International Journal of Biomedical and Clinical Sciences
Articles Information
International Journal of Biomedical and Clinical Sciences, Vol.6, No.2, Jun. 2021, Pub. Date: May 15, 2021
Knowledge, Attitudes, Perceptions and Practice About Vitamin D, Its Deficiency, and Management Amongst Undergraduate Medical Students
Pages: 44-57 Views: 1102 Downloads: 292
Authors
[01] Shalini Krishnappan, Faculty of Medicine, Melaka-Manipal Medical College, Manipal Academy of Higher Education (MAHE), Melaka, Malaysia.
[02] Azel Azam Nair, Faculty of Medicine, Melaka-Manipal Medical College, Manipal Academy of Higher Education (MAHE), Melaka, Malaysia.
[03] Sanjei Basker, Faculty of Medicine, Melaka-Manipal Medical College, Manipal Academy of Higher Education (MAHE), Melaka, Malaysia.
[04] Vinithaa Gunasagaran, Faculty of Medicine, Melaka-Manipal Medical College, Manipal Academy of Higher Education (MAHE), Melaka, Malaysia.
[05] Rhimaza Abdul Rishad, Faculty of Medicine, Melaka-Manipal Medical College, Manipal Academy of Higher Education (MAHE), Melaka, Malaysia.
Abstract
We being medical students have a rudimentary understanding of the metabolism and functions of Vitamin D but how well can that be translated to everyday life. We aimed to find out the knowledge, attitude and perception about Vitamin D, its deficiency and management amongst undergraduate medical students. A cross-sectional study was conducted amongst fourth- and fifth-year clinical phase medical students of Melaka Manipal Medical College. An online questionnaire was distributed via google forms and a total of 110 total responses were collected. The data was then analyzed statistically using Epi info software version 7.2.4.0. Unpaired T-test, ANOVA, X2 and logistic regression tests were used to analyze the data. The findings show that 82.73% of participants obtained a low knowledge score. A massive 91.82% participants obtain their Vitamin D information via university lecture classes. In regard to, to attitude, the majority of participants 67.27% have a poor attitude towards sunlight exposure. 71.82% of participants do not take a vitamin D supplement. This study shows that there is a significant association (P-value= 0.030) between race of participant and the attitude towards sunlight exposure. A significant positive association was established between the presence of a history of familial Vitamin D deficiency with the consumption of Vitamin D supplements (OR=16.23, 95% CI=2.96-88.93, P-value <0.001, X2 value=14.97). However, there was no association between the year of study and the knowledge of participants. In summary, it is clear that both Knowledge and attitude of participants are clearly underwhelming. The perception of participants towards Vitamin D is very low. Thus, it is clear that we make the recommendation to the institute to emphasize and increase student participation in relation towards said students knowledge of Vitamin D and its deficiency so that when said students become practitioners of medicine they will not miss a diagnosis of Vitamin D deficiency.
Keywords
Knowledge, Attitudes, Perception, Practice, Vitamin D Deficiency, Medical Students
References
[01] Ellison DL, Moran HR. Vitamin D: Vitamin or Hormone? Nurs Clin North Am. 2021 Mar;56(1):47-57. doi: 10.1016/j.cnur.2020.10.004. Epub 2020 Dec 28. PMID: 33549285.
[02] Latic N, Erben RG. Vitamin D and Cardiovascular Disease, with Emphasis on Hypertension, Atherosclerosis, and Heart Failure. Int J Mol Sci. 2020 Sep 4;21(18):6483. doi: 10.3390/ijms21186483. PMID: 32899880; PMCID: PMC7555466.
[03] Pereira M, Ribas de Farias Costa P, Miranda Pereira E, Russoni de Lima Lago I, Marlucia Oliveira A. Does vitamin D deficiency increase the risk of obesity in adults and the elderly? A systematic review of prospective cohort studies. Public Health. 2021 Jan;190:123-131. doi: 10.1016/j.puhe.2020.04.031. Epub 2021 Jan 13. PMID: 33453688.
[04] Grant WB, Holick MF. Benefits and requirements of vitamin D for optimal health: a review. Altern Med Rev. 2005 Jun; 10(2): 94-111. PMID: 15989379.
[05] Khan AW, Zadran N, Khan A, Ishaq M, Kumar J, Ibrar A, Tahir A. Vitamin D Levels and Bone Mineral Density in Premenopausal Women Compared to Postmenopausal Women: A Multi-Centre Study From Pakistan. Cureus. 2020 Nov 11;12(11):e11439. doi: 10.7759/cureus.11439. PMID: 33324522; PMCID: PMC7732786.
