The Journal of Advanced Health Informatics Vol. 1 Issue. 4 July-Dec. 2018
The Journal of Advanced The Journal of Advanced Health Informatics Health Informatics JAHI
ISSN: e – 2456-9313 Available from URL: http://mbnc.edu.in/UTUJAHI.html
RESEARCH ARTICLE The Effect of Aerobic Exercises on Reduction of Dysmenorrhoea among Adolescent Girls
Mrs.Nimmy Augustine, Mrs. Sudha Maheswari, Sr. Jacintha D’Souza Lourde College of Nursing, Taliparamba, Kannur.
ARTICLE INFO ABSTRACT Article History: Dysmenorrhea is the most common gynecologic complaint among adolescent Received 10th Sept, 2018 females. It is usually primary, and is associated with normal ovulatory cycles and
th with no pelvic pathology. An evaluatory approach with Quasi experimental (non- Received in revised form 26 Sept,2018 equivalent control group) design was used for the study. The sample consisted of 30 adolescent girls (15+15) selected by purposive sampling technique. Data were Accepted on 1st Oct. 2018 collected using dysmenorrhoea assessment scale which included descriptive pain Published online on 4th Oct. 2018 scale and symptom rating scale, prepared by the investigator. Aerobic exercises were taught and supervised by the investigator. The mean percentage of post test dysmenorrrhoea score (54.58) was lower than the pre test score (83.87) in the Key Words: experimental group which was significant at 0.05 level. The statistical analysis Aerobic, Exercise, Dysmenor- showed a significant reduction in the severity of dysmenorrhoea among adoles- cent girls in the experimental group after the introduction of aerobic exercises rhoea, Adolescent. (t14=19.21). The mean percentage of post-test dysmenorrhoea scores (54.58) of experimental group was less than the post test dysmenorrhoea scores (64.58) of the control group. The‘t’ value computed between the experimental and control Corresponding Author: group after the intervention was statistically significant at 0.05 level. (t28=12.06). Mrs. Nimmy Augustine, The findings of the study showed that dysmenorrhoea scores of adolescent girls Lourde College of Nursing, Talipa- in experimental group reduced after the aerobic exercises, whereas, it remained the same in control group. The adolescent care providers’ role is to explain the ramba, Kannur. pathophysiology of dysmenorrrhoea to every adolescent female, address any con- cern that the adolescent has, about her menstrual period, and review effective ex- ercise options for Dysmenorrhea with the adolescents.
Copyright © UTUJAHI 2018. Mrs. Nimmy Augustine, Mrs. Sudha Maheswari, and Sr. Jacintha D’Souza This is an open access article distribut- ed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Introduction Need for the Study Adolescence is a period in a young girl’s life which her- An estimated 25% of India's population out of 138 million alds a change; not quite a little girl, not quite a young is aged 15-25 years. Girls aged 10-19 years comprise woman. It is regarded as the unique phase of human de- about 22% of the female population. A wide range of is- velopment and the parents of near future are moulded dur- sues and concerns are faced by adolescents in India, in- ing this stage. It is a fascinating period of life as well as a cluding reproductive health problems, nutritional deficien- period of great complexity that marks a vital stage in hu- cies, sexually transmitted diseases, and mental and physi- man development. Adolescence refers to a long transition cal stress-related problems. Stress often results in the period in life between childhood and adulthood involving abuse of tobacco and other habit-forming drugs. Nutrition, major biologic, physiological, cognitive and social devel- reproductive health, pregnancy, sexuality, and mental and opment. The period of adolescence is filled with intellec- social concerns are also related to adolescents. tual and emotional changes in addition to other major bio- One of the physiological changes among adolescent girls logical and physical changes. It is a time of discovery of is menarche. The adolescent girl may feel it as a critical self and one’s relationship to the world around her. Ado- life event. Menarche is the first real indication that a girl’s lescence is a sensitive and important phase in an individu- reproductive mechanism is matured. Menstruation is a al's life during which a multidisciplinary approach must be normal physiological cycle, common to all females of re- taken to both understanding and solving her problems. productive age group.
The Journal of Advanced Health Informatics Vol. 1 Issue. 4 July-Dec. 2018 Millions of women of reproductive age have recurrent Sample and sampling techniques emotional, cognitive and physical symptoms related to Sample: The study sample consisted of 30 adolescent their menstrual cycles like dysmenorrhoea, amenorrhea girls with dysmenorrhoea, studying in selected rural PU and oligomenorrhoea. colleges, Mulki, Mangalore. Experimental group had 15 adolescent girls who Statement of the problem were given the aerobic exercises. Control group had 15 Effect of aerobic exercises on relief of dysmenorrhoea adolescent girls who were not given the aerobic exercises. among adolescent girls in selected rural colleges of Mulki, Mangalore. Inclusion criteria: Adolescent girls; Objectives of selected rural colleges in Mulki, Mangalore. To determine the severity of dysmenorrhoea among who are in the age group of 16 – 19 years. adolescent girls in experimental and control group who have regular menstruation. using dysmenorrhoea assessment scale. who have moderate to unbearable pain. To find the effect of aerobic exercises in terms of re- who are willing to participate in the study. duction in dysmenorrhoea score in experimental group. Exclusion criteria: To compare the severity of dysmenorrhoea in experi- Adolescent girls; mental and control groups. who had already been under treatment for dysmenor- rhoea. Hypothesis who had mild pain H1: There will be significant difference between the mean who had undergone similar training pre and post test dysmenorrhoea scores of adolescent girls in the experimental group. Sampling techniques H2: There will be significant difference between the mean Purposive sampling technique was used in order to post test dysmenorrhoea scores of adolescent girls in ex- achieve the objectives. perimental and control groups. Description of the tools In this study, three tools were used. They are: Methods and Materials Tool I: Pre- screening assessment: This was designed Research approach: An evaluatory resear ch approach to identify the samples who fulfilled the criteria. It had was used and the subjects were selected by purposive seven statements. sampling and then assigned randomly for the intended Tool II: Baseline characteristics: This was prepared to treatment. obtain the background information of the participants and Research design: The resear ch design selected for this consisted of four statements. study was quasi experimental (non-equivalent control Tool III: Dysmenorrhoea assessment scale. It had two group) design because the study was intended to ascertain parts. the reduction of severity of dysmenorrhoea among adoles- cent girls with the help of aerobic exercises. Part I: Descriptive pain scale: This was a five point scale to determine the severity of pain during dysmenor- Variables rhoea among the subjects. Dependent variable: Severity of dysmenorrhoea is the de- Scoring: pendent variable, which includes pain and associated No pain-0 symptoms among adolescent girls. Mild pain-2 Independent variable: The independent variable is the Moderate pain-4 aerobic exercises which were expected to bring the change Severe pain-6 Minimum score- 0 in dependent variable. Unbearable pain-8 Maximum score- 8 Part II: Symptom rating scale: It consisted of 20 symp- Settings of the study toms which adolescent girls usually experience during Study was conducted in selected rural colleges where co- dysmenorrhoea. education is offered and has a total strength of 606 stu- Scoring: dents which are situated within 5 kilometers from the Always-2 study centre. Sometimes-1 Minimum score- 0 Never-0 Maximum score- 48
The Journal of Advanced Health Informatics Vol. 1 Issue. 4 July-Dec. 2018 Arbitrary grading of dysmenorrhoea: Opinion fr om Data presented in the table show that all (100%) adolescent girls the statistician, guide and experts were taken to develop had severe pain before aerobic exercises and all (100%) the ado- the criteria for interpretation of the level of dysmenor- lescent girls had a relief from severe pain after aerobic exercis- rhoea which are arbitrarily described as follows: es. Table 3: Severity of Dysmenorrhoea Before and After Grade Score Percentage (%) Aerobic Exercise in Control Group. n=15 Mild 01-16 ≤ 33 Moderate 17-32 34 - 66 Severity Pre-test Post-test Severe 33-48 67 - 100 F % F % Description of aerobic exercises Mild Pain (01-16) 0 0 0 The intervention for the present study was aerobic exercis- Moderate pain (17-32 11 73.3 11 73.3 es for relief of dysmenorrhoea. The investigator had un- Severe pain (33-48) 4 26.7 4 26.7 dergone one week of practical training. Warm up exercis- es, aerobic exercises and stretching exercises were admin- Data presented in the table show that majority (73.3%) of istered to adolescent girls with dysmenorrhoea, for 45 adolescents had moderate pain and 26.7 % had severe pain minutes, for one month, daily, starting from the last day of in pre test and the scores remained same in post test of their menstruation till they get their next menses, under control group. the supervision and participation of the investigator. Table 4: Mean, Standard deviation, Mean difference Results and t‟ value of pre-test and post-test dysmenorrhoea scores in experimental group. n=15 Table 1: Range, Mean, Median and Standard deviation of dysmenorrhoea scores of adolescents in the experi- Test Mean SD Mean dif- ‘t’ value mental and control group. n=15+15 score ference Pre-test 40.26 1.869 Group Test Ra Me Me Standard 14.06 Post- 26.20 1.859 19.21* nge an dia deviation test n Experi- Pre 37- 40. 41 1.869 t (14)=2.145, p<0.05 *= Significant mental test 42 3 Data in the table show that the mean post test dysmenor- group Post 22- 26. 26 1.859 rhoea score (26.2) was lower than the mean pre test dys- test 30 2 menorrhoea score (40.26). The calculated t‟ value Control Pre 22- 28. 28 7.22 (t14=19.21) was greater than the table value (t14=2.145) test 41 8 group at 0.05 level of significance. Hence the null hypothesis 27- Post 31 29 4.62 (H01) was rejected and the research hypothesis was ac- test 40 cepted indicating that aerobic exercise were effective in (Maximum score=48) reducing dysmenorrhoea. The data in the table show that the mean post test dysmen- orrhoea score (26.2±1.859) was less than the mean pre- Table 5: Mean, Standard deviation, Mean difference test dysmenorrhoea scores (40.3±1.869) in the experi- and t‟ value of pre-test and post-test symptom scores in experimental group. n=15 mental group, whereas in the control group, the mean post test dysmenorrhoea score (31.0±4.62) was higher than the Test Mean SD Mean dif- ‘t’ value pre test dysmenorrhoea score (28.8±7.22). It was also ob- score ference served that the mean post test dysmenorrhoea scores of the Pre-test 32.93 1.437 8.46 14.675* experimental group (26.2±1.859) was less when compared Post- 24.47 1.423 with the mean post test dysmenorrhoea score (31±4.62) of test the control group. Table 2: Severity of Dysmenorrhoea Before and After t (14)=2.145, p<0.05 *= Significant Aerobic Exercise in Experimental Group. n=15 Data in the table show that the mean post test symptoms Severity Pre-test Post-test score (24.47) was lower than the mean pre test symptoms score (32.93). The calculated t‟ value (t14=14.675) was F % F % greater than the table value (t14=2.145) at 0.05 levels of Mild Pain (01-16) 0 0 0 significance. It is evident that the aerobic exercises re- Moderate pain (17-32 0 0 15 100 duced dysmenorrhoea symptoms. Severe pain (33-48) 15 100 0
The Journal of Advanced Health Informatics Vol. 1 Issue. 4 July-Dec. 2018 Table 6: Mean, Standar d deviation, Mean difference energetic and enthusiastic. It also improves academic per- and ‘t’ value of post test dysmenorrhoea scores in experi- formance, strength, flexibility, co-ordination and range of mental and control group. n=15 motion. As the present health care system focuses on pre- ventive rather than curative medicine, the curriculum Test Mean SD Mean dif- ‘t’ value should include education of students regarding the im- score ference portance of exercises. It should also include preparation of Pre-test 26.2 1.859 booklets and pamphlets on need for exercises and its ad- 4.8 12.06* Post- 31 4.629 vantages. Students should be given chance to learn and test practice exercises within the colleges itself which in turn help them to promote their precious life in a healthy way t (14)=2.145, p<0.05 *= Significant with full of zeal.
