Background: Shoulder pain, a prevalent musculoskeletal condition, poses a significant threat to individuals' quality of life. Despite its impact, limited research has explored public awareness and knowledge concerning risk factors and prevention strategies for shoulder pain, particularly in the unique demographic and geographical context of Himachal Pradesh. This study, named "Shoulder Savvy Himachal," aims to address this gap by conducting a comprehensive assessment of the awareness landscape in the region. Materials and Methods: Utilizing a descriptive cross-sectional survey design, the study focused on Himachal Pradesh's adult population, with a sample size of 400 residents. A Google Form questionnaire, encompassing socio-demographic details and 20 knowledge-related questions on shoulder pain, was employed. Data collection occurred from July to October 2023 through online platforms like email and social media. Analysis was conducted using Epi Info V7 software, employing appropriate statistical tests. Results: The study revealed a notable awareness level among participants, with 80.25% recognizing shoulder pain and its causes. Lifestyle factors were acknowledged by 66.25%, while 72.25% emphasized the role of diet in shoulder health. Notably, 29.75% exhibited very good knowledge, 33% good knowledge, 24.5% fair knowledge and 12.75% poor knowledge regarding shoulder pain's risk and preventive factors. Conclusion: The "Shoulder Savvy Himachal" study sheds light on the commendable awareness of shoulder pain in Himachal Pradesh, emphasizing the significance of preventive measures. Identified gaps, including the need for improved public health campaigns and workplace ergonomics, pave the way for targeted interventions.
Shoulder pain is a prevalent musculoskeletal condition that can significantly impact the quality of life of individuals, affecting their daily activities and overall well-being. Recognizing the importance of addressing this health concern, "Shoulder Savvy Himachal" aims to conduct a comprehensive assessment of public awareness and knowledge on risk factors and prevention strategies for shoulder pain among the general population of Himachal Pradesh. Understanding the factors contributing to shoulder pain and promoting preventive measures is crucial for minimizing the burden of this condition on individuals and the healthcare system [1-3].
The shoulder is a complex and highly mobile joint that plays a vital role in various activities, including lifting, reaching and throwing. Despite its importance, shoulder pain is often underestimated, leading to delayed diagnosis and management. The etiology of shoulder pain is multifactorial, encompassing a range of causes such as rotator cuff injuries, overuse, trauma and inflammatory conditions. Prevention and early intervention strategies are key to reducing the incidence and severity of shoulder pain, emphasizing the need for a well-informed and proactive public [4-7].
The state of Himachal Pradesh, nestled in the lap of the Himalayas, has a unique demographic and geographical profile. Despite the prevalence of shoulder pain, public awareness and knowledge regarding its risk factors and preventive strategies remain understudied, especially in the context of Himachal Pradesh. This study seeks to contribute valuable insights that can inform public health initiatives, educational campaigns and healthcare policies tailored to the unique needs of the Himachal Pradesh population.
By evaluating the existing awareness levels, the study aims to identify gaps and misconceptions that may hinder effective prevention and management of shoulder pain. Moreover, the findings could serve as a foundation for developing targeted educational programs to enhance public knowledge and promote proactive measures for shoulder health.
Objectives of the Study
To evaluate the awareness and knowledge regarding risk and Preventive Factors for Shoulder Pain among general public of Himachal Pradesh.
Research Approach: Descriptive
Research Design: Cross-sectional survey design
Study Area: State of Himachal Pradesh
Study Duration: Between July 2023 to October 2023
Study Population: The study's target population encompassed all adults aged 18 and above who had been residents of Himachal Pradesh for a minimum of 12 months
Sample Size: A robust sample size of 400 adults was determined using a 95% confidence level, an estimated knowledge level of 50% regarding risk and Preventive Factors for Shoulder Pain, a precise 5% absolute error margin and a conservative 5% non-response rate
Study Tool: A google form questionnaire consisting of questions regarding socio-demography and knowledge regarding risk and Preventive Factors for Shoulder Pain was created. The questionnaire was initially pre-tested on a small number of participants to identify any difficulty in understanding by the respondents
Description of Tool
Demographic Data Survey Instrument: The demographic form elicited information on participants’ background: age, marital status, religion, employment, education and many more
Questionnaire: The questionnaire contains 20 structured knowledge related questions regarding risk and Preventive Factors for Shoulder Pain. One mark was given for each correct answer and zero for incorrect answer. The maximum score was 20 and minimum score was zero. Scoring was done on the basis of marks as >80% (16-20) = very good, 60-79% (12-15) = Good, 41-59% (8-11) = Fair, <40% (<8) = poor
Validity of Tool: By the experts in this field
Data Collection: Data was collected under the guidance of supervisors. The google form questionnaire was circulated among the residents of Himachal Pradesh for responses using online modes like e-mail and social media platforms like Whatsapp groups, Facebook, Instagram and Linkedin till the 400 responses were collected
Data Analysis: Data was collected and entered in Microsoft excel spread sheet, cleaned for errors and analyzed with Epi Info V7 Software with appropriate statistical test in terms of frequencies and percentage.
