KNOWLEDGE, ATTITUDE AND PERCEPTION WITH REGARDS TO PREVENTION OF HYPERTENSION AMONG BANKERS IN MUSHIN LOCAL GOVERNMENT AREA, LAGOS, NIGERIA

CHAPTER ONE

INTRODUCTION

1.1       Background to the Study

Globally, hypertension is the third leading risk factor contributing to mortality and morbidity rate, and this is over powered only by malnutrition and smoking.The African continent is undergoing a double burden of disease, with Hypertension among the leading cause of non- communicable disease (WHO, 2012). The African region has the highest prevalence rate of hypertension with the estimate of 46% (WHO, 2013). Hypertension is said to be responsible for 45% of death due to heart disease and 51% of death due to stroke worldwide, and billions of people being affected globally (Addo, Smeeth & Leon, 2007; Kearney, Whelton, Reynolds, Muntner & Whelton, 2004; WHO, 2013).  In Nigeria, Hypertension is the most common cardiovascular disease reported, with the death rate of 13.62% per 100,000 population as at 2014 (Ogah, Madukwe, Chukwuonyi, Onyeonoro, Ukegbe &Akhimien, 2013; WHO 2014).

Sedentary lifestyle is one of the major risk factors of hypertension (Henson, Yates, Biddle, Edwardson & Khunti, 2013). Thus sedentary lifestyle can be seen as a social problem that requires attention. Jobs that require mostly sitting is high and occupations have become more sedentary and less physically active over the past few decades (Chau, van der Ploeg, Merom, Chey & Bauman, 2012; Vhurch, Thomas, Tudor-Locke, Katzmarzyk, Earnest, Rodarte et al., 2011). The occupations that are most at risk of prolonged sitting include office work, transportation, white collar jobs and highly mechanized trades (Owen, Healy, Mathew & Dunstan, 2010). Bankers in the banking halls  spend almost all  day sitting, which  include their customer service, cashiers, office assistance, and other members of staff (Jogunola & Awoyemi, 2010), people in these occupations typically spend a great deal of the working day sitting down. In a normal 16-hour day, it’s easily possible to spend over 80% of the time seated.

The increase in physical inactivity worldwide is considered by World Health Organization (WHO) to be an epidemic in both the developing and developed countries, with physical inactivity estimated to account for 6% of global deaths (WHO, 2009).  The WHO’s 2004 Global Strategy on Diet, Physical Activity and Health highlights the workplace as an important setting for health promotion stating that “Workplaces are important settings forhealth promotion and disease prevention…” Also, was the WHO’s Global Plan of Action on Worker’s Health 2008-2017, which specified that “Health promotion and prevention of non-communicable diseases should be further stimulated in the workplace, in particular by advocating healthy diet and physical activity among workers …”.  Promoting health in the workplace increases the chances of health and well-being focused on promoting worker health through reduction of individual risk-related behaviors such as a sedentary lifestyle (LeMontagne, 2004; Marshall, 2004; O’Donnell, 2002).

Only 9% of public sector bankers perform gym activity regularly (Naqvi, Zehra & Nizami, 2013).  Evidence shows that sedentary behavior is associated with greater waist-to-hip ratio, increased risk of low back pain, cancer, metabolic syndrome and all-cause and CVD mortality, cardiac complications, increased risk for certain cancers, early mortality, type2 diabetes, cardiovascular disease, and mortality (Proper, 2011; Roffey, 2010; Schmid & Leitzmann, 2014; Sisson, 2009; Thorp, Owen, Neuhaus & Dunstan, 2011; Wilmot, Edwardson, Achana, Davies, Gorely, Gray et al.,2012; Van Uffelen, 2010). There is a 15% increased risk of death in the next three years if you sit for 8-11 hours per day, when compared to those who sit for less than four hours per day. This risk increases to 40% for those who sit for greater than 11 hours per day (Parry & Straker, 2013; Smith, Hamer, Ucci, Marmot, Gardner, Sawyer et al.,2015; Van der Ploeg, Chey, Korda, Banks & Bauman, 2012).

With this in mind, sedentary behaviour is now being considered as a potential work health and safety issue (Straker, Coenen, Dunstan, Gilson & Healy, 2016) It has been established that 150 minutes of at least moderate intensity aerobic physical activity throughout the week to reduce the risk of chronic disease, albeit even when individuals engage in 150 min per week of physical activity, studies suggest that what happens in the remaining approximately 6500 minutes of the waking week is important for health (WHO, 2010). The longer the time spent sitting down each day, the higher the risk of dying prematurely, even if regular daily exercise is performed showing that the increase risk of mortality from time spent sitting appears to be independent of physical activity level (Hamilton, Genevieve, Dunstat, Zderic & Owen, 2008; Patel, 2010).