The mean post test dysmenorrhoea score (26.2) of the ex- Nursing practice: perimental group after aerobic exercise program was low- Nurses play a vital role in the health care delivery system. er than the mean post test dysmenorrhoea score (31.0) of They should be in forefront to alleviate the problems faced the control group. The calculated t‟ value (t28= 12.06) by adolescent girls and to improve their performance in all was greater than the table value (t28=1.701) at 0.05 level settings; hospital, community and educational institutions. of significance. Hence the null hypothesis (H02) was re- Nurses working in the hospitals as well as in the commu- jected and the research hypothesis was accepted. This nity should be equipped with the knowledge of taking care shows that aerobic exercises were effective in reducing of patients with dysmenorrhea. School health nurse can dysmenorrhoea. very well identify the cases and encourage them to do ex- ercises and thereby helping them to avoid all NSAIDs, Discussion which may have serious side effects in the near future. The statistical analysis showed a significant reduction in the severity of dysmenorrhoea among adolescent girls in Nursing research: the experimental group after the introduction of aerobic Learning is a never ending process. Nurses, who come exercises (t14=19.21, p<0.05). This indicates that the aer- across lots of patients and students with dysmenorrhea, are obic exercises were effective in reducing dysmenorrhoea. the best persons to do research on various management modalities of the same to provide quality care to them. Conclusion Emphasis should be laid on research in the area of non- The pre test findings revealed that all adolescent girls in pharmacological measures of management of dysmenor- experimental group had severe dysmenorrhoea whereas rhea and promoting the physical, psychological and social the adolescent girls in control group were in two catego- wellbeing. Nurses should be facilitators of research and ries; moderate and severe. It also depicted that adolescent consider it as their responsibility to conduct researches on girls experienced various symptoms like nausea, vomiting, various problems of adolescent girls and their manage- pain in legs, headache, and mood swings which were ment and disseminate the findings. found to be less severe in post test. The post test findings showed that post test dysmenorrhoea scores were lower References than those of pre test scores in the experimental group, Olyai R, Dutta DK. Recent advances in adolescent whereas it remained almost same in the control group. The health. New Delhi: Jaypee brothers medical publish- mean percentage dysmenorrhoea score reduction support- ers; 2011. 119- 125. ed that aerobic exercises were effective in reducing dys- Swaminathan N. Improving adolescent health in India. menorrhoea. Health Action 2013 Jan; 26 (1): 4-8. Pandit DR, Hansotia DM. Adolescent girl education Implications of the study: empowerment. The journal of OBG of India 1999;13 The findings of the present study have several implica- (1): 21-22. tions in the field of nursing education, nursing practice, Sundel KJ, Hartz NY. Issues of adolescence and rem- nursing administration and nursing research. edies. BMJ 2006 Feb; 23(5): 87-90. Nursing education: Suryakantha AH. Community medicine with recent Dysmenorrhea is a threat to the adolescent girls that make advances. 3rd ed. New Delhi: Jaypee brothers medical them absent from classes and isolate them from society. It publishers; 2010. 716-29. prevents them from being energetic, vital and zealous. Adolescent girls should be encouraged to practice exercis- es as a part of daily life so that they remain fresh,
The Journal of Advanced Health Informatics Vol. 1 Issue. 4 July-Dec. 2018
The Journal of Advanced The Journal of Advanced Health Informatics Health Informatics JAHI
ISSN: e – 2456-9313 Available from URL: http://mbnc.edu.in/UTUJAHI.html
RESEARCH ARTICLE A Study to Assess the Knowledge and Practice of the Parents with Hypertension Regarding Primordial Prevention in their Children
Mrs. Valsamma Cherian, Mrs. Irene T.R Alvares Lourde College of Nursing, Taliparamba, Kannur
ARTICLE INFO ABSTRACT
Hypertension is one of the most prevalent and powerful contributor to the coro- Article History: nary artery disease, cerebrovascular disorders and to renal failure. A descriptive survey design was conducted to assess the knowledge and practice of the par- Received on 24thSept, 2018 ents with hypertension regarding primordial prevention in their children in se- Received in lected communities of Mangalore , at Mullerkad . The sample comprised of 100 revised form 24th Sept, 2018 parents with children aged less than 18 years selected by purposive sampling technique. A structured interview schedule for both knowledge and practice was Accepted on 28th Sept, 2018 used to collect the data. The results of the study showed that, the mean knowledge score was 28.08. The mean knowledge score was highest in the area Published online on 4th Oct. 2018 of causes (92.33%) and least in the area of concepts (74%). It shows that sub- jects had very good knowledge in the area of causes and least in the area of ef- fects of hypertension. Majority (58%) of the subjects had good practice and 31% of the subjects had moderate practice where as 11% of the subjects had Key Words: very good practices regarding primordial prevention of hypertension in their children. The mean practice score was 34.51. The mean percentage of the prac- Hypertension; Parents; Children; tice score was highest (82.41%) in the area of prevention of hypertension educa- Primordial prevention; Descriptive tion on life style diseases, whereas management of stress was 74.3%, mainte- survey approach. nance of diet 70.78 % and exercise (60.66%). There was no significant relation- ship was found between knowledge level of parents and their practice. The Corresponding Author: findings also showed a statistically significant negative relationship between Mrs. Valsamma Cherian knowledge and practice of parents with hypertension regarding primordial pre- Associate Professor vention in their children. The Karl Pearson Correlation Coefficient r’ value is Lourde College of Nursing, (r= -0. 261). The chi-square value showed that there was significant association Taliparamba, Kannur between practice and selected baseline variables like education (c2 =6.229, p <0.05), and number of children (c2 =10.446, p <0.05).
Copyright © UTUJAHI 2018. . Mrs. Valsamma Cherian. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Introduction Chronic non-communicable diseases (NCDs) are increas- of coronary heart disease (CHD), cerebrovascular accident ing among the adult population in both developed and de- and renal failure. It is one of the major risk factors for car- veloping countries. NCDs are becoming the main cause of diovascular mortality, which accounts for 20-50% of all death and disease in the developing world. Hypertension deaths. Hypertension is the result of interaction between is an important public health concern and challenge in the the genetic predisposition and the environmental factors world. Hypertension is an important modifiable risk factor which are modifiable, such as, excess calorie intake, high for cardiovascular disease (CVD), end stage renal disease dietary salt, alcohol consumption, obesity and lack of and peripheral vascular disease and is also a leading cause physical exercise.
The Journal of Advanced Health Informatics Vol. 1 Issue. 4 July-Dec. 2018 Statement of the problem Criteria for sample selection A study to assess the knowledge and practice of the par- Inclusion criteria ents with hypertension regarding primordial prevention in 1. Parents who were diagnosed to have their blood pres- their children in selected communities of Mangalore. sure more than 140/90 mmHg. Objectives of the study 2. Parents with high blood pressure who were willing to 1. To determine the knowledge level of parents regard- participate in the study. ing primordial prevention of hypertension by using 3. Parents who could understand Kannada, English or structured interview schedule. Malayalam. 2. To assess the practice of the parents regarding primor- 4. Parents with high blood pressure whose children were dial prevention of hypertension by using structured below the age of 18 years. interview schedule. Exclusion criteria: Parents who are not suffer ing fr om 3. To find the relationship between the knowledge and hypertension. practice regarding primordial prevention of hyperten- Description of the tool : To conduct this study, three sion. tools were prepared by the investigator 4. To determine the association between knowledge, Tool 1: Pre-screening tool and baseline proforma practice and selected baseline variables. Part I : Pre-screening tool : It consisted of 7 items on Hypothesis basic information about the subjects including age of the H1: There will be significant relationship between the parent, gender, previous history of hypertension, treatment knowledge and practice score. of hypertension and name of the drugs. H2: There will be significant association between Baseline proforma: It consisted of 13 items for obtain- knowledge and selected baseline variables. ing information, religion, education, occupation, type of H3: There will be significant association between family, dietary pattern, monthly income, number of chil- practice and selected baseline variables. dren, family history of hypertension and their relationship, Methods &material health information related to hypertension and the source A descriptive survey design was used for this study. The of information. study was conducted in a home setting at Mullerkad urban Tool 2: Structured interview schedule to assess the community of Mangalore. The main study was conducted knowledge level of parents with hypertension regard- from October 26th to November 14th of 2009. A structured ing primordial prevention in their children interview schedule for both knowledge and practice was Part II-Section A & Section B: The str uctured inter- used to collect the data. The sample comprised of 100 par- view schedule had 11 structured multiple choice questions ents with children aged less than 18 years selected by pur- and 11 true or false statements. For every correct answer 1 posive sampling technique. score was allotted and for every wrong answer 0 score Research approach: The descriptive survey approach was allotted. Reverse scoring allotted for negatively stated with non-experimental research design was used for this items. study. Tool 3: Structured interview schedule on practice Research Design: A descr iptive survey design is used (rating scale) of parents with hypertension regarding for this study. primordial prevention in their children Variables: Extraneous variables are used for this study.ie, This tool had 24 items. The scale was in the form of posi- age of the parents, religion, education, occupa- tion of the tive and negative statements. This tool had a three point parents, monthly family income, type of fami- ly, number scale with responses as ‘Always’ (A), ‘Some times’ (S), of children, family history of hypertension, and source of ‘Never’ (N).. The positive statements scores were 2, 1, information of hypertension and 0 and negative statements reverse scoring allotted. Setting of the study: The study was conducted at se- lected community of Mangalore, i.e., Mullerkad, in the Results natural home setting of the clients who were diagnosed to Organisation of findings: The data was analysed and have systolic blood pressure >140 mmHg and diastolic presented under the following headings blood pressure >90 mmHg. Father Muller community cen- Section I: Baseline characteristics tre, which is governed by Father Muller Charitable Insti- Section II: Determination of the knowledge level of par- tute. ents with hypertension regarding primordial prevention in Sample and sampling technique: The sample consists their children of 100 parents who fulfilled the sampling criteria .The Section III: Assessment of practices of parents with hyper- purposive sampling technique was used for this study tension regarding primordial prevention in their children.
