General health-related disorders, medical treatment preferences, and health management practices in South Indians during COVID-19 pandemic - An exploratory study

DP Punitha; DP Sudhagar

doi:10.4103/jdrntruhs.jdrntruhs_17_22

ORIGINAL ARTICLE

Year : 2022 | Volume : 11 | Issue : 4 | Page : 307-313

General health-related disorders, medical treatment preferences, and health management practices in South Indians during COVID-19 pandemic - An exploratory study

DP Punitha¹, DP Sudhagar²
¹ Department of General Medicine, Government Tiruvannamalai Medical College and Hospital, Tiruvannamalai, Outer Ring Road, Vengikkal, Tiruvannamalai Taluk, Tiruvannamalai District, Tamil Nadu, India
² Associate Professor, Garden City University, Bengaluru, Karnataka, India

Date of Submission	03-Feb-2022
Date of Acceptance	04-Mar-2022
Date of Web Publication	17-Mar-2023

Correspondence Address:
Dr. D P Punitha
Government Tiruvannamalai Medical College and Hospital, Tiruvannamalai, Outer Ring Road, Vengikkal, Tiruvannamalai Taluk, Tiruvannamalai District, Tamil Nadu - 606 604
India

Source of Support: None, Conflict of Interest: None

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DOI: 10.4103/jdrntruhs.jdrntruhs_17_22

Abstract

Introduction: The number and type of health related disorders are increasing day by day across the globe and India is not an exception. The emergence of COVID 19 in India is also fuelling health related disorders among Indians. The present study is focused on understanding general health related disorders, medical treatment preferences, and health management practices in South Indians using an exploratory approach.
Methods: A survey method was followed to conduct the study using a structured questionnaire. The questionnaire was developed based on a focus group discussion with the experts and researchers in the general medicine field. A convenience sampling method and online survey method were used to collect the data from the respondents.
Results: The top six health related disorders reported in the study were skin related problems, eye problems, menstrual problems, mental stress, dental problems, and vitamin and nutritional deficiencies. The most preferred treatment option is allopathy medicine, followed by ayurveda and homeopathy. The preferred place for the treatment were private hospitals, followed by clinics and then government hospitals. A list of 22 positive and negative health related practices currently followed by the respondents was also identified in the study.
Discussion: The results of the study will be helpful to understand a comprehensive overview of the study topic by the health professionals, hospital authorities, health researchers, and policymakers to develop strategies to manage the health related disorders, provide effective medical treatment, and enhance the current health management practices.
Conclusion: Effective treatment for the top six health-related disorders identified in the study and more awareness programs and training will help achieve better health management.

Keywords: COVID-19, exploratory study, health management practices, health-related disorders, medical treatment preferences, pandemic, South Indian, South Indians

How to cite this article:
Punitha D P, Sudhagar D P. General health-related disorders, medical treatment preferences, and health management practices in South Indians during COVID-19 pandemic - An exploratory study. J NTR Univ Health Sci 2022;11:307-13

How to cite this URL:
Punitha D P, Sudhagar D P. General health-related disorders, medical treatment preferences, and health management practices in South Indians during COVID-19 pandemic - An exploratory study. J NTR Univ Health Sci [serial online] 2022 [cited 2023 Apr 1];11:307-13. Available from: https://www.jdrntruhs.org/text.asp?2022/11/4/307/371754