Ethical Considerations: Participants confidentiality and anonymity was maintained
The goal of the current study was to assess the knowledge regarding risk and Preventive Factors for Shoulder Pain among general public of Himachal Pradesh through a non-experimental descriptive survey. A total of 400 respondents including 203 (50.75%) were from urban area and 197 (49.25%) were from rural area were participated in the study (Table 1).
Table 1: Knowledge Regarding Risk and Preventive Factors for Shoulder Pain among Study Participants
| Statements | Frequency of Correct Responses | % |
Are you aware of what shoulder pain is and its common causes? | 321 | 80.25 |
Can you identify any specific risk factors that may contribute to the development of shoulder pain? | 276 | 69 |
Do you think lifestyle factors, such as occupation or daily activities, play a role in the occurrence of shoulder pain? | 265 | 66.25 |
Have you ever experienced shoulder pain and if so, what preventive measures, if any, do you take to minimize its occurrence? | 253 | 63.25 |
Are you familiar with the concept of ergonomics and its relevance in preventing shoulder pain? | 204 | 51 |
How often do you engage in exercises or activities specifically targeting shoulder health? | 262 | 65.5 |
Are there any cultural or regional practices in Himachal Pradesh that you believe may influence the prevalence of shoulder pain? | 279 | 69.75 |
Do you think awareness about shoulder pain is adequately addressed in public health campaigns or educational programs in Himachal Pradesh? | 203 | 50.75 |
Can you identify signs or symptoms that may indicate an increased risk of developing shoulder pain? | 234 | 58.5 |
Are there any misconceptions about shoulder pain that you have come across within your community? | 198 | 49.5 |
How would you rate your knowledge about the impact of posture on shoulder health? | 238 | 59.5 |
Are there specific age groups or demographics that you think are more susceptible to shoulder pain and why? | 210 | 52.5 |
Have you ever sought professional advice or treatment for shoulder pain and if so, what was your experience? | 196 | 49 |
Are there any traditional remedies or practices in Himachal Pradesh believed to alleviate or prevent shoulder pain? | 258 | 64.5 |
What role do you believe diet and nutrition play in maintaining shoulder health? | 289 | 72.25 |
Do you think there is enough emphasis on workplace ergonomics to prevent shoulder pain in occupational settings? | 176 | 44 |
Are you aware of any community-based initiatives or programs that focus on shoulder health in Himachal Pradesh? | 128 | 32 |
How important do you think early intervention is in preventing the progression of shoulder pain? | 255 | 63.75 |
Are you familiar with the role of stress and mental health in relation to shoulder pain? | 190 | 47.5 |
What, in your opinion, could be done to improve awareness and knowledge about risk and preventive factors for shoulder pain in Himachal Pradesh? | 216 | 54 |
Table 2: Knowledge Scores towards risk and Preventive Factors for Shoulder Pain among Study Participants
| Category (Marks) | Frequency (n = 400) | % |
| V. Good (16-20) | 119 | 29.75 |
| Good (12-15) | 132 | 33 |
| Fair (8-11) | 98 | 24.5 |
| Poor (<8) | 51 | 12.75 |
In the present study 29.75% (119) participants had very good knowledge (16-20 marks) towards risk and Preventive Factors for Shoulder Pain, 33% (132) had good knowledge (12-15 marks), 24.5% (98) had fair knowledge (8-11 marks) and 12.75% (51) having poor knowledge (<8 marks) (Table 2).