The Journal of Advanced Health Informatics Vol. 1 Issue. 4 July-Dec. 2018
Mean % Section IV: Relationship between knowledge level and Max. Mea Infer- Area SD Practice practice regarding primordial prevention of hypertension score n ence Score in their children. Maintenance 14 9.91 1.676 70.78 Good Section V: Association between knowledge level and of diet selected baseline variables. Exercise 12 7.28 2.782 60.66 Mod- Table 1: Distr ibution of samples according to the grad- erate Management 10 7.43 1.526 74.3 Good ing of knowledge & practice score n=100 of stress
K R in % Ctg % PS R in Ctg % Education on 12 9.89 1.803 82.41 Good % lifestyle dis- ≤15 ≤45 PK 0 ≤22 ≤45 PP 0 eases Practice 48 34.51 5.246 71.89 Good 15-21 46-65 AK 7 23-31 46-65 MP 31 overall
22-28 66-85 GK 4 32-40 66-85 GP 58 [Maximum score = 48] 0 >28 >85 VG 5 41-48 >85 VG 11 Table 4: Relationship between knowledge and practice K 3 P n=100
[ Note: K= Knowledge; R= Range; Ctg= Category; PK = Variables Mean S D r’ value Inference Knowledge 28.08 3.277 Not signifi- Poor Knowledge; Ak = Average Knowledge; GK = Good -0. 261 Knowledge; VGK = Very Good Knowledge; PP = Poor Practice 34.51 5.246 cant Practice; MP= Moderate Practice; GP= Good Practice; VGP = Very good practice.] [r (98) = 0.209 at 0.05 level of significance] Knowledge- maximum score -33, Practice maximum Table 4 shows that the Karl Pearson Correlation between score :48 knowledge and practice scores is not significant at 0.05 level as the calculated value of (r = -0. 261) was less than Table 2: Area-wise mean standard deviation and mean the table value ( r= 0.209). Hence the null hypothesis was percentage of knowledge score n=100 accepted and it is inferred that there is no relation between
Mean the knowledge and practice of the parents with hyperten- Max. Mea Level of Area SD % score n knowledge sion regarding primordial prevention in their children. KS Concept 6 4.44 1.373 74.00 Good H01: There will be no significant relationship between
Causes 3 2.76 0.510 92.33 Very good knowledge and practice of the parents with hypertension regarding primordial prevention in their children at 0.05 Effects 9 8.22 1.011 91.30 Very Good levels. Prevention Table 5: Association between knowledge and selected -diet 5 4.53 0.881 90.60 Very good baseline variables n=100 Exercise 4 3.27 0. 723 81.75 Very good < ³ c2 In- Harmful No Variable df habits 2 1.82 0.386 91.00 Very good Me- Me- fere dian dian nce Stress 4 3.03 0.717 75.75 Good 1 Age of the parent (years) Overall 33
knowledge 28.08 3.335 85.09 Very good Below 40 12 11 41-50 17 27 2 2.23 NS
51 and above 18 15 [Maximum score: 33] 2 Religion Table 2 reveals that the mean knowledge score Hindu 34 44 1 1.65 NS was highest in the area of causes (92.33%), 91.3% in the Others 13 9 area of effects, and least in the area of concepts (74%).It 3 Education shows that subjects had very good knowledge in the area Illiterate 6 1 of causes and in the area of effects, least in the area of Primary 30 29 concepts of hypertension. Secondary 6 18 2 6.20 S* Table 3: Ar ea wise distr ibution of mean, mean per- Higher Second- centage, standard deviation and practice score ary 3 3 n= 100 Degree or above 2 2
The Journal of Advanced Health Informatics Vol. 1 Issue. 4 July-Dec. 2018
No Variable
4 Occupation 4 Occupation Professional 3 1 Professional 0 4 Technical/ Technical/ skilled 10 12 skilled 11 11 worker worker 4.15 3 NS Daily wages 3 0 3 4.102 NS Daily wages 0 3 5 Farming 0 1 Farming 1 0 Selfeployed 19 29 Self-employed 24 24 Unemployed 11 11 Unemployed 12 10 5 Dietary Pattern 5 Dietary Pattern Vegetarian 2 1 0.01 Vegetarian 1 2 1 NS 1 0.000 NS Mixed diet 45 52 1 Mixed diet 46 51 6 Number of children 6 Number of children One 6 8 One 6 8 10.4 Two 13 26 2 6.078 S* Two 23 13 2 S* 46 More than 2 28 19 More than 2 15 32 7 Family history of hypertension 7 Family history of hypertension Yes 28 44 6. 1 S* Yes No 19 9 791 36 36 0.92 1 NS No 11 17 9 (df(1) = 3.84 at 0.05 level of significance NS –Not signifi- cant, S* Significant; df 5.99 , df 7.81) (2)= (3)= The data presented in Table 6 shows that the chi-square The data presented in Table 5 reveals that the chi-square value computed between practice score and selected varia- test values computed between knowledge and selected bles such as education (c2 =6.229) and number of children baseline variables like education (c2= 6.208), number of (c2=10.446) was significant at 0.05 level. Hence the re- children (c2= 6.078) and family history of hypertension search hypothesis was accepted and the null hypothesis (c2= 6.791) were significant at 0.05 level. Hence the re- was rejected and it is inferred that there was significant search hypothesis was accepted and the null hypothesis association between education and number of children. was rejected and it is inferred that there was significant association between education, number of children and Discussion family history of hypertension. Section I: Baseline characteristics Majority of the subjects (44%) belonged to the age group Table 6: Association between practice and selected of 41-50 years. The findings of the study are consistent baseline variables. n=100 with a cross-sectional study which was conducted in China No Variable < ³ df c2 In- to identify the prevalence, distribution, current status of Me- Me- fere awareness and control of hypertension in adult population, dian nce dian which reported the prevalence of hypertension between 45 1 Age of the parent (years) -64 years as 65.7%. Below 40 13 10 3.80 41-50 23 21 2 NS 3 Section II: Determination of knowledge level of parents 51 and above 11 22 with hypertension regarding primordial prevention in 2 Religion their children Hindu 39 39 1.28 1 NS The findings of the study supported by a similar study Others 8 14 1 which was conducted to analyse the trends in prevalence, 3 Education awareness, treatment and control of hypertension in mid- Illiterate 3 4 dle-aged Chinese population. A cross-sectional survey in Primary 30 29 the year 1992-1993 & 1998 in rural and urban areas. The Secondary 13 11 6.22 2 S* Higher Second- 9 participants were aged 35-59 years. Findings revealed that ary 0 6 25% of the subjects had good knowledge regarding hy- Degree or above 1 3 pertension like concept of hypertension and stress.
