Rajiv Gandhi University of Health Sciences Bangalore, Karnataka s16
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RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES BANGALORE, KARNATAKA
PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION
“A STUDY TO ASSESS KNOWLEDGE ON SELF-CARE ACTIVITIES AMONG ORTHOPAEDIC PATIENTS TO PREPARE LEARNING PACKAGE IN C.G. HOSPITAL DAVANGERE”
MR. RAVIKANT. N MANDRE FIRST YEAR M.SC. NURSING, MEDICAL SURGICAL NURSING
BAPUJI COLLEGE OF NURSING DAVANGERE-577 004. RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES BANGALORE, KARNATAKA.
SYNOPSIS PROFORMA FOR REGISTRATION OF SUBJECT FOR DESSERTATION.
1 Name of the Candidate MR. RAVIKANT. N. MANDRE with address FIRST YEAR M.Sc. NURSING, BAPUJI COLLEGE OF NURSING, DAVANGERE -4 KARNATAKA.
2 Name of the Institution BAPUJI COLLEGE OF NURSING, DAVANGERE-4
3 Course of Study & FIRST YEAR M.Sc. NURSING, Subject MEDICAL SURGICAL NURING
4 Date of admission to FIRST JUNE 2008 course
5 Title of the topic “ KNOWLEDGE ON SELF-CARE ACTIVITIES AMONG ORTHOPAEDIC PATIENTS TO PRAPARE LEARNING PACKAGE IN C.G. HOSPITAL. DAVANGERE.
6 BRIEF RESUME OF THE INTENDED WORK : INTRODUCTION : Self-care refers to those activities an individual performs independently throughout life to promote and maintain personal well-being. Orem’s self- care deficit theory explains not only when Nursing is needed but also how people can be assisted through five methods of helping, acting or doing for, guiding, teaching, supporting & providing an environment that promotes the individuals abilities to meet current & future demands1. Self-care means the individuals themselves handle the activities to present disease, to promote health, limit illness and restore functioning. By definition, a self-care deficit causes an alteration in ability to perform activities of daily living. In a culture that values independence, the inability to perform personal care tasks for oneself has significant psychological and physical implications2. In nursing self care is believed to be corner stone of the health promotion and the major nursing goal is to encourage. The nurse should foster self care in patients by providing information about nutrition, sleep, exercise, stress management, sexuality, psychological wellbeing, personal safety and environment management. In the hospital setting orthopedic patients stay in long duration and lack in personal hygiene and self-care activities 6.1 NEED FOR THE STUDY Most of the orthopedic patients are bedridden and of chronic type. They need long term care in the wards, but lack in personal hygiene nutrition, exercises, sleep etc. some of them are immobilized and they lack in knowledge of self care and intern affects their physical and mental health. The knowledge of self-care equip them to adjust to their surroundings and achieve optimum level of health. After hip Fracture and surgical repair, the client is likely to experience some degree of self care deficit in hygiene and dressing limited mobility may decrease independence in self-care and assistive devices may be required3. The orthopedic patient suffer with malnutrition, depression, insomnia, stress and pressure sores. So these problems can be prevented by providing sufficient knowledge and health education in self care. There is urgent need for the empowerment of knowledge through nursing staff in the ward. Patients have the right to participant in decisions regarding their health care plan and responsibility to participate to the extent possible in implementing it. Every patient has the having right to make appropriate arrangement to allow wellness healthcare to deliver, set up, and offer training on prescribed self-care techniques.
6.2 REVIEW OF LITERATURE The purpose for review of literature is to obtain comprehensive knowledge base and in depth of information from previous studies.
1. Marin R, Cyhan T, Miklos W : Am J Phys Med Rehabil 2006;85:
430-435.(2006)
This is a prospective cross section survey study on sleep disturbance in patients with chronic low back pain of 268 patients in the hospital setting, the survey consisted 43 item questionnaries the Pittsburgh sleep quality index
(PSQOI) a pain visual analog scale (VAS) and questions regarding bed type, sleep position and patients sleep description results reveal that there was significant relationship between sleep with a 55% increase in proportion of subjects reporting restless after pain onset, chronic low back pain significantly effects quality of sleep. Sleep problems should be addressed as an integral part of pain management plan4.
2. Madhuri Reddy, MD, MSc; Sudeep S. Gill, MD, MSc; Paula A
Rochon, MD, MPH JAMA 2006 ; 296: 974-984. (2006)
A descriptive study on preventing pressure ulcers : A systematic review conducted in 2006. Date sources and study selection from Medline, Embase and Cinahl, cohranne database searched to identify relevant randomized controlled trails (RCTs), 59 RCTs selected and grouped into 3 categories, impairment in mobility, nutrition or skin health, effective strategies that addressed impaired mobility included the use of support surfaces, mattress overlays on operating tables and surfaces, mattress overlays. There is a need for well designed RCTs that follow standard criteria for reporting non- pharmacological interventions and that provided data on cost effectiveness for these interventions5.
