Knowledge, Attitude and Practice Among Overweight Patients in General Medical Clinic, Hospital Queen Elizabeth

Abstract

Obesity is a complex and an epidemic disease distributed among all age groups. Knowledge, attitude and practice (KAP) studies are largely used to understand the disease burden in a certain population. Thus, the aim of this study is to evaluate KAP of overweight patients in an urban tertiary centre setting and test the validity of the questionnaire used to assess the KAP. This hospital-based cross-sectional study involves 113 overweight patients based on Asia Pacific Body Mass Index (BMI) scale aged 12 to 50 years old attending the general medical clinic in Hospital Queen Elizabeth, Sabah. Patients were chosen based on convenience sampling with a calculates sample size of 93. Sociodemographic details and BMI awareness were gathered after obtaining patient’s consent. For the assessment of attitude and preparedness level of patient to lose weight, a modified Likert scale questionnaire was used. Sociodemographic data and the stage of readiness were analysed based on the mean distribution and standard deviation. Chi-square tests, Fisher exact tests and One-Way ANOVA tests were used to see the correlation between basic sociodemographic data namely age, gender, race, education level, and BMI with awareness. Subsequently, Chi-square test and One-Way ANOVA tests was used to assess the correlation of BMI classification, BMI awareness level and their preparedness to enrol to weight loss program based on stage of readiness. In addition, to find out the influence of BMI awareness level and BMI classification on response to each question from the Likert scale questionnaire, analysis using Chi-square test was done. Finally, the reliability and validity of the questionnaire was tested from two statistical validity point of view with the first using predictive validity via multiple regression (Criterion Validity) and second calculating the Cronbach’s alpha coefficient (reliability) as well as the convergent and discriminant validity (Construct Validity). Predominant involvement of female participants and obesity class 2 stage were observed overall. Only 53% of the obese class respondents were aware of their BMI with all the pre-obese class patients being unaware of their BMI signifying the poor awareness. Statistically, only BMI and gender has a significant correlation with awareness. (p<0.001, p=0.048) Majority of the patients were grouped under the stage of preparation and above but no significant association analysed towards BMI awareness level. (n:109, 96%) Notably, significant correlations were found between question 4 and BMI awareness level (F=4.485, p=0.036) as well as question 3 and BMI class (F=3.364, p=0.0038). The questionnaire used was deemed valid and reliable by confirming the internal consistency using Cronbach’s alpha (α=0.69) and assessing the convergent and discriminative validity (0.3<r<0.7). All the questionnaire variables were statistically significant, marking the predictive validity of the questionnaire. F (5, 107) = 59.928, p < 0.001, R² = 0.737. This study identifies most of the patient in an urban setting belongs to obese class with poor awareness on their BMI scale despite majority of them being prepared to lose weight. Applying the validity of the questionnaire, this small-scale study concludes the need of awareness teaching to aid in obesity prevention.