the disease being more prevalent among males compared to females.…”

“…The study aimed to explore the prevalence of HLA-B*27 among the healthy Kurdish population and in patients with AS 9 along with another conducted in Baghdad. 12…”