Introduction

As per the report of the (Worldometer),^[1] the present population of India is 1,398,087,214, and the size of the population is equivalent to 17.7% of the total world population, with the median age of Indians being 28.4 years. A total of 35.0% of the Indian population represents the urban area, and the population density is 464 per Km² (1,202 people per mi²). India is known for several diversities, such as geographical diversity, racial diversity, climatic diversity, social diversity, language diversity, and religious diversity (yourarticlelibrary.com).^[2] Along with these diversities, one can witness health diversities across the population of India. Due to the rapid urbanization, transformation in the lifestyle, adoption of modern agriculture methods involving synthetic chemicals and fertilizers, increasing land, air, water, and soil pollution has resulted in several health-related disorders, and this condition is worsening day by day. As per the report published by National Institute for Public Finance and Policy (2014),^[3] India's health status was below compared to other developing countries across the globe. Jain et al.^[4] and Narain et al.^[5] reported that non-communicable disease (NCD) contributed to 60% of death in the country. The critical health-related disorder includes heart disease, cancer, diabetes, and chronic pulmonary disease and these four diseases contributed to 80%. The root cause of these disorders includes wrong consumption of alcohol, usage of tobacco, improper and unhealthy diet, and deficiency in the involvement of the exercise and physical activities. In this context, an understanding of general health-related disorders, medical treatment preferences, and health management practices of Indian during the COVID-19 pandemic is the need of the hour so that country's health status can be fixed.

Review of Literature

A list of selected existing literature is reviewed as part of the present study to understand the research conducted in the past and propose the research gap. Sunitha and Gururaj^[6] reported that approximately 10–30% of the young individuals suffering from health-causing behaviors and conditions needed immediate attention from the policymakers and the public health professionals. The study found that nutritional disorders, which include malnutrition and over-nutrition, tobacco usage, alcohol usage, substance abuse, high-risk sexual behaviors, mental disorders leading to road traffic injury, suicides, various types of violence, affected the young population and resulted in long-term impact. The authors observed several behaviors and conditions among the same individuals leading to the cause of poor health. This condition could be one of the main causes of NCD. This includes mental and neurological disorders and injuries. This scenario played a significant challenge regarding mortality, disability, morbidity, and socioeconomic loss. The authors recommended that a healthy lifestyle, health promotion policies, programs related to youth health, and studies based on the population are required in India. This, in turn, is expected to address the increasing number of NCDs and other injuries. Backing up this finding, WHO^[7] reported that the challenge of mental health problems in India accounts for 2443 disability-adjusted life years per 10000 population. WHO also reported that the age-adjusted suicide rate per 100000 population is 21.1. The reports also indicated that USD 1.03 trillion could be the expected economic loss due to mental health-related issues. Sinha et al.^[8] investigated the prevalence of common mental disorders in older adults. The results of their study indicate that older adults had higher depressive disorders than younger adults. The study did not observe any difference in the anxiety disorders between the different age groups. Specific phobias followed by agoraphobia were commonly noticed anxiety disorders among older adults. The study also found that common mental disorders among the older population were more common among the female gender, residing in urban metros, unemployed, unmarried, and lower household income. Hoskote et al.^[9] conducted a study on health outcome, education, healthcare delivery, and quality. The study found common symptoms among children below 12 years were runny nose, sneezing, nasal obstruction, and cough. In the case of adults, sneezing and cough were the most noticed symptom, followed by a runny nose. In addition, allergic rhinitis and asthma were observed in both adults and children. A family history of allergic disorders and symptoms lasting about 3 to 4 days was also observed in the study. The most common reason for the allergic disorder was dust, followed by a strong odor, and finally due to food. The study also found a discrepancy in the perceived and identified trigger by following the skin prick test. Interestingly, the study found that only 13% of the patients were on alternative medicine such as ayurveda and homeopathy, and 12% of the patients were only using reliever inhalers despite the symptoms observed was indicating asthma. Nair et al.^[10] conducted a study on knowledge, attitude, and practices towards vocal health care amongst Indian carnatic singers. The sample size of the study includes 100 participants. The results indicated that the participants had good knowledge and positive attitudes towards vocal health care. Predominately, the participants had reported that they were involved in taking home remedies while comparing to the intention to take medical assistance. The study also reported that using various home remedies and vocal and non-vocal measures was important for maintaining good vocal health. Kaur et al.^[11] reported that the postpartum weight management module included diet, physical activity, sleep, and breastfeeding information. This practice was designed to be used in usual clinical practices, focusing on the Indian context. Amalakanti et al.^[12] found above an average score regarding knowledge related to Coronavirus 2019, displayed a positive attitude about the COVID 19 situation, and predominately the participants had followed good preventive practices. Interestingly, the study found women, people with low education and non-medical background, displayed poor knowledge and practices. Also, the participants' attitude involved in the physical work was poor. The authors recommended a better health policy to focus the group which displayed poor scores and attitude. Sankar et al.^[13] explored the desire for information and preference for participation in treatment decisions in patients with cancer from the Department of General Surgery in a Tertiary Care Hospital in India. The study found that 81% of the study participants had the intention to know if the illness was cancer and above 70% of the participants expressed their need or willingness to know about prognosis, treatment options, and adverse effects. Positively, 97% of the patients had the support of the treating physicians to make decisions related to their treatment, and 60% intended to make a shared decision with the family members. Samal and Dehury^[14] investigated the utilization, preference, perception, and characteristics of people adopting traditional and AYUSH systems of medicine in India using a systematic review. The results indicate that utilization was observed in a selected geographical area (states) and from a specific group of people such as tribal and general population and medical practitioners and religious groups. The general perception about AYUSH varied from different segments of the society. The reason for the preference of AYUSH was due to distrust or frustration about allopathic medicine, cost-effectiveness, accessibility of the AYUSH medicine, non -availability of other options, and fewer side effects from AYUSH medicines. The study also reported that people preferred the AYUSH system of medicine due to their own personal experience and the recommendation received from other people. Prasad^[15] reported that migrant households preferred private hospitals for medical treatments and the non-migrant households preferred and displayed faith in herbal and magician for the medical treatment. The study also found that migrant households opted for institutional delivery and spent money on healthy foods. The households displayed health consciousness and were involved in health promotion programs such as polio, immunization, and children's health checkup. In addition, the migrant households had first aid boxes stocked with general pills including paracetamol, B-complex, and syrup. Few of the migrant households even had a thermometer and were involved in measuring the body temperature and taking medicines to control fever when witnessed among the households. Nirmal et al.^[16] explored the preference of inhalants over pills/injections among pulmonary tuberculosis patients in Western India using a cross-sectional study. The study found that preference of inhalants over pills versus injections among pulmonary TB patients was associated with clinical characteristics. The study found that patients who underwent treatment over 1-year preferred inhalants over pills or injections compared to patients who underwent treatment for less than a year. In the case of the patients taking five or more pills a day, they preferred to go for inhalants over pills/injections compared to patients taking less than four pills per day. Based on the literature evidence, it is evident that studies focusing on understanding the general health-related disorders and health management practice is limited. The present study is aimed to fill up the gap observed in the literature.