3. Johansson K, salantera S, Katajisto J. (2006)
An experimental study on empowering orthopedic patients through pre admission education result for a clinical study conducted in 2006, 123 elective hip orthroplasty patients grouped by random method group A (n=62) who received pre admission education as the concept map method written education material, & group B (n=61) who received the educational material non-systematic oral education. Data collected from both groups 4 wks prior to hospital admission, at admission and at discharge using questionnaries
Preadmission education using the concept map methods and written education material seems to yield better learning results than the use of written education material with non systematic oral education. Empowering preadmission education using concept method is beneficial for patients6.
4. Katja Heikkinen, Helena Leino-Kilpi, Ari Hiltunen Katija Heikkinen, Kirsi Johansoon, Anne Kalijonen, Sirkku Rakinen, et.al (2004)
A descriptive comparative cross sectional study (Pre and post test) on ambulatory orthopedic surgery patient knowledge expectations and perceptions of received from 120 consecutive patients, using hospital patient’s knowledge expectations scale and hospital patients received knowledge scale.
All patients participated in pre operative education. Session given by nurse patients knowledge expectation are greater than the knowledge they perceived that they receive, and they cannot become empowered if they lack imp.
Knowledge. Further research is needed to learn about meeting patients knowledge expectations7.
5. Kirsi Johansson RN, Lisamaija Nuutila MNSc Rn, Heli Vitrtanen
MNSc RN, Jaouko Katajistion, MSocSci and sanna Salaritera PhD RN.
(2003)
The descriptive study of on preoperative education for orthopaedic patients ; systematic review conducted in 2003. Studies included 1044 adult orthopedic patients based on randomised controlled or clinical trials. The education based on written materials and with other teaching methods. The most common outcome measures related to pain, knowledge, anxiety, exercises, length of stay and the least common to self efficiency and empowerment. The review clearly high lights the need for well designed, methodologically sound research into the out comes of patient education. It also points to the need to study patient education. From the point of view of empowerment8.
6. Kirsi Johansson, Sanna Salanteraa, Jouko Katajistob and Helena
Leino Kilpia. (2002)
A descriptive study on written patient education. Materials from the point of view of empowerment by education in 2002. 25 orthopedic patients selected this study. An analytics frame work was developed by panel of nursing scientists and clinical experts. The patient education materials evaluated. They are well prepared, but much was left to be desired with regard to contents and instructiveness. Development needs to focus on making better use of methods of visual representation; on increasing the coverage of content areas that so far have received less attention liked social experimental, ethical and financial empowerment9.
7. Melba Sheila DeSouza M.Sc. (N) M.Phil (N) (2002)
A descriptive explanatory study on effectiveness of nursing interventions in allevating perceived problems among orthopedic patients conducted in 2002, the purpose of the study to assess the effectiveness of Ng interventions in allevating the problems as perceived by 50 hospitalised orthopedic patients selected through convenience sampling structured interview schedule with 90 items and check list with 3 point rating designed.
Finding of study are most perceived problems urinary retention (46%) least is diarrhea (8%) pain (92%) foot drop (14%) no family support (8) financial problems (30%) unhapply with nurses attitude (20%). The most effective nursing measure in relieving anorexia – ensuring food provided in clean and pleasant environment (50%) administration of enema to relieve constipation
(100%) offering urinal and privacy (100%) psychological problems and information (50%) nurses explain (100%) psychological problems and information (50%) nurses explain (100%) there was no association between perceived problems and variables age durations of stay, immobility, sex etc.10
8. Veena Sharma. Lecturer, Rufaida College of Nursing Jamia Hamdard,
New Delhi. (2000)
A descriptive study on spinal cord injury and emotional problems
The research approach adopted is descriptive, co-relational survey. 31 spinal cord injury (SCI) patients in in-patients units of two selected hospitals in Delhi included in the study. Amritsar Depressive inventory developed by
Singh et al (1974) to asses depression. Data shows that SCI patients severly depressed 61.3%, 16% were probably depressed 22.5% were not depressed. The findings of study suggest that SSI patient were markedly anxious and depressed.
The existing health services have emphasized on physical health.
Psychologicl aspect of the health has been neglected. Nurses should participate in providing holistic health care and in rehabilitation of SCI patients by early detection of emotional problems and by taking individual, need based timely intervention to reduce these problems.11
6.3 Statement of problem :
“A study to assess knowledge on self care activities among orthopedic patients to prepare learning package in C.G. Hospital Davangere”.
6.4 Objective of the study :
i) To assess the knowledge of self care activities among orthopedic
patients.
ii) To prepare learning package on self care activities for orthopedic
patients.
iii) To find out association between knowledge of self care activities
with social demographic variable. 6.5 Hypothesis :
Orthopedic patients will gain knowledge regarding self-care actgiviteis.
6.6 Assumptions :
i) Orthopedic client may deficit knowledge regarding self-care activities
ii) Learning package will provide them more knowledge on self-care
activities.