The Journal of Advanced Health Informatics Vol. 1 Issue. 4 July-Dec. 2018
5% of the subjects had only poor knowledge about hyper- The present study was done to assess the knowledge and tension and the preventive aspects. A similar study was practice of the parents with hypertension regarding pri- conducted in USA to determine the level and determinants mordial prevention in their children in selected communi- of knowledge of the risks for hypertension and its preven- ties of Mangalore. The study findings revealed that most tion in an urban African-American community. The results of the parents had good knowledge regarding basic aspects showed that the mean high blood pressure knowledge of hypertension, its concepts, causes, and effects, preven- score was 83.1%. There were subgroup differences in the tive aspects of diet, exercise and harmful habits. They had scores with significant associations between high blood good practice in the area of maintenance of diet, stress pressure knowledge score and level of education (P management, teaching of various kinds of lifestyle diseas- = .002) and a personal history of hypertension. es in their children. Majority of the parents with hyperten- sion have does not give importance to exercise, and also Section III: Assessment of practices of the parents with they are not encouraging to do the exercises among their hypertension regarding primordial prevention in their children. children Nursing implications of the study The study findings revealed that practice of majority of the The study findings will help to think and implement sever- parents (58%) with hypertension regarding primordial pre- al possible strategies in the field of nursing practice, nurs- vention in their children, were good in certain aspects like ing education, nursing research and nursing administration dietary management, management of stress and education Limitations of the study of lifestyle diseases, practice was moderate (31%) in the 1. The present study was limited to a small sample size area of exercise. A similar study done in Boston reported that limited the generalisations of results. the importance of control of modifiable risk factors like 2. Some parents with hypertension were not willing to BMI, daily exercise , diet, alcohol in preventing hyperten- participate in the study. sion . The result showed the incidence of hypertension was 3. The investigator did not use any observational check- only in 12, 319 out of 83, 882 adults after they practiced list for assessing the practice of parents. the control of modifiable risk factors. This study empha- Recommendations sises the practice of controlling modifiable risk factors. The following recommendations are made based Section IV: Relationship between knowledge and prac- on the present study: tice of the parents with hypertension regarding pri- 1. Replication of the same study on a larger sample may mordial prevention in their children help to draw more definite conclusions and make gen- The findings of the study revealed that there was no signif- eralisation. icant correlation between knowledge and practice of the 2. An experimental study could be conducted to deter- parents with hypertension regarding primordial prevention mine the patients with hypertension and primordial in their children. (r = -0.261, P<0.05). prevention in children on a long-term basis. 3. A study can be conducted on the burden of children Section V: Association between knowledge and selected suffering from hypertension in their parents those who baseline variables have hypertension. The findings of the study showed that there was signifi- 4. A comparative study can be conducted in knowledge cant association between knowledge and selected baseline and practice of the parents with hypertension. variables like education, number of children and family 5. A similar study can be conducted in hospital settings history of hypertension, other variables like age of the par- and rural areas of community. ent, occupation and dietary pattern has no significant asso- References ciation with knowledge of the parents on hypertension. 1. Giampaoli S. Primordial Prevention of Cardiovascular The findings of the present study are supported by an ex- Disease-The Role of Blood Pressure. European Cardi- ploratory study conducted in Manipal, to find the effec- ovascular Disease 2007 - Issue II Nov 2007. Available tiveness of an awareness programme. One of the findings from: URL:http://www.touchcardiology.com/articles/ of the study was that the knowledge of the samples is in- primordial-prevention-cardiovascular-disease-the-role dependent of their age, education, occupation, gender, so- -blood-pressure cioeconomic status and exposure to mass media. 2. Wikipedia, the free encyclopaedia [Online series]. [ cited 2009 Dec 23] Available from : URL:http:// Conclusion en.wikipedia. org/wiki/Hypertension. Hypertension is a silent killer disease of the modern civi- 3. Gupta R. Prevention of Coronary Heart Disease lized society. Primordial prevention has important impli- among Indians: Focus on Primary Prevention. J Indian cations for the relationship between socioeconomic cir- Med Assoc 2000 Nov;98(11):703-4, 706-9 cumstances and adult risk factors.
The Journal of Advanced Health Informatics Vol. 1 Issue. 4 July-Dec. 2018
The Journal of Advanced The Journal of Advanced Health Informatics Health Informatics JAHI
ISSN: e – 2456-9313 Available from URL: http://mbnc.edu.in/UTUJAHI.html
RESEARCH ARTICLE Effectiveness of Structured Teaching Programme on Knowledge and Attitude Regarding Cervical Cancer among Women of Reproductive Age at Selected Rural Area of Bardoli
Ms. Richa Gosvami and Dr. Kavitha Narayanan Maniba Bhula Nursing College, Gopal Vidyanagar-Tarsadi, Bardoli
ARTICLE INFO ABSTRACT
A study was conducted on knowledge and attitude regarding cervical cancer Article History: among women of reproductive age at the selected rural area of Bardoli. The ob- Received on 5thOct. 2018 jectives of the study were assess the knowledge and attitude regarding cervical cancer, to find out the effectiveness of STP, to find out association of pre-test Received in knowledge score with selected socio-demographic variables and correlation be- revised form 17th Oct. 2018 tween knowledge and attitude. The pre experimental research approach was Accepted on 19th Oct. 2018 used with one group pre-test and post-test design. The investigator used simple random sampling technique for selecting the 100 samples. A structured teaching Published online on 20th Oct. 2018 programme for cervical cancer was prepared for the samples. A structured knowledge questionnaire and Likert’s attitude scale were prepared to assess the knowledge and attitude of the women. Descriptive and inferential statistics were used to analyze the data. The mean pre-test knowledge score was 7.82 and the Key Words: mean post test knowledge score was 11.81. The mean pre-test attitude score was 76.4 and the mean post-test attitude score was 83.96. significance of the differ- Knowledge, Attitude, Cervical ence between pre-test and post-test knowledge and attitude was statistically test- Cancer, Reproductive Age Group ed using paired ‘t’ test and it was found significant at 0.05 level. There is an association between pre-test knowledge score and selected socio-demographic Corresponding Author: variables such as, educational status, marital status, family income and source of Ms. Richa Gosvami getting information. These is no co-relation between knowledge and attitude (r=0.039). There was increase in the knowledge and change in attitude of wom- Lecturer , MBNC ,UTU, en regarding cervical cancer. Hence, it was concluded that STP was effective in Gopal Vidyanagar, Bardoli improving the knowledge and attitude of reproductive age group women.
Copyright © UTUJAHI 2018. Ms. Richa Gosvami. This is an open access article distributed under the Creative Commons Attribution Li- cense, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Introduction in India cancer. Women, living in rural community need Cervical cancer is the major and devastating death for knowledge about the cervical cancer for early detection, cause to young girls and their mothers. Approximately screening and treatment about cervical cancer. A teaching 132,000 new cases are diagnosed and 74,000 die annually programme for the women living in rural area will help in India, accounting to nearly 1/3rd of the global cervical them to know about etiological risk factor, signs symp- cancer deaths. Cervical cancer, mainly caused by Human toms, and diagnosis and treatment aspects of cervical can- Papillomavirus infection, is the leading cancer in Indian cer which will help in early diagnosis and prompt treat- women and the second most common cancer in women ment. National Center for Biotechnology Information worldwide. Though there are several methods of preven- Journal reported that Cervical cancer is the most common tion of cervical cancer, prevention by vaccination is cancer among females in Gujarat. This accounts for about emerging as the most effective option. Early detection and 28-30 per cent of all cancers in women. Every year 12000 timely treatment can reduce the burden of cervical cancer women diagnose with breast, cervix and ovarian cancer.
The Journal of Advanced Health Informatics Vol. 1 Issue. 4 July-Dec. 2018 Need for the Study Hypothesis Cancer is one of the leading causes of death today and is H01 – There is no significant difference between pre- advancing in rank year by year. One out of every five test and post-test knowledge and attitude regard- women in the world suffering from this disease belongs to ing cervical cancer among women of reproductive India. At current incidence rates, the annual burden of new age group at selected rural area of Bardoli, Guja- cases in India is projected to increase to 225,000 by 2025, rat. but there are few large-scale, organized cervical cancer H02 –There is no significant association between pre- prevention programs in the country. Cervical cancer ranks test knowledge regarding cervical cancer with as the 1st most frequent cancer among women in India, selected socio-demographic variables among and the 1st most frequent cancer among women between women of reproductive age group at selected rural 18 and 44 years of age. area of Bardoli, Gujarat. WHO estimated every year nearly 5,00,000 women across H03 –There is no significant association between pre- the world are diagnosed with cervical cancer. out of that, test attitude regarding cervical cancer with select- nearly about 3,00,000 die per year. India has more cervi- ed socio-demographic variables among women of cal cancer cases than any other countries in the world. reproductive age group at selected rural area of More than 1,30,000 Indian women are diagnosed with this Bardoli, Gujarat. disease and more than 74,000 die from it. H04 – There is no significant co-relation between The cancer data compilation by NCH (New Civil Hospi- knowledge and attitude regarding cervical cancer tal) revealed that breast cancer cases are double than the among women of reproductive age group at se- cervical cancer cases. lected rural area of Bardoli, Gujarat.
Statement of the problem Conceptual framework A Study to Assess the Effectiveness of Structured Teach- In present study, Conceptual framework used based on ing Programme on Knowledge and Attitude regarding The Health Belief Model (HBM) by Dr.Pender in 1950. Cervical Cancer among Women of Reproductive age at selected rural area of Bardoli, Gujarat.” Methodology Research Approach:-Quantitative approach Objectives of the study Research Design:- Experimental Resear ch design 1. To assess the socio-demographic variables of repro- ductive age women. Research Method:-Pre-experimental one group pre- 2. To assess the knowledge and attitude regarding cer- test post-test design is adopted for the study. vical cancer among women of reproductive age Research Setting:- Mota village, Bardoli. group at selected rural area of Bardoli, Gujarat. Research population:-Reproductive women who are 3. To assess the effectiveness of structured teaching residing at Mota village. programme on knowledge and attitude regarding cer- Target population:- Reproductive age group wom- vical cancer among women of reproductive age en (18-45years) in Mota village, Bardoli. group at selected rural area of Bardoli, Gujarat. Accessible Population:-Rreproductive age group 4. To find the association between pre-test knowledge women (18-45years) who can fulfill the inclusion cri- regarding cervical cancer with selected socio- teria. demographic variables among women of reproduc- tive age group at selected rural area of Bardoli, Guja- Sample - Selected reproductive age group women rat. who are fulfill the inclusion criteria. 5. To find the association between pre-test attitude re- Sample size: - 100 reproductive age group women. garding cervical cancer with selected socio- demographic variables among women of reproduc- Criteria for sample selection tive age group at selected rural area of Bardoli, Guja- Inclusion criteria rat. Women who are willing to participate 6. To find the co-relation between knowledge and atti- Women who are under the age group of 18-45 years. tude regarding cervical cancer among women of re- Women who are permanent resident of the selected productive age group at selected rural area of Bar- rural area. doli, Gujarat. Women who knows to read and write in Guajarati.