Objective of the Study

The main purpose of the study is to understand the general health-related disorders, medical treatment preferences, and health management practices in South Indians during the COVID-19 pandemic.

Materials and Methods

An online survey was conducted with the help of a structured questionnaire. The questionnaire was developed based on the focus group discussion with the experts, including doctors, policymakers, and health researchers. The questionnaire collected information about the demographic profile of the participants, current health-related disorders, treatment preference in terms of method and place of the treatment, and a list of questions related to the health management practices. The participants for the study include respondents from four major states of South India. Convenience sampling was adopted for the study since the present study is exploratory.

Ethical approval for 'South Indians general health-related disorders, medical treatment preferences, and health management practices during COVID-19 pandemic - An exploratory study was issued by GCU-Ethics Committee- Member Secretary, 16^th KM, Old Madras Road, Garden City University, Bengaluru-49, granted by the Ethical Committee of Garden City University, Bengaluru, on 13/02/2022 with the Protocol number: 01/FA-2022.

Analysis and Results

5.1. Demographic details of the respondents

The demographic profile of the respondents as per [Table 5.1] indicates that predominantly the respondents were female, representing the age group of 21–30 years and living in an urban area. The majority of the respondents were students who had completed UG Programme. In addition, the majority of the respondents were unmarried from a nuclear family with an annual income below 2 lakhs.