1.2       Statement of the Problem

It has been revealed that 30 minutes of physical activity or 10,000 steps per day produces significant clinical health benefits to an individual’s health, however, those in sedentary occupations are more likely to not meet the minimum requirements to experience the health benefits associated with physical activity (Le Masurier, Sidman, & Corbin, 2003) predisposing them to developing hypertension or other diseases due to sedentary lifestyle. It has been established that there is a high prevalence of sedentary lifestyle among bankers (Jogunola & Awoyemi, 2010) putting them at high level of susceptibility to hypertension and other cardiovascular diseases established to be as a result of sedentary lifestyle and most especially prolonged sitting (Proper, 2011; Roffey, 2010; Sisson, 2009; Thorp et al., 2011; Wilmot et al., 2012; Van Uffelen, 2010). However, there are no documented efforts at reducing these behaviors among the bankers. Workplace Health Promotion has over been under explored especially in combating sedentary lifestyle and promoting physical activities. From literature reviewed, it is evident that there are no studies that have comprehensively assessed the knowledge, attitude and perception of bankers to sedentary lifestyle and the availability of workplace health promotion promoting physical activities in Nigerian banks.

1.3       Objective of the Study

The main objective for the study was to assess Banker’s knowledge, attitude and perception on sedentary lifestyle as a predisposing factor to hypertension together with availability of workplace health promotion towards combating hypertension susceptibly among bankers in Mushin local government area of Lagos State.The specific objectives are to:

1. determine the knowledge of Respondents on sedentary lifestyle as a risk factor to hypertension;
2. assess the attitudinal disposition of Respondents towards sedentary lifestyle as a risk factor to hypertension;
3. identify perception of respondents towards sedentary lifestyle as a risk factor to hypertension;
4. enumerate the practice of sedentary lifestyle among respondents and
5. ascertain the availability of workplace health promotion to reduce sedentary lifestyle in Bank.

1.4       Research Questions

1. At what level is the knowledge of Respondents on sedentary lifestyle as a risk factor to hypertension?
2. What is the attitudinal disposition of Respondents towards sedentary lifestyle as a risk factor to hypertension?
3. What is the level of perception of respondents towards sedentary lifestyle as a risk factor to hypertension?
4. At what level is the practice of sedentary lifestyle among respondents?
5. Is there available workplace health promotion to reduce sedentary lifestyle in Bank?

1.5       Justification for the Study

Evidences have shown that office workers, most especially bankers, are at high risk of not only hypertension but also a number of cardiovascular diseases, reducing their life expectancy, this is due to their practice of sedentary lifestyle, prolonged siting to be specific. This community of people however can be less susceptible with improved health promotion practice which hasn’t been documented to be present in the Banking environment.

In light of this, it is important that this study be carried out to assess the knowledge, attitude and perception with regards to prevention of hypertension and also availability of workplace health promotion in the banking environment as an enabling factor to reduction of sedentary lifestyle among the selected population. This will give the needed foundation for intervention towards improving physical activities in Banks and also give a theoretically grounded evidence for further studies its will also bring about policies that will improve workplace health promotion and increase health literacy among bankers.

1.6       Hypotheses

H₁:       There is a significant relationship between the knowledge on sedentary

lifestyle as risk factor to hypertension and the practice of sedentary lifestyle among respondents.

H₂:       There is a significant relationship between the attitude towards sedentary

lifestyle as risk factor to hypertension and the practice of sedentary lifestyle among respondents.

H₃:       There is a significant relationship between the perception on sedentary

Lifestyle as risk factor to hypertension and the practice of sedentary lifestyle among respondents.

H₄:       There is a significant association between availability of workplace health

Promotion and the practice of sedentary lifestyle among respondents.

1.7       Operational Definition of Terms

1. Sedentarty life-style; it is a process in which one is inactive, motionless, sluggish or just sitting in a particular place for a long period of time.
2. Cardiovascular: anything relating to the circulatory system that is the heart and the blood vessels.
3. HRQL: health related quality of life.
4. CDC: center for disease control.
5. Modification: the action of modifying something that is making changes on anything.
6. Rehabilitation: it is a treatment or treatments designed to facilitate the process of recovery from injury, illness, or disease to as normal condition as possible.
7. Perception: the interpretation we give to information that get into our system or the way in which something is understood.
8. Predisposing: to make someone liable or inclined to a specific attitude, action or condition.

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