Knowledge of Acute Pancreatitis among health-related students at Umm Al-Qura University, Saudi Arabia

Introduction

Acute pancreatitis (AP), an emergent medical condition that necessitates hospitalization, is defined as an acute inflammatory process arising in the pancreas, which can vary in presentation severity 1-8. Its incidence is rising significantly, with 13–45 per 100,000 individuals/year affected 9, 10.

Acknowledging the pattern of AP, including its aetiologies, intensity, mortality, and factors that influence a population, is essential for guiding management, preventing recurrence, lowering mortality rates, and ensuring optimal care delivery 1, 2. However, observational data that discuss these factors, particularly in the Middle East, are significantly lacking 1,3,12.

Concerning AP, risk factors such as lifestyle and weight gain have become major health concerns globally, contributing to more health complications than ever before 1, 13-15. However, considerable advancements in critical care as well as in surgical and endoscopic management have occurred 1, 13-15. In addition, clinical examinations and laboratory tests such as amylase and lipase are vital to reach a final diagnosis 4. This study highlights the awareness and level of knowledge among health specialties students at Umm Al-Qura University, Saudi Arabia.

Subjects and methods

This cross-sectional survey was carried out during September 2021. Ethical approval was granted by Umm Al-Qura University under IRB no. HAPO-02-K-012-2021-10-779 in 2021. All health-related departments were included in this survey, while students who refused to participate were excluded. This survey followed the principles of the Declaration of Helsinki.

To estimate the sample size, we used Epi Info™ 7.1.5 software (Centers for Disease Control and Prevention; Atlanta, Georgia, USA). Consequently, the smallest sample size to reach sufficient power was 353. However, the final sample size was 372.

After obtaining appropriate online consent from all participants, we surveyed students using a structured survey distributed using the Google platform. This survey contained two parts; the first part focused on students’ demographics, while the second part assessed students’ knowledge of the causes, symptoms, risk factors, signs, physical examination, diagnosis workup, ER management, and surgical/medical management of AP. The second part of the survey was driven from a previously published study 16, 17. Total knowledge scores were calculated according to the modified Bloom’s cut-off point, with scores between 80% and 100% considered as good, 50% and 79% moderate, and less than 50% poor 18.

The data were extracted into Microsoft Excel spreadsheets. After checking for comprehensiveness and adjusting for minor typographical inaccuracies, these data were transferred into a spreadsheet in Statistical Package for the Social Sciences v. 23 (IBM, Armonk, NY). We used percentages for the categorical data, whereas we used mean ± standard deviation (SD) for the continuous data. A p-value of less than 5% was considered as significant. The Chi-square test was used to compare the categorical variables.

Results

Overall, 372 students in Umm Al-Qura University’s health-related departments were included in this survey. The mean age of contributors was 22.79 years (SD=1.45); the 23–25 age group was the most represented (n=237, 63.7%), while the 26–30 age group was the least (n=4, 1.1%). Most of the participants were men (n=305, 82%) and single (n=357, 96.0%) [Table 1].

Students from the College of Medicine were predominately represented (n=274, 73.7%), followed by the Colleges of Dentistry (n=49, 13.2%) and Pharmacy (n=35, 9.4%). Moreover, 5th-year students comprised the majority of the respondents (n=155, 41.7%), followed by 6th-year students (n=74, 19.9%). Regarding students’ awareness of ever having heard about acute pancreatitis, most had a good level of awareness (n=306, 82.3%) [Table 1].

A 21-item questionnaire was used to evaluate the level of knowledge of AP; students’ correct responses are shown in Table 2. More than 50% of the students provided the correct responses to the questions on AP’s causes, symptoms, clinical examination, hospitalization indications, risk factors, early and fluid resuscitation management.

According to the modified Bloom’s criteria used to calculate the knowledge score 18, most of the students had a poor level of knowledge of AP (n=209, 68.3%), while 97 (31.7%) had a moderate level [Figure 1]. None of our respondents showed a good level of knowledge.

Male participants had a significant association with knowledge of “signs and physical examination” and “diagnosis workup” (P value, 0.001, 0.006, respectively) [Table 3]. Conversely, “overviews: causes, symptoms, and risk factors”, “ER management”, and “surgical/medical management” showed no significant association with gender (P value, 0.688, 0.200, 0.878, respectively) [Table 2].

Moreover, 5th-year students, 6th-year students, and interns showed a significant association with “overviews: causes, symptoms, and risk factors”, “signs and physical examination”, “diagnosis workup”, and “ER management” (P value, 0.000, 0.009, 0.023, 0.000, respectively) [Table 4]. Furthermore, the College of Medicine corresponded more significantly to the subgroup questions of “signs and physical examination” (P value, 0.000) than the other health-related colleges. At the same time, no significant associations were found between the health colleges and other subgroup questions [Table 4]. Additionally, our results showed that health-related colleges corresponded significantly to the level of knowledge, especially the College of Medicine (P value, 0.013), whereas students’ age, gender, academic year, and marital status showed no statistically significant relations with the level of knowledge (P-value, 0.176, 0.526, 0.093, 0.360, respectively) [Table 5].

Discussion

Acute pancreatitis is a common GI disease that necessitates hospitalization and has high morbidity and mortality rates. Numerous care guidelines for AP management are available from medical and surgical societies 17, 19. Thus, surgeons and physicians must constantly be updated with evidence-based treatment and recommendations to provide and improve the healthcare quality critical to delivering high-quality care 17, 20-24.

Improper compliance to standard guidelines can be influenced by many circumstances, including clinicians’ lack of expertise and clinical decision support systems 17. It has been shown that once physicians are educated and clinical decision support systems are implemented to manage patients with AP, clinical outcomes improve and adherence to guidelines enhances 11, 17, 24.

Importantly, health-related students have a vital role to play in preventing and promoting AP as they become future healthcare providers. This is the first study to examine the awareness and level of knowledge of AP among health-related students in Saudi Arabia, to the best of our knowledge. This survey emphasized the knowledge gap and recommended strategies to increase awareness and knowledge. Additionally, the current study suggested that the knowledge of AP is still inadequate and could be improved.

The current study showed that awareness of having ever heard about AP is better than the level of knowledge. However, knowledge of AP’s causes, symptoms, and factors influencing the urgent hospitalization of patients with AP is lower than that for other subgroup questions. Furthermore, students have inadequate knowledge of the subgroups of questions focused on AP management. This finding is in line with the cross-sectional investigation conducted by Mehmood (2019) 17 in which the majority of residents inadequately recognized diagnosis workup plans and interventions compared with management strategies. Moreover, according to Mehmood (2019) 17, more educational programmes are vital to enhance the awareness of clinical practice guidelines for the early management of AP.

This study had some limitations, demanding further investigation among all health-related colleges in Saudi Arabia. Moreover, most of the respondents were 5th-year students, while 6th-year students’ and interns’ responses were insufficient.

Conclusion

Our findings suggest that students have a better awareness of AP than their level of knowledge. On the other hand, students respond well to AP patients’ questions about the causes, symptoms, and urgency of hospitalization of AP. We recommend further investigation and the development of an awareness programme on AP by health-related stakeholders.

Funding:

Nil

Conflict of interest:

Nil

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