[06] Tabrizi R, Moosazadeh M, Akbari M, Dabbaghmanesh MH, Mohamadkhani M, Asemi Z, Heydari ST, Akbari M, Lankarani KB. High Prevalence of Vitamin D Deficiency among Iranian Population: A Systematic Review and Meta-Analysis. Iran J Med Sci. 2018 Mar;43(2):125-139. PMID: 29749981; PMCID: PMC5936844.
[07] Mendes MM, Hart KH, Lanham-New SA, Botelho PB. Exploring the Impact of Individual UVB Radiation Levels on Serum 25-Hydroxyvitamin D in Women Living in High Versus Low Latitudes: A Cross-Sectional Analysis from the D-SOL Study. Nutrients. 2020 Dec 11;12(12):3805. doi: 10.3390/nu12123805. PMID: 33322498; PMCID: PMC7764022.
[08] Al-Yatama FI, AlOtaibi F, Al-Bader MD, Al-Shoumer KA. The Effect of Clothing on Vitamin D Status, Bone Turnover Markers, and Bone Mineral Density in Young Kuwaiti Females. Int J Endocrinol. 2019 Jun 23;2019:6794837. doi: 10.1155/2019/6794837. PMID: 31341474; PMCID: PMC6612396.
[09] Alamoudi LH, Almuteeri RZ, Al-Otaibi ME, Alshaer DA, Fatani SK, Alghamdi MM, Safdar OY. Awareness of Vitamin D Deficiency among the General Population in Jeddah, Saudi Arabia. J Nutr Metab. 2019 Mar 3;2019:4138187. doi: 10.1155/2019/4138187. PMID: 30944738; PMCID: PMC6421804.
[10] Pettifor JM, Thandrayen K, Thacher TD. Vitamin D Deficiency and Nutritional Rickets in Children [Internet]. Vitamin D (Fourth Edition). Academic Press; 2017 [cited 2020Dec24]. Available from: https://www.sciencedirect.com/science/article/pii/B9780128099636000675?via=ihub
[11] Nowreen, Nida & Hameed, Reqaya. (2019). Awareness regarding the importance of vitamin D and prevention of its deficiency among female undergraduate medical students. International Journal of Basic & Clinical Pharmacology. 8. 10.18203/2319-2003.ijbcp20191563.
[12] Palacios C, Gonzalez L. Is vitamin D deficiency a major global public health problem? J Steroid Biochem Mol Biol. 2014 Oct; 144 Pt A: 138-45. doi: 10.1016/j.jsbmb.2013.11.003. Epub 2013 Nov 12. PMID: 24239505; PMCID: PMC4018438.
[13] Qureshi AZ, Zia Z, Gitay MN, Khan MU, Khan MS. Attitude of future healthcare provider towards vitamin D significance in relation to sunlight exposure. Saudi Pharmaceutical Journal: SPJ: the Official Publication of the Saudi Pharmaceutical Society. 2015 Oct; 23 (5): 523-527. DOI: 10.1016/j.jsps.2015.01.004.
[14] Bothmer MIKV, Fridlund BIKV. Gender differences in health habits and in motivation for a healthy lifestyle among Swedish university students [Internet]. Wiley Online Library. John Wiley & Sons, Ltd; 2005 [cited 2020Dec24]. Available from: https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1442-2018.2005.00227.x
[15] Edmonds ET. Osteoporosis knowledge, beliefs, and behaviours of college students: utilization of the health belief model [dissertation], Abstracts International Section A: Humanities and Social Science. 70: 2908, 2009.
[16] Geddawy A, Al-Burayk AK, Almhaine AA, Al-Ayed YS, Bin-Hotan AS, Bahakim NO, Al-Ghamdi S. Response regarding the importance of vitamin D and calcium among undergraduate health sciences students in Al Kharj, Saudi Arabia. Arch Osteoporos. 2020 Jul 23; 15 (1): 114. doi: 10.1007/s11657-020-00790-9. PMID: 32705622; PMCID: PMC7376825.
[17] Von Ah D; Ebert S; Ngamvitroj A; Park N; Kang DH; Predictors of health behaviours in college students [Internet]. Journal of advanced nursing. U.S. National Library of Medicine; [cited 2020Dec24]. Available from: https://pubmed.ncbi.nlm.nih.gov/15533084/
[18] Haase A, Phil ASD, Sallis JF, Wardle J. Leisure-time physical activity in university students from 23 countries: associations with health beliefs, risk awareness, and national economic development. Preventive Medicine [Internet]. 2004 Jul; 39 (1): 182-190. Available from: https://www.sciencedirect.com/science/article/abs/pii/S009174350400060X Subscription required.