Delimitations :
i) The study is limited to orthopedic patients.
ii) Orthopedic patients who have self-care deficit
Projected outcome :
The orthopedics patients will have enhancement in knowledge
regarding self care activities.
7 MATERIAL AND METHODS :
Source of Data Collection
The date will be collected from orthopedic patients who have self care
deficit at C.G. Hospital Davangere .
Research Design : Descriptive design Setting : The study will be conducted in male and female orthopedics wards
C.G. Hospital, Davangere.
Operational definition :
Assess : In this study it refers to organized systematic and continuous process of collecting data from orthopedic patient.
Self-care activities: In this study it refer to individuals themselves handle the activities to prevent disease, to promote health, limit illness and restore functioning.
Knowledge : In this study it refer to correct response of orthopedic clients with self-care activities items on the assessment by knowledge score.
Orthopaedic patients : In this study it refer to immobilised, bed ridden and ambulatory clients with fractures of various aspects of the body parts.
Population : In the study population consists of orthopedic patients with in self-care activities and who are admitted in male and female orthopedic ward of the item of study at C.G. Hospital Davangere.
Sample Size : The total study sample consists of 60 orthopedic patients with self-care deficit. Inclusive criteria for sampling :
a) Both male & female patients are included.
b) Patients in the age group of 20 -70 years of age will be included.
c) Patients with fractures and self care deficit.
d) Those who are willing to participate in the study.
Exclusive criteria :
a) Patient who are not willing to participate in the study.
b) Patient who are critically ill.
c) Ortho patients who are well in self care activities.
7.2 Method of data collection :
Sampling technique : Purposive sampling.
Step I : Socio-demographic data.
Step II : Structured questionnaire will be prepared to assess the knowledge on self-care activities of orthopedic patients.
7.2 Data Collection Method :
Step I : Investigator introduces himself to clients Step II : Administration on assessment of knowledge by giving questionnaire
on self-care activities.
Step III : Preparing learning package on self-care activities.
Step IV. Find out association between knowledge of self-care activities with
socio-demographic variables.
Plan for data analysis :
The data will be analysed by using appropriate statistical method and
the findings will be presented in the form of figures and tables.
7.3 DOES THE STUDY REQUIRE ANY INVESTIGATION OR INTERVENTION TO BE
CONDUCTED ON PATIENTS OR OTHER HUMANS OR ANIMALS? IF SO PLEASE
DESCRIBE BRIEFLY.
Yes. Learning Package will be prepared and provided on self-care
activities for orthopedic patients.
7.4 HAS ETHICAL CLEARANCE BEEN OBTAINED FROM YOUR INSTITUTION IN
CASE OF 7.3
Yes. Written permission will be obtained from institution as well as
from hospital. 8 List of references : 1. Fundaments of Ng concepts, process and practice. 7th edition : page ;77.
Author : Barbara Kozier. Glenore Erb. Audrey Berman Karen Burke.
2. Fundamentals of Ng : 5th edition : Page : 732 Author : Lippin cott
Williams & wilkins.
3. Medical Surgical Ng : 7th edition : Vol : 1. Page 643
Author : Yoce M Black, Jane Hokanson Hawks.
4. Marin R, Cyhan T, Miklos W: Sleep Disturbance in Patients with
chronic low back pain. Am j phys Med Rehabil 2006;85:430-435
5. Madhuri Reddy, MD, Msc; Sudeep S. Gill, MD, Msc; Paula A.
Rochon, MD, MPH Preventing Pressure Ulcers : A Systematic Review
JAMA. 2006; 296:974-984
6. Johansson K, Salantera s, Katajisto J, Empowering Orthopedic patients
through preadmission education : results from a clinical study.
University of turku, Department of nursing science, FIN 20014 Turku,
Finland.
7. Katja Heikkinen, Helena Leino Kilpi, Ari Hiltunen, Kirsi Johansson,
Anne Kaljonen, Sirkku Rankinen, et. Al. Ambulatory orthopedic
surgery patients knowledge expectations and perceptions of received
knowledge. Department of Nursing Science, University of Turku, Turku, Finland
8. Kirsi Johansson MNSc RN, Liisamajia Nuutila MNSc RN, Heli
Virtanen MNSc RN Jourko Katajisto MSocSci and Sanna Salantewra
PhD RN Preoperative education for orthopaedic patients : Systematic
review.
9. Kirsi Johansson, Sanna, Salantera, Jouko Katajisto and Helena Leino
Kilpi. Written orthopedic patient education materials from the point of
view of empowerment by education.
Department of Nursing Science, University of Turku, FIND 20014.
10. Melba Shelia DeSouza M.Sc., (N), M.Phil (N)
Assistant Proffessor, Karnatak, Laxmi Memorial College of Nursing,
India. Effectiveness of nursing interventions in alleviating perceived
problems among orthopaedic patients.
11. Veena Sharma. Lecturer, Rufaida College of Nursing, Jamia Hamdard,
New Delhi. Spinal Cord injury and Emotional Problems. Nursing
Journal of India. January 2005 vol. XCVI, No.1pg.no.12 -13