The Journal of Advanced Health Informatics Vol. 1 Issue. 4 July-Dec. 2018 Exclusion criteria: After content validity, the investigator prepared final draft Women who are not present during the time of study of structured teaching programme. Knowledge and Atti- Women who does not give consent for the study tude portion of cervical cancer. The topic included intro- duction, definition, incidence, risk factor, sign and symp- Women who having cervical cancer. toms, diagnostic test, stages, prevention and treatment. Variables: The lecture cum discussion method was adopted for teach- ing along with power point presentation and video. Independent Variable:- Structured Teaching Pro-
gramme on cervical cancer Results Dependent Variable:- knowledge and attitude re- The Findings of the present study as follows: garding cervical cancer. Section-1: Socio-demographic variables: In present study out of 100 women, 38(38%) of the women belonged Description of the tool : The Investigator prepared to the age groups of 18-24 years, 42(42%) women had a structured knowledge questionnaires and Likert-scale to secondary education, 73(73%) women were non-working, assess the knowledge and attitude regarding cervical can- Majority of women 75(75%) were married, 40(40%) cer. The research tools consist of three sections. women had no child, 29(29%) women having family in- Section-A: Demographic Data come more than Rs.12001, all women 100 (100%) were The section contained 11 items for obtaining the following Hindu religion, Majority of women 90(90%) information regarding in women age, educational status, were living in nuclear family, Majority of women 85 occupation, marital status, family income, and religion, (85%) were not using any types of contraceptives. The type of family, use of contraceptive, any past history of majority of women 76(76%) were having no any genitou- infectious diseases, bad habits and source of information rinary infection diseases. The majority of women 93(93%) on cervical cancer. were not having any bad habit. 46(46%) women were get- ting information from health personnel. Section-B: Knowledge questionnaires on cervical can- cer : Investigator developed the str uctured knowledge Section-2(a) Knowledge related to cervical cancer : questionnaires to assess the knowledge of women in the In pre-test, 64 women were having average knowledge, 34 Mota village of Bardoli. This section consists of 20 items women were having poor knowledge and 2 women were of multiple choice questions and each item carries 1mark. having good knowledge about cervical cancer. After ad- Maximum scores of questionnaires is 20. Every correct ministrating of STP their knowledge score was increased. answer was given score is 1 and incorrect answer was giv- And Post-test knowledge score results, 57 women were en score is 0. The answer key for structured knowledge having average knowledge, 34 women were having good questionnaires was prepared by the investigator. Question- knowledge and only 9 women were having poor naires prepared based on definition, causes, risk factors, knowledge. sign and symptoms, diagnostic test, stages, prevention and treatment. The tool was developed in English and Gujarati Graph:1- Bar graph of Distr ibution of women accord- language. ing to pre-test and post-test knowledge score. Section-C: Likert scale on cervical cancer: Investigator develops the Likert-scale to assess the attitude of women regarding cervical cancer in the Mota village of Bardoli. Likert scale consists 25 items. The maximum score is 125 and minimum score is 25. The answer key for Likert scale was prepared by the investigator.
Description of STP : Investigator develops the struc- tured teaching programme by the extensive research and non research literature and also took the opinion of expert before planning the structured teaching programme the central and specific objectives were formulated. The in- vestigators select content and appropriate teaching learn- ing activity and organized in the appropriate manner con- sidering the sequence at the level of the sample. The ex- pert did content validity of the STP.
The Journal of Advanced Health Informatics Vol. 1 Issue. 4 July-Dec. 2018 Mea Section 2 (b)- Attitude related to cervical cancer: At- SD Cal. Ta n titu def- SE t b. t d In pre-test, 60(60%) women were having unfavorable Mean def- SD de eren MD val- val f attitude and 40 (40%) women were having favorable atti- eren test ce ue ue tude. After administration of STP post test results was, ce majority of women 93 (93%) were having favorable atti- Pre- 6.4 test 76.42 6 13.2 1.9 9 tude and 7 (7%) women were having unfavorable attitude Post 7.54 0.48 0.57 5.9 0 8 9 regarding cervical cancer. – 83.96 test 8 Graph-2: Bar graph of Distribution of women accord- ing to pre-test and post-test attitude score. Table 2 reveals that, calculated paired‘t’ value (t cal =
13.20) is greater than the tabulated value (t tab= 1.98). Hence H01 is rejected. This indicates that the change in attitude of women is statistically significant higher than the pre-test attitude at p< 0.05 levels. Therefore, the struc- tured teaching programme (STP) on cervical cancer is ef- fective to positive change in women’s attitude.
Section-4: Finding related to association between the pre-test knowledge score with selected socio- demographic variables. Finding of the study revealed that the Calculated chi- square value is less than tabulated chi-square value in most of demographic variables for that There was no association between pre-test knowledge with the selected socio demographic variables such as Age, Occupation, No of child, type of family, use of contraceptive, history Section-3: Effectiveness of structured teaching pro- of any genitourinary infection and Bad habits. And There gramme. was association between pre-test knowledge with the se- Table - 1: Mean difference (d), Standard Error of dif- lected socio demographic variables such as educational ference (SEd) and paired‘t’ values of knowledge scores of status (χ2=14.21), marital status (χ2=8.14), family in- women. n=100 come (χ2=13.4), and source of information (χ2=13.47), at
SD level of significance. Know Mean Cal. t Tab. t defer- SEMD df ledge defer- value value test ence ence Section –5: Finding related to association between the Pre- pre-test attitude score with selected socio-demographic test 3.99 0.74 0.17 22.36 1.98 99 variables. Post - Finding of the study revealed that the calculated chi- test square value is less than tabulated chi-square value in Table 1 reveals that, calculated paired‘t’ value (t cal = most of demographic variables for that There was no as- 22.36) is greater than tabulated value (t tab= 1.98). Hence sociation between pre-test attitude with the selected socio H01 is rejected. This indicates that the gain in knowledge demographic variables such as Age, Occupation, No of score is statistically significant higher than the pre-test child, type of family, use of contraceptive, history of any knowledge scores at p< 0.05 levels. Therefore, the struc- genitourinary infection and Bad habits. And There was tured teaching programme (STP) on cervical cancer is ef- association between pre-test attitude with the selected fective to improve the knowledge of women. socio demographic variables such as educational status (χ2=8.22,), marital status (χ2=9.30), family income Table-2: Mean differ ence (d), Standard Error of dif- (χ2=9.16), and source of information (χ2=7.82), at 0.05 ference (SEd) and paired‘t’ values of attitude scores of level of significance. women regarding cervical cancer. n=100 Section-6: Co-relation between pre-test knowledge and attitude score regarding cervical cancer. Knowledge mean score was 7.82 and attitude mean was 76.42, here calculated r value is 0.039 less than the table
The Journal of Advanced Health Informatics Vol. 1 Issue. 4 July-Dec. 2018 value (tab=0.195). It indicated that there is no correlation Nursing administration: Nur sing administr ation may between knowledge and attitude regarding cervical cancer. involve in policy making and budgeting for the health pro- gramme and also formulate policies that will include Figure-3: Bar graph of correlation between Pre-test women to be actively in health education programmes in Knowledge and Attitude. their respective village.
Nursing education: The health care delivery system at present is given more emphasis on all aspects cervical can- cer and health promotion. Women should be trained to acquire knowledge in assessing the learning substance of the women and plan out STP based on the same in the vil- lage.
Nursing research: One of the aims of nursing resear ch is to expand and broaden the scope of nursing. The find- ings of this study serve the professionals and the students to conduct further studies. This dissemination of the find- ing through conference and professional journals will Limitations of the study make application of research to be effective. 1. A study is limited to 100 samples only.
2. A study is limited to specific time duration 1 year only Conclusion 3. The study did not use any control group, hence there Researcher, found a lack of awareness among women re- were possibilities of threats to internal validity such as garding cervical cancer. This may be due to socioeconom- events occurring between the pre-test and post-test ic factors, unaffordable beliefs and fear about the disease, session, influences of mass media or people in the en- partner’s attitude and poor accessibility of health services. vironment on subjects knowledge. Cervical cancer education is provided accurate infor- 4. Investigators assessed only the knowledge and attitude mation and to raise public awareness about cervical can- of women. cer. So researcher wants to enhance the knowledge about
cervical cancer. Recommendations
Keeping in view the finding of the present study, the fol- References lowing recommendations have been made for study. 1. D.C Dutta. “Textbook of Gynaecology", New central 1. Similar study can be replicated on a large sample. book agency publication, Kolkata, 6th edi; 2001, Pg no 2. A study can be conducted with control group. -245 3. A comparative study can be conducted between urban 2. Avani denish, “International journal for women’s and rural area. health, “Epidemiology of cervical cancer with special 4. A study can be conducted on college students and focus on India school teachers. 3. Available.from:https://www.ncbi.nlm.nih.gov/pmc/ 5. Regular in service education programme conducted articles/PMC44049 for staff nurses. 4. Roshani Agrawal Khatry, Biji Joseph. “A Study to 6. Similar research can be conducted among female Evaluate The Effectiveness of Self Instructional Mod- health worker / ANMs who have more contact with ule on Knowledge Regarding Pap Smear Screening the women and thus cervical cancer can be prevented among Female Teachers from Selected Schools of by imparting knowledge to them at their door step. Bangalore”, International Journal of Health Sciences
and Research, (online), Jul 7, 2017. Nursing implication: The findings of this present study 5. Mayo clinic staff, “ cervical cancer symptoms and have implicated in nursing practice, nursing administra- causes Available from:- http://www.mayoclinic.org/ tion, nursing education and nursing research. diseases-conditions/cervical-cancer/symptoms-causes/
dxc-20210892 Nursing practice: Investigator s should be for the as- 6. C Mongsawaeng et al. Knowledge, Attitude, and Prac- sessment of knowledge and attitude they should have good tice Regarding Cervical Cancer Among Rural Com- observational skill and also should have up to date munity Women in Northeast Thailand. PubMed Jour- knowledge regarding cervical cancer. nal [online], vol-18(5)
The Journal of Advanced Health Informatics Vol. 1 Issue. 4 July-Dec. 2018
The Journal of Advanced The Journal of Advanced Health Informatics Health Informatics JAHI
ISSN: e – 2456-9313 Available from URL: http://mbnc.edu.in/UTUJAHI.html
RESEARCH ARTICLE EFFECTIVENESS OF SNAKE AND LADDER GAME ON KNOWLEDGE REGARDING HEALTHY DIETARY PATTERN AMONG PRIMARY SCHOOL CHILDREN Ms. Rinal Barad and Mr. Gibin Thomas Maniba Bhula Nursing College, UTU, Bardoli
ARTICLE INFO ABSTRACT
Healthy eating means eating a variety of foods that gives the nutrients needed to Article History: maintain health, feel good, and have energy. The importance of nutrition in school age children has been emphasized because nutritional deficiency during Received on 14th Oct. 2018 this period can decrease not only physical and mental development but also the Received in learning ability of children. India has seven states where more than 33 percent revised form 19th Oct. 2018 of children are under weight. Out of that lacks of malnourished or highly mal- nourished children are there in Gujarat. There are over 5,500 highly malnour- th Accepted on 20 Oct. 2018 ished children in Surat. On this background pre- experimental one group pre-test and post-test research design was used to assess the effectiveness of Snake and Published online on 22nd Nov. 2018 Ladder Game on knowledge regarding healthy dietary pattern. A total number
of 50 students were selected from the third standard of Primary Government Key Words: School of Kadodara by using simple random sampling technique and structured knowledge questionnaire was used to collect the data. The results of the study Effectiveness; Snake and Ladder; showed that out of 50 children, majority of respondents 47 (94%) had average Knowledge; Primary; School; Chil- knowledge during pre- test whereas 49(98%) respondent possessed good dren. knowledge in pre-test and the calculated paired ‘t’ test value (t cal.= 33.24) was greater than tabulated value (t tab.= 2.26). The study highlighted that, there was Corresponding Author: significant association between the father’s education and pre-test knowledge score. But there was no significant association between age, gender, residence, Ms. Rinal Barad family income, dietary pattern, religion, education of mother, occupation of fa- Lecturer , MBNC ,UTU ther and mother, number of siblings, ordinal position in family, type of family, Gopal Vidyanagar, Bardoli sources of information and diet history. The study concludes that education to- wards the nutrition may improve health status of school children.