[19] Roth, D., Al., E., Author Affiliations From the Department of Pediatrics (D. E. R., Others, J., F. P. Polack and Others, & S. S. Abdool Karim and T. de Oliveira. (2018, November 08). Vitamin D supplementation in pregnancy and lactation and INFANT Growth: Nejm. Retrieved April 03, 2021, from https://www.nejm.org/doi/full/10.1056/NEJMoa1800927
[20] Tariq A, Khan SR, Basharat A. Assessment of knowledge, attitudes and practice towards Vitamin D among university students in Pakistan. BMC Public Health. 2020 Mar 18; 20 (1): 355. doi: 10.1186/s12889-020-8453-y. PMID: 32183774; PMCID: PMC7079348.
[21] Quah SW, Abdul Majid H, Al-Sadat N, Yahya A, Su TT, Jalaludin MY. Risk factors of vitamin D deficiency among 15-year-old adolescents participating in the Malaysian Health and Adolescents Longitudinal Research Team Study (MyHeARTs). PLoS ONE [Internet]. 2018 Jul 19; 13 (7): e0200736. Available from: https://doi.org/10.1371/journal.pone.0200736
[22] Woon FC, Chin YS, Ismail IH, Batterham M, Abdul Latiff AH, Gan WY, et al. (2019) Vitamin D deficiency during pregnancy and its associated factors among third trimester Malaysian pregnant women. PLoS ONE 14 (6): e0216439. https://doi.org/10.1371/journal.pone.0216439
[23] Al-Sadat N, Majid HA, Sim PY, Su TT, Dahlui M, Bakar MFA, et al. Vitamin D deficiency in Malaysian adolescents aged 13 years: findings from the Malaysian Health and Adolescents Longitudinal Research Team study (MyHeARTs). BMJ Open [Internet]. 2016 Aug; 6 (8): e010689. doi: 10.1136/bmjopen-2015-010689.
[24] Josh Mitteldorf. (2021, March 21). Weight and Aging: A Paradox, Part 2. Retrieved April 04, 2021, from https://joshmitteldorf.scienceblog.com/2021/03/21/weight-and-aging-a-paradox-part-2/
[25] Teixeira JS, Bull Ferreira Campos A, Cordeiro A, Pereira SE, Saboya CJ, Ramalho A. Vitamin D nutritional status and its relationship with metabolic changes in adolescents and adults with severe obesity. Nutr Hosp. 2018 Aug 2;35(4):847-853. doi: 10.20960/nh.1657. PMID: 30070873.
[26] Blebil AQ, Dujaili J, Teoh E, Wong PS. KC B. Assessment of Awareness, Knowledge, Attitude, and the Practice of Vitamin D among the General Public in Malaysia. Journal of Karnali Academy of Health Sciences. 2019 Dec 11; 2 (3): 171-180.
[27] Jamil NA, Shahudin NN, Abdul Aziz NS, et al. Knowledge, Attitude and Practice Related to Vitamin D and Its Relationship with Vitamin D Status among Malay Female Office Workers. Int J Environ Res Public Health. 2019 Nov 27; 16 (23): 4735. doi: 10.3390/ijerph16234735.
[28] Green LW and Kreuter MW, Health Program Planning: An Educational and Ecological Approach, McGraw-Hill, New York, NY, USA, 4th edition, 2005.
[29] Brewster, Amanda L.; Wilson, Traci L.; Curry, Leslie A. ; Kunkel, Suzanne R. ; Achieving Population Health impacts through Health Promotion Programs Offered by Community-based Organizations, Medical Care, Volume 59, Number 3, 11 March 2021, pp. 273-279 (7), Wolters Kluwer, DOI: https://doi.org/10.1097/MLR.0000000000001492
[30] Lhamo Y, Chugh PK, Gautam SR, Tripathi CD. Epidemic of Vitamin D Deficiency and Its Management: Awareness among Indian Medical Undergraduates. J Environ Public Health. 2017; 2017: 2517207. doi: 10.1155/2017/2517207. Epub 2017 Apr 3. PMID: 28473860; PMCID: PMC5394390.
[31] O’Connor C, Glatt D, White L, Iniesta RR. Knowledge, Attitudes and Perceptions towards Vitamin D in a UK Adult Population: A Cross-Sectional Study. Int. J. Environ. Res. Public Health [Internet]. 2018; 15 (11): 2387. Available from: https://www.mdpi.com/1660-4601/15/11/2387/htm#B15-ijerph-15-02387
[32] Alaa Al Amiry, Moyad Shahwan, Vitamin D deficiency and associated factors among Ajman university students, United Arab Emirates, Obesity Medicine, Volume 17, 2020, 100176, ISSN 2451-8476, https://doi.org/10.1016/j.obmed.2019.100176
[33] Moore CE, Radcliffe JD, Liu Y. (2013). Vitamin D intakes of adults differ by income, gender and race/ethnicity in the USA, 2007 to 2010. Public Health Nutrition, 17 (4), 756–763. https://doi.org/10.1017/s1368980013002929.