5.2. General Health related disorders faced by the respondents

As per [Table 5.2], the top six health-related disorders faced by Indians are skin-related problems, eye problems, menstrual problems, mental stress, dental problems, and vitamin and nutritional deficiencies. The changing climatic conditions, increasing pollution, erratic lifestyle, and exposure to online platforms could contribute to the top health-related disorders identified in the current study.

5.3. Preferred treatment option for the health-related disorders

As per [Table 5.3], most respondents preferred allopathy medicine, and the second most preferred treatment option is Ayurveda and homeopathy. The prevalence of allopathy medicine is higher in the country due to curing health-related disorders in a shorter period. Very recently, the government of India has been promoting the Indian system of medicine such as ayurveda and homeopathy. This could be the main reason for the preferred treatment option for health-related disorders.

5.4. Preferred place for the treatment

[Table 5.4] shows the statistical data on the preferred place for the treatment. The majority of the respondents preferred private hospitals and clinics over government hospitals for their treatment. The ease of accessibility and availability of the private hospitals and clinics could be the reason for choosing them.

5.5. Current health management practice

[Table 5.5] provides results of the current health management practice followed by the respondents of the study. Out of 22 health management practices, 10 are alarming and require immediate intervention from the concerned health authorities, doctors, and policymakers to correct the health management practice. These efforts will help reduce any critical health complications that may arise due to improper health management practice. The list of practice that requires interventions are,

Only 67% of the respondents were involved in exercise, yoga, meditation to keep them fit. Lack of physical activity may lead to health-related disorders.
A total of 62% of the respondents were frequently involved in self-medication when they suffered from health-related disorders. A total of 56% of the respondents are involved in taking over-the-counter medication to cure any health-related disorders. A total of 60% of the respondents have taken tablets as soon as the onset of the symptom. This practice will lead to improper management of the actual health disorder and thereby increase the risk of treating the disorder.
About 75% of the respondents have the habit of browsing on the internet to find out the health disorders based on their symptoms. This is one of the worrying practices identified in the current study, and this may lead to improper self-diagnosis, leading to wrong self-treatment.
About 82% of the respondents habit visiting the doctor only when the symptoms persist for a more extended period. About 62% of the respondents have accepted that they visit the doctor only when severe symptoms. This habit is also likely to pose a threat in handling severe health disorders, which might get worse if it is not reported when it is in the nascent stage.
Only 45% of the respondents usually go for periodical health checkups to find any health-related disorders. This practice is not recommended. It is essential for people to go for periodical health checkups to find any health-related disorders. This will help detect health-related disorders early and start the treatment early.
Only 67% of the respondents consciously practice balanced meals at all times, and only 57% of the respondents preferred a vegetarian meal over a non-vegetarian meal. Food plays an important role in managing sound health. The current results regarding practicing balanced meals and preference of vegetarian meal over a non-vegetarian meal are not satisfactory.

Overall, more awareness programs and training should be conducted on the general population to correct health management practices.

Discussion

The study has provided insights into the general health-related disorders, medical treatment preferences, and health management practices in Indians during the COVID-19 pandemic. Based on the study's findings, the doctors and the researchers should engage in research to develop an effective treatment in treating top health-related disorders reported in the study (skin related problems, eye problems, menstrual problems, mental stress, dental problems, vitamin and nutritional deficiencies). Besides the treatment options, lifestyle modifications that include opting for vegetarian food, eating a balanced meal, and getting involved in physical activities will help treat the early stage of health-related disorders. Also, these efforts will help enhance the effectiveness of the treatment and prevent any future health-related complications.

Limitations

The study results cannot be generalized due to the moderate sample size and the sampling method followed for the study. The study is limited to respondents in India, and these two are the main limitations of the present study.

Future Research Directions

Future research must focus on replicating the current study with more sample size. Future studies should use the probability sampling method.

Conclusion

The present study has significantly contributed towards understanding the general health-related disorders, medical treatment preferences, and health management practices in Indians during the COVID-19 pandemic. Using the results obtained from the present study, the doctor, health policymakers, and health researchers can align their respective health-related strategies to enhance the health and wellness of the Indians, leading to creating a nation with health, happiness, and prosperity.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

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