Copyright © UTUJAHI 2018. Ms. Rinal Barad. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Introduction especially for children because they are undergoing the School age is the active growing phase of childhood. It complex processes of growth and development. represents a dynamic period of growth and development because children undergo physical, mental, emotional and Need for the study social changes. Habits formed in childhood have a long- Food intake patterns and overweight are associated with term impact on health and wellbeing. Healthy dietary pat- different immediate complications and major long-term tern means the quantities, proportions, variety or combina- consequences including cardiovascular diseases, diabetes, tion of different foods, drinks, and nutrients in diets, and high blood pressure, stroke, cancer, dental caries, asthma, the frequency with which they are habitually consumed. It and some other psychological disorders like depression. is very essential to provide attention to nutritional status According to Press Information Bureau, in India nearly
The Journal of Advanced Health Informatics Vol. 1 Issue. 4 July-Dec. 2018 one in four children is underweight. The RSOC reports Conceptual Framework shows that, 38.7% are considered as stunted children (low The conceptual framework used for this study was based height for age), 29.4% are considered as underweight (low on Health Belief Model developed by Hochbaum, weight for age), 15 % are considered as wasted as wasted Rosenstock and Kegels working. children (low weight for height). The problem of hidden hunger-that is deficiencies of essential vitamins and min- Research methodology erals, such as iron, Vitamin A and iodine - is also severe. Research Approach : Quantitative India has seven states where more than 33 percent of chil- Research Design : Pre- experimental dren are underweight. Out of that lacks of malnourished or Research method : One group pre-test and post- highly malnourished children are there in Gujarat. There test research method are over 5,500 highly malnourished children in Surat. To Setting : Government primary school, aware the children regarding healthy dietary pattern, Kadodara, Surat, games can be used as an innovative and challenging edu- Research Population : Primary school children, Guja cational tool as a teaching strategy in child for promoting rat state self-learning and participation. Target Population : Primary school children of Government Primary School of Statement of the problem Kadodara, Surat, Gujarat A Study To Assess The Effectiveness Of The Snake And Sample : Third standard students Ladder Game On Knowledge Regarding Healthy Dietary Sample size 50 Pattern Among The Primary School Children In Selected Sampling Technique : Simple r andom sampling tech Government School, Surat, Gujarat State. nique Selection criteria for Samples Objectives Inclusion criteria Objectives of the study are to; 1. Students who are studying in third standard of select- To assess the socio-demographic variables of the pri- ed government schools, Surat. mary school children. 2. Whose age group is 7 to more than 10 years of age. To assess the existing level of knowledge regarding 3. Those who can read and write in Gujarati healthy dietary pattern among the primary school chil- Exclusion criteria dren. 1. Those who are not willing to play snake and ladder To evaluate the effectiveness of Snake and Ladder game. game on knowledge regarding healthy dietary pattern 2. Those who are not available at the time of data collec- among the primary school children. tion. To find out the association between pre-test knowledge score regarding healthy dietary pattern Variables among the primary school children with their selected Independent variable: Snake and Ladder game regard- socio-demographic variables. ing healthy dietary pattern Dependent variable: Knowledge of school children re- Assumptions garding healthy dietary pattern 1. Primary school children may not have adequate knowledge regarding the healthy dietary pattern. Description of tool 2. Game-based learning through the snake and ladder Section-I: It includes demographic data which gives base- game may not motivate the primary school children to line information to be obtained from the school children learn easily about healthy dietary pattern. such as age, gender, religion, residence, type of family, family income, education of mother and father, occupa- Hypotheses tion of mother and father, number of siblings, ordinal po- sitions in family, dietary pattern, sources of getting infor- H01- There is no significant difference between the pre- test and post-test knowledge scores of primary school mation about healthy dietary pattern and diet history. children regarding healthy dietary pattern. Section-II: It includes the structured knowledge ques- tionnaire to assess the knowledge of school children re- H02- There is no significant association between the pre- test knowledge score among primary school children re- garding the healthy dietary pattern. It consisted of 4 parts; garding healthy dietary pattern with their selected socio- Part-A, Part-B, Part-C, Part-D. demographic variables. Part A: It consists of 8 questions regarding healthy die- tary pattern.
The Journal of Advanced Health Informatics Vol. 1 Issue. 4 July-Dec. 2018 Section –III: Effectiveness of Snake and Ladder Game on Part B: It consists of 10 questions about healthy diet. knowledge. Part C: It consists of 7 questions about unhealthy diet. Regarding effectiveness of snake and ladder game, the Part D: It consists of 5 questions about food hygiene. calculated paired ‘t’ test value (t = 33.24) is greater under-five cal. than tabulated value (t = 2.26). This indicates that the tab. gain in knowledge score was statistically higher than the Results pre- test knowledge scores. Therefore, the snake and lad- Major findings of the study as follows: der game regarding healthy dietary pattern was effective Section -I: Socio-demographic variables to improve the knowledge of respondents. The study findings reveals that , out of 50 samples, ma- jority 26(52%) were from the age group of 7-8 years, 29 Table-1: Mean, mean differ ence, standar d deviation of (58%) were boys, 36(72%) were staying in urban resi- difference, standard error of mean difference and ‘t’ value dence, 29(58%) respondents’ dietary pattern was vegetari- of pre-test and post-test knowledge scores an, 27(54%) belonged to nuclear family, 20(40%) re- n=50 spondents’ parents were in the income range of less than Rs. 5,000 per month, 28(56%) respondents’ education of Paired ‘t’ val- Kldg ues mother belonged to primary education, 18 (36%) respond- SE Scores Mean MD SD Tab ents’ education of father belonged to secondary education, MD Cal (@ 30(60%) respondents’ occupation of mother belonged to df=49) housewife, 23 (46%) of the respondents’ occupation of Pre- father belonged to labor, 23(46%) respondents had more test 14.14 33.2 11.74 0.19 0.03 2.02 than two siblings, 20(40%) respondents had second ordi- 4 nal position, 39(78%) were belonged to Hindu, 22(44%) Post- 25.88 test respondents’ source of information was parents, 33(66%) respondents’ carbohydrate level in diet history was low, Table 1 shows that the calculate ‘t’ value (33.24) is greater 34(68%) had low protein level whereas, 34(68%) had low than the tabulated value (2.02) at 49 degrees of freedom. fat level. Hence H is accepted. 1 Section-IV: Association between pre- test knowledge Section –II: Knowledge regarding healthy dietary pat- tern. score with their selected socio-demographic variables. The pre-test knowledge scores showed that majority of The study results depicts that, there was significant associ- respondents 47 (94%) had average knowledge whereas, ation between the father’s education and pre-test the post-test knowledge score showed that 49(98%) re- knowledge score. But there was no significant association spondent possess good knowledge. between age, gender, residence, family income, dietary pattern, religion, education of mother, occupation of father Graph 1: Knowledge regarding healthy dietary pat- tern and mother, number of siblings, ordinal position in family, among primary school children type of family, sources of information and diet history.
Discussion In present study, the statistical paired ‘t’ implies that the difference between pre-test and post-test knowledge score was found statistically significant at 0.05 levels with a paired ‘t’ value of 33.24. This reveals a statistical signifi- cant in the enhancement of knowledge scores indicating the significant effectiveness of snake and ladder game re- garding healthy dietary pattern. The study finding was supported by Ghimire Sasmita. (2015) carried out a study to assess the effectiveness of snake and ladder game on knowledge regarding the healthy dietary pattern among the government primary school children, Nagarbhavi, Bengaluru, India. The findings of the study showed that, paired t value calculated 20.45 was significant at p<0.05. which indicates that, snake and ladder game is effective to improve the knowledge of respondents.