[34] The Causes of Vitamin D Deficiency are Probably NOT What You Think! (n.d.). Retrieved January 25, 2021, from https://www.easy-immune-health.com/Causes-of-Vitamin-D-Deficiency.html
[35] Verdoia M, Schaffer A, Barbieri L, Giovine G, Marino P, Suryapranata H, Luca G. (2015, February 07). Impact of gender difference on vitamin D status and its relationship with the extent of coronary artery disease. Retrieved January 25, 2021, from https://www.sciencedirect.com/science/article/abs/pii/S0939475315000277
[36] Ministry of Health Malaysia. RNI Recommended Nutrient Intakes for Malaysia. Putrajaya; 2017. Available from: https://expert.taylors.edu.my/file/rems/publication/107126_3033_1.pdf
[37] Chittari V. Harinarayan, Michael F, Holick, Upadrasta V, Prasad, Palavali S, Vani, Himabindu G. Vitamin D status and sun exposure in India. Dermato-Endocrinology. 2013; 5 (1) 130-141. Referenced in doi: 10.4161/derm.23873.
[38] Institute of Medicine (US) Committee to Review Dietary Reference Intakes for Vitamin D and Calcium; Ross AC, Taylor CL, Yaktine AL, et al., editors. Dietary Reference Intakes for Calcium and Vitamin D. Washington (DC): National Academies Press (US); 2011. 5, Dietary Reference Intakes for Adequacy: Calcium and Vitamin D. Available from: https://www.ncbi.nlm.nih.gov/books/NBK56056/
[39] Soliman A. Vitamin D deficiency: A major global epidemic that requires effective strategy and guidelines for management. Indian J Endocrinol Metab. 2016; 0 (0): 0. Referenced in doi: 10.4103/2230-8210.194345
[40] Kotta S, Gadhvi D, Jakeways N, Saeed M, Sohanpal R, Hull S, Famakin O, Martineau A, Griffiths C. "Test me and treat me"--attitudes to vitamin D deficiency and supplementation: a qualitative study. BMJ Open. 2015 Jul 14; 5 (7): e007401. doi: 10.1136/bmjopen-2014-007401. PMID: 26173717; PMCID: PMC4513450. Deschasaux M, Souberbielle JC, Partula
[41] V, Lécuyer L, Gonzalez R, Srour B, Guinot C, Malvy D, Latino-Martel P, Druesne-Pecollo N, Galan P, Hercberg S, Kesse-Guyot E, Fassier P, Ezzedine K, Touvier M. What Do People Know and Believe about Vitamin D? Nutrients. 2016 Nov 11; 8 (11): 718. doi: 10.3390/nu8110718. PMID: 27845705; PMCID: PMC5133104.
[42] Salmanpour VA, Ibrahim HS, Salameh AG, Yahya AM, Debal BK. Vitamin D deficiency: knowledge and practices among the adult population in Sharjah, United Arab Emirates. Arch Osteoporos. 2016; 11: 15. doi: 10.1007/s11657-016-0269-0. Epub 2016 Mar 30. PMID: 27026018.
[43] Almuqati, R., Alamri, A., & Almuqati, N. (2019, January 23). Knowledge, attitude, and practices toward sun exposure and use of sun protection among non-medical, female, university students in Saudi Arabia: A cross-sectional study. Retrieved April 04, 2021, from https://www.sciencedirect.com/science/article/pii/S2352647518300728.
[44] Alzaman NS, Dawson-Hughes B, Nelson J, D'Alessio D, Pittas AG. Vitamin D status of black and white Americans and changes in vitamin D metabolites after varied doses of vitamin D supplementation. Am J Clin Nutr. 2016 Jul; 104 (1): 205-14. doi: 10.3945/ajcn.115.129478. Epub 2016 May 18. PMID: 27194308; PMCID: PMC4919528.
[45] Poh BK, Rojroongwasinkul N, Nguyen BK, Sandjaja, Ruzita AT, Yamborisut U, Hong TN, Ernawati F, Deurenberg P, Parikh P; SEANUTS Study Group. 25-hydroxy-vitamin D demography and the risk of vitamin D insufficiency in the South East Asian Nutrition Surveys (SEANUTS). Asia Pac J Clin Nutr. 2016; 25 (3): 538-48. doi: 10.6133/apjcn.092015.02. PMID: 27440689.
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