The insights gained from the "Shoulder Savvy Himachal" study offer a nuanced understanding of the awareness and knowledge levels regarding risk factors and prevention strategies for shoulder pain in the general public of Himachal Pradesh. This study, encompassing a diverse sample from urban and rural areas, not only reflects global trends in musculoskeletal health but also brings to light unique regional considerations.
The study's participants displayed a commendable awareness of shoulder pain and its common causes, aligning with global recognition of musculoskeletal health. This understanding is pivotal for early recognition and intervention, as demonstrated by similar studies conducted in urban settings in India [7].
The acknowledgement of lifestyle factors contributing to shoulder pain is crucial, echoing findings from a study conducted in South India that emphasized the impact of occupational demands on musculoskeletal health [8]. This underlines the need for tailored interventions considering occupational ergonomics and lifestyle modifications.
The positive association between engaging in shoulder-specific exercises and awareness of ergonomics aligns with existing literature emphasizing the effectiveness of exercise and ergonomic interventions in preventing shoulder pain, as observed in a study conducted in Maharashtra [9].
Participants recognized the potential influence of cultural and regional practices on shoulder pain. While this finding resonates with our understanding, further qualitative research, similar to studies conducted in diverse cultural settings in India [10], may unveil specific cultural practices affecting shoulder health in Himachal Pradesh.
Approximately half of the respondents expressed the need for more attention in public health campaigns and educational programs. This finding echoes the sentiments expressed in studies conducted in various Indian states, emphasizing the importance of targeted health education programs to bridge existing awareness gaps [11].
Recognition of traditional remedies and the perceived role of diet and nutrition in maintaining shoulder health signifies an integration of cultural beliefs into health practices. Similar studies conducted in Gujarat [12], have highlighted the importance of incorporating traditional wisdom into healthcare initiatives for enhanced community engagement.
The study identified a need for increased emphasis on workplace ergonomics, especially in occupational settings. This resonates with findings from studies conducted in urban workplaces in India, emphasizing the role of ergonomic interventions in preventing work-related musculoskeletal disorders [13].
A relatively lower awareness of community-based initiatives focusing on shoulder health suggests an area for improvement. This finding aligns with studies conducted in rural communities in India [14], indicating the need for collaborative efforts involving community leaders and healthcare providers to enhance program reach and impact.
A substantial proportion recognized the importance of early intervention, aligning with evidence from studies conducted in India emphasizing the benefits of early diagnosis and intervention in musculoskeletal conditions [15].
The study population showed awareness of the potential role of stress and mental health in relation to shoulder pain. Similar findings have been observed in studies conducted in India, highlighting the growing recognition of psychosocial factors influencing musculoskeletal health [16].
Participants' suggestions for improvement provide valuable insights that can inform the development of targeted interventions and campaigns, as observed in similar studies conducted in Indian populations [17].
When comparing these findings with studies conducted in various Indian states, it is evident that while there are commonalities, there are also distinct regional variations. The regional context, cultural practices and healthcare infrastructure significantly influence the knowledge landscape, emphasizing the need for tailored interventions in each setting.
Limitations
While the present study provides valuable insights, it is essential to acknowledge its limitations. The use of an online survey may introduce selection bias, as it primarily captures responses from individuals with internet access. The cross-sectional design limits the establishment of causation, offering a snapshot rather than a longitudinal perspective. Additionally, the reliance on self-reported data poses a risk of recall bias, influencing the accuracy of participants' responses. Despite these limitations, the study serves as a crucial starting point for understanding shoulder health awareness in Himachal Pradesh.
In conclusion, the "Shoulder Savvy Himachal" study has provided invaluable insights into the awareness and knowledge levels surrounding risk factors and prevention strategies for shoulder pain among the diverse population of Himachal Pradesh. The commendable awareness exhibited by participants regarding shoulder pain causes, lifestyle factors and the significance of preventive measures underscores the potential for proactive public health interventions. While the study has highlighted areas of strength, such as the acknowledgment of cultural influences and the importance of early intervention, it also brings attention to specific gaps, including the need for enhanced public health campaigns and workplace ergonomics. By comparing these findings with relevant Indian studies, we've contextualized the results within the broader landscape of musculoskeletal health in the country, emphasizing the importance of tailoring interventions to regional nuances. This study lays the foundation for targeted educational programs and community-based initiatives that can bridge existing gaps, ultimately contributing to improved shoulder health awareness and practices in the unique setting of Himachal Pradesh.
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