The Journal of Advanced Health Informatics Vol. 1 Issue. 4 July-Dec. 2018
Nursing implications Recommendations The study has several implications like nursing education, A similar study can be done on a large sample to gen- nursing practice, nursing administration and nursing re- eralize the findings. search. A similar study can be done to determine the effec- tiveness of snake and ladder game among school chil- Nursing Education dren for various topics like oral hygiene, personal hy- Nursing curriculum must be updated by including topics giene, healthy habits. like educating children with the help of games and also A comparative study can be performed to evaluate the should give more emphasis on preventive and promotive effectiveness of snake and ladder game with health aspects of health care practice regarding healthy dietary education and game without health education on pattern. Nursing professionals can be trained through sem- healthy dietary pattern. inars, workshops and conferences regarding assessment of A comparative study can be done between rural and nutritional status for school children which make nursing urban children on the level of knowledge, attitude and professional competent enough to take care of the future practice regarding healthy dietary pattern. generation healthier. A study can be done to assess the effectiveness of structured teaching programme on healthy dietary pat- Nursing Practice tern among school children. A game is an effective and efficient way to improve the A descriptive study can be done to find out the inci- knowledge of primary school children. School health dence of nutritional disorders among school children. nurse can use this snake and ladder game to teach the chil- dren regarding ill effects of unhealthy dietary pattern as Conclusion well as other health habits such as personal hygiene, hand The overall findings of the study clearly showed that there washing, oral hygiene. Nurse can plan the goal of nursing is a need for conducting educational programs to increase management for the children with nutritional problem and the knowledge level of the primary school children regard- can create the awareness regarding way to maintain ing healthy dietary pattern. The study proved that the pri- healthy dietary pattern. Training program can be arranged mary school children were having inadequate knowledge for school teachers for maintenance of good health so regarding healthy dietary pattern during pre-test and through that they can train the school children in better gained adequate knowledge level after educating through way. Regular screening of school children to detect the snake and ladder game. The study also emphasizes the nutritional deficiency and refer them to doctors before the effectiveness of snake and ladder game. Still there is a complication arises. need to create awareness among parents and community people regarding healthy dietary pattern. Nursing Administration
As per the present study findings, it is the duty of nurse References: administrators to organize educational programme for 1. Maqbool Asim. Clinical assessment of nutritional Sta- school teachers and school health nurses regarding tus. Research gate.[online].January 2008; [cited on maintenance of healthy dietary pattern. The nurse admin- 25th May 2017]. Available from URL: https:// istrators have to motivate the school teachers to incorpo- www.researchgate.net/ rate various simple and cost effective method to educate publication/242085606_Clinical_ Assess- children rather than traditional method of teaching. ment_of_Nutritional_Status. 2. Dr.IshratRafiqueEshita. Nutritional status of adoles- Nursing Research cent School of Urban and Rural Area, Kindle edition The present study serves as a evidence based practice for [online]. April 2016; [cited on 13th February]. Availa- the further studies. The various innovative ideas can be ble from URL: https://www.amazon.in/Nutritional- invented and implement to improve the healthy dietary Status-Adolescent-Children-Selective-ebook/dp/ pattern. B06XY9VMJ2 3. Dutta Parul, Pediatric Nursing . 2ndedition. New Del- Limitations hi; Jaypee Brothers Medical publishers Pvt. Ltd;2009. Small number of subjects limits generalization of the Page no: 200-201 study. 4. Chang HS, Kim MJ. Study on Dietary Behaviors of Only a single domain that is knowledge is considered Elementary School Student in Chungnam Area. in the present study. Korean Journal of Community Nutrition. 2006 Oct; 11
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RESEARCH ARTICLE Effectiveness of Assertiveness Training on Assertive Behaviour among Adolescent Girls
Ms. Amita Chaudhari, Mr. Jinto Philip Maniba Bhula Nursing College, Gopal Vidyanagar-Tarsadi, Bardoli.
ARTICLE INFO ABSTRACT
Adolescence is a crucial period in the development of the self-concept. Asser- Article History: tiveness is a way of thinking and behaving that allows a person to stand up for Received on 26thNov. 2018 his or her rights while respecting the rights of others. Acting assertively can in- crease self confidence in relationship, helps to feel better and give a sense of Received in control in everyday situations. Objective: The main objective of the study was revised form 28th Nov. 2018 to assess the effectiveness of assertiveness training among adolescent girls in Accepted on 30thNov. 2018 experimental group. Methodology: A quasi experimental, non-randomized con- trol group design was adopted for this study. Convenient sampling was used to Published online on 4th Dec. 2018 select the samples. Samples: Total 60 adolescent girls in the age group of 13 to th th 16 years studying in 9 and 10 standard were selected. 30 samples each were Key Words: assigned to experimental and control group. Modified Rathus Assertiveness scale was used to collect the data. The assertiveness training consisted five ses- Assertiveness, Training, Behaviour, sions with duration of one hour each. Results: Independent t-test was used Adolescent, Girls. at0.05 level significance for the analysis of the data. While the t-value obtained Corresponding Author: for pre-test in experimental group was 0.96, the t-value for post-test was 9.72. Ms. Amita Chaudhari Conclusion: The asser tiveness training session was found to be effective in improving the assertive behaviour of adolescent girls. Assertiveness training can LECTURER, MBNC ,UTU, be effective in enhancing the self- confidence and self-esteem thereby, prevent- Gopal Vidyanagar, Bardoli ing or reducing anxiety and depression among adolescent girls.
Copyright © UTUJAHI 2018. Ms. Amita Chaudhari. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Introduction the third leading cause of illness and disability among ad- Human life is divided into five main stages namely infan- olescents, and suicide is the third leading cause of death in cy, childhood, adolescence, adulthood and old age. In older adolescents (15–19 years). Violence, poverty, humil- each of these stages an individual has to find himself in iation and feeling devalued can increase the risk of devel- different situations and face different problems. Many ad- oping mental health problems. A study conducted in 2015 olescents do not let their ideas out which is inside to them on School bullying an aggressive behaviour which tends because it may go wrong. The adolescents face so many to harm another in school environment. The study showed problems in physical as well as psychological aspect. It is a high significant association between assertive not easy for them to cope up with the problems. If they knowledge and assertive behaviour in pre-test and post- fail to cope up, it may lead to mental health problems. All test and a low significant association between abuse histo- India survey estimated (2015) 243 million number of ado- ries with the assertiveness. And the study recommended lescents in India. About one-quarter of India’s population that the assertive training for adolescents should become a are adolescents. Globally, 1 in 10 girls under the age of 20 part of health school program with teacher and parents’ years report experiencing sexual violence. Depression is support.
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Statement of the problem Adolescent girls who undergone Assertiveness Train- A quasi experimental study to assess the effectiveness of ing Programme previously. assertiveness training on assertive behaviour among ado- Adolescent girls whose age group is other than 13-16 lescent girls in a selected school at Bardoli, Surat, Gujarat years of age.
Objective of the study Description of tool: To assess the effectiveness of assertiveness training 1. Socio-demographic Proforma among adolescent girls in experimental and control group. 2. Modified Rathus Assertiveness Scale. It is a 3 point rating scale which is self-administered. It consisted of Hypotheses 35 items. H01: There is no significant difference between pre- test scores of assertive behaviour in experimental Description of Assertiveness training session group and control group. The assertiveness training session for assertiveness behav- H02: There is no significant difference between post- ior among adolescent girls was developed by the research- test scores of assertive behaviour in experimental er. The training consisted of five sessions included various group and control group. topics such as assertiveness, assertive right and self-
H03: There is no significant difference between pre- confidence, dealing with criticism and communication test and post-test scores of assertive behaviour in ex- skills. perimental group.
H04: There is no significant difference between pre-test Conceptual framework scores and post-test scores of assertive behaviour in In present study, Conceptual framework used based on control group The Health Belief Model (HBM) by Dr. Pender in 1950.
Delimitations: The study was delimited to Results Adolescent girls in the age group of 13 to 16 years. Table No 1: Mean, median, mode, standar d deviation, Adolescent girls studying in 9th and 10th standard of a and range of assertive behaviour level score of subjects on selected School. adolescent girls in experimental group. n=30
Area of Mean Median Mode SD Range Materials and methods analysis (H-L) Research Approach : Quantitative Evaluative ap- Pre test 58.53 59 55 3.90 18 proach Post test 75.16 75 70 4.8 22 Research Design : Quasi experimental, Non- randomized control group Research population : Adolescent gir ls The table No. 1 showed that in the experimental group Research Setting : B.A.B.S High School, Bar- mean in pre-test is 58.53 and in post-test 75.16, the medi- doli, Surat, Gujarat. an in pre-test is 59 and in post-test 75, the mode in pre- Sample : Adolescent girls (age 13-16 test is 55 and in post-test 70, the standard deviation in pre- years and studying in 9th and 10th std) test is 3.90 and in post-test 4.8 and the range in pre-test is Sample size : 60 (30 experimental and 30 18 and in post-test 22. control group) Sampling Technique : Convenient sampling tech- Graph 1. Bar diagram showing the effect of assertiveness training on assertive behaviour of adolescent girls in experi- nique mental group.
Inclusion Criteria Adolescent girls whose age group is between 13-16 years of age. Adolescent girls who are willing to participate. Adolescent girls who can speak and understand Eng- lish/Gujarati. Exclusion Criteria Adolescent girls who are not co-operative at the time of data collection.
The Journal of Advanced Health Informatics Vol. 1 Issue. 4 July-Dec. 2018 Table No 2: Mean, median, mode, standar d deviation, Table no 4 revealed that, in the post-test calculated inde- and range of assertive behaviour level score of subjects on pendent‘t’ value (t cal = 9.72) is greater than tabulated val- adolescent girls in control group. n=30 ue (t tab= 2.00). Hence, the null hypothesis rejected.
Area of Mean Median Mode SD Range From the above tables (Table no 3 and Table no 4), it is analysis (H-L) Pre test 59.6 59.5 59 4.6 20 statistically proven that assertiveness training session among adolescent girls was effective. Post test 65 65.5 64 3.05 11 Discussion The table No. 2 showed that the mean in the pre-test is In the present study, researcher conducted five sessions of 59.6 and in post-test is 65, median in the pre-test is 59.5 assertiveness training each with duration of 60 minutes for and in post-test is 65.5, mode in the pre-test is 59 and in the experimental group. In a similar study conducted by post-test is 64, standard deviation in the pre-test is 4.6 and Raziyeh Saeed Manesh et. al. (2015) the experimental in post-test is 3.05 and the range in the pre-test is 20 and group received assertiveness training in 8 sessions of at in post-test is 11 in the control group. most 60 minutes. The study Results indicated that social anxiety scores in the intervention and control groups de- Graph 2. Cone diagram showing the effect of assertiveness creased more than in the placebo group and also indicates training on assertive behaviour of adolescent girls in control the importance of assertiveness skill training on the social group. anxiety. In the present study researcher adopted independent ‘t’ test for analysing significance of difference between the mean pre-test and post-test assertive behaviour level re- garding assertiveness training among adolescent girls in the experimental and control group. And the findings re- vealed that there is statistical significant difference in the experimental group which proved the effective of asser- tiveness training. This finding was supported by a study, which was conducted by Qadir, S. A. at all (2015) to iden- tify the effectiveness of an assertiveness training program on assertiveness skills and mental, physical and spiritual wellbeing of Muslim adolescent girls. The study results
showed that the assertiveness training programme has Table No 3: Mean difference, standar d deviation of the been very effective in improving the assertiveness as well difference and standard error of the mean difference and as the overall wellbeing of the adolescents. The study also independent‘t’ value of pre-test scores between experi- supported by a study, which was conducted by Jeba Shali mental and control group. n1+n2 = 60 P. (2015) on the effectiveness of assertiveness training on Mean dif- SDD SEMD Independent ‘t’ values social anxiety among adolescent girls. The study showed ference Cal. Val. Tab. Val. @ that assertiveness training was effective in reducing the (d) df 58 level of pain in social anxiety and also reducing the level 1.06 0.72 1.10 0.96 2.00 of social anxiety. References: Table no 3 showed that, in the pre-test calculated inde- 1. Adolescent health and development. WHO Regional pendent ‘t’ value (t cal = 0.96) is lesser than tabulated val- 1. Office for South-East Asia. http:// ue (t tab= 2.00). Hence, the null hypothesis was accepted. www.searo.who.int/entity/child_adolescent/topics/ adolescent_health/en/index. html. Table No 4: Mean difference, standar d deviation of the 2. UNICEF India. Press Releases. Adolescence - An Age mean difference and standard error of the mean difference of Opportunity. URL:http://unicef.in/ and independent‘t’ value of post-test scores between ex- PressReleases/87/Adolescence-An-Age-of- perimental and control group. n +n = 60 1 2 Opportunity. Mean dif- SDD SEMD Independent ‘t’ values 3. Himanshu Kaushik. Nearly 30% of Gujarat population ference Cal. Val. Tab. Val. @ aged between10-24 years: Census. Times of India, (d) df 58 city. https://timesofindia.indiatimes.com/city/ 10.30 1.67 1.05 9.72 2.00 ahmedabad/Nearly-30-of.
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RESEARCH ARTICLE To assess the Knowledge and Practice regarding Prevention of Protein Energy Malnutrition [PEM] among the Mothers of under-five children
Ms. Dhanya George and Mr. Chanagiri Aurasang Maniba Bhula Nursing College, Gopal Vidyanagar-Tarsadi, Bardoli
ARTICLE INFO ABSTRACT Article History: Protein–energy malnutrition refers to a range of pathological conditions arising from coincident lack of varying proportions of protein and calorie named th Received on 24 Nov. 2018 Kwashiorkor and Marasmus, occurring most frequently in infants and young Received in children and often associated with infection. A descriptive study was conducted revised form 27thNov. 2018 to assess the knowledge and practice regarding Prevention of Protein Energy Malnutrition [PEM] among the mothers of under-five children residing at select- th Accepted on 30 Oct. 2018 ed rural areas of Sarbhon PHC in Bardoli, Surat, Gujarat with a view to devel- op an information booklet. Data was collected from 60 mothers of under-five Published online on 4th Dec. 2018 children through structured interview schedule from 03/03/2018 to 31/03/2018. Key Words: Collected data computed by using descriptive and inferential statistical methods. The results of the study showed that, majority of the subjects 53 (88.3%) had Knowledge, Practice, Prevention, average knowledge and 34 (56.7%) had average practice scores. there is no cor- PEM, Mothers, Children relation between knowledge and practice. Hence the H01 is accepted. There is no Corresponding Author: association between knowledge scores and their selected socio-demographic Ms. Dhanya George variables. There is no association between practice scores and their selected so- cio-demographic variables. The study concludes that there is need to improve LECTURER, MBNC ,UTU the knowledge of mothers regarding nutrition of the children. Gopal Vidyanagar, Bardoli
Copyright © UTUJAHI 2018. Ms. Dhanya George. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Introduction Signs of PEM were higher in younger age groups of 3-5 Proteins are one of the most amazing group of molecules years than in 11-33 years, while vitamin deficiency signs in the human body. They are complex combinations of were more in 11-33 years age groups. The peak preva- smaller chemical compounds called amino acids. These lence of Kwashiorker was frequently seen in the age group are like the bricks or building blocks of a building. It is a of 2-3 years and Marasmus in 1-2 years. About 50 % of component of every cell in your body. In fact, hair and children were anaemic. nails are mostly made of protein. It is an important build- ing block of bones, muscles, cartilage, skin, and blood. Need for the Study Energy fuels your body's internal functions, repairs, builds It has been found that, the child reacts to the stress of and maintains cells and body tissues, and supports the ex- PEM and secretes cortisol which mobilises protein from ternal activities that enable you to interact with the physi- muscle and subcutaneous tissue to amino-acid pool result- cal world. ing in wasting with no oedema and no hepatomegaly. Ac- Malnutrition refers to the situation where there is an un- cording to WHO, In 2016 globally, 52 million children balanced diet in which some nutrients are in excess, lack- under five were wasted and 17 million were severely ing or wrong proportion. Simply put, we can categorize it wasted. This translates into a prevalence 7.7 per cent and to be under-nutrition and over-nutrition. 2.5 per cent, respectively. In 2016, World Bank Group
The Journal of Advanced Health Informatics Vol. 1 Issue. 4 July-Dec. 2018 joint malnutrition estimates, 22.9 %, or just under one in Conceptual framework four children under age five worldwide had stunted The linkage of research findings into a coherent structure growth. makes the body of accumulated knowledge more accessi- In 2017, WHO reports, between 2000 and 2016, the num- ble when an appropriate conceptual framework is incorpo- ber of stunted children under 5 worldwide declined from rated. 198 million to 155 million. In 2015, Global Hunger In- The conceptual framework is a set of broad ideas and dex (GHI) Reports that, India ranked 20th amongst lead- principles taken from relevant field of inquiry and used to ing countries with a serious hunger situation. The preva- structure a subsequent presentation. It carries potential lence rate of severe degree of PEM in our community is 3- usefulness as a tool to scaffold research and assist re- 5% for every 3-5 cases of severe PEM. In Gujarat state, searcher to make the meaning of subsequent findings. Women and Child Development department estimates, the Conceptual model of the present study is based on Ludwig percentage of children suffering from malnutrition in the Von Bertlanfly’s general system of theory (1964). state has fallen to under 5.85% in children younger than six years old. 3.41% of Anganwadi children were found to Methodology have malnutrition. In Surat district, as per Women and Research Approach : Quantitative Survey ap- Child Development Department in March 2016, 10.59 % proach of children are moderately Underweight , 1.29 % of Se- Research Design : Non experimental resear ch de- vere Underweight and the total percent under-weight are sign 11.88 out of 88.12 percent of normal under-fives. Key Variables : Knowledge, Practice and Infor- mation booklet Statement of the problem Research Setting : Villages of Sarbhon PHC in A study to assess the knowledge and practice regarding Bardoli Tehsil. Prevention of Protein Energy Malnutrition [PEM] among Research Populations : Mothers of Under -Five the mothers of under-five children residing at selected ru- Children. ral areas of Sarbhon PHC in Bardoli, Surat, Gujarat with Target Population : Mothers of under five children a view to develop an information booklet residing at selected village of Sarbhon PHC in Bar- doli Tehsil. Objectives of the study Sample : mothers of under -five children. 1. To assess the socio-demographic variables of the Sample size : 60 mothers of under -five children mothers of under-five children. Sampling Technique : Convenient sampling tech- 2. To assess the knowledge and practice regarding the nique prevention of protein energy malnutrition among mothers of under-five children. Criteria for sample selection 3. To find out the correlation between knowledge and Inclusion criteria: Mothers of under -five children practice among mothers of under-five children regard- 1. who are willing to participate in this study. ing the prevention of protein energy malnutrition. 2. who are comprehend English and Gujarati language. 4. To find the association between knowledge and prac- tice scores among mothers of under-five children re- Exclusion criteria: Mothers who are not available garding the prevention of protein energy malnutrition during the time of data collection. with their selected socio-demographic variables. 5. To develop an information booklet for mothers of Variables: Knowledge and Practice of the mothers under-five children regarding the prevention of pro- tein energy malnutrition. Results The data presented under the following sections: Hypothesis Section I: Distribution of sample characteristics ac- H01: –There is no correlation between knowledge and cording to their socio-demographic variables. practice scores of mothers of under-five children regard- Section II : The analysis and interpretation of collect- ing prevention of protein energy malnutrition. ed data regarding knowledge and practice scores of H02: -There is no association between knowledge and subjects on PEM. practice scores with their selected socio-demographical Section III : Testing Hypothesis. variables.
The Journal of Advanced Health Informatics Vol. 1 Issue. 4 July-Dec. 2018
Section –I Table No. 2: Frequency and percentage distribution of Out of 60 samples, Majority of the subjects 48 (80%) be- knowledge scores of subjects regarding PEM. n=60 longed to the age group of 18-21 years. Most of the sub- jects participated in the study 58 (96.7%) were illiterate. Knowledge score Frequency (f) Percentage (%) All of the subjects (10) participated in the study were be- Good (27-40) 0 0 longed to Hindu community (100%) .Highest of the sub- Average (14-26) 53 88.3 jects participated in the study were belonged to joint fami- Poor (0-13) 7 11.7 ly 32 (53.3%). The maximum number of age of last child between one –two were 42 (70%). Many of the subjects participated in the study were house wives 58 (96.7%). Table 2 depicts that the majority of the subjects 53 Most of the mothers had only one child were 42 (70%). (88.3%) had average knowledge, 7 (11.7%) had poor Highest of the subjects participated in the study were hav- knowledge and nobody had Good knowledge scores re- ing monthly income below 5000 are 47 (78.3%). Majority garding prevention of PEM. of the subjects participated in the study 50 (83.3%) were consuming vegetarian diet. Most of the participants of the Table No. 3: Frequency and percentage distribution of main study were getting the health informations by health practice scores of subjects regarding PEM. n=60 professionals 31 (51.7%). Practice score Frequency (f) Percentage (%) Section– II Good (35-40) 26 43.3 Table No. 1: Mean, Median, Mode, Standard Devia- Average (18-34) 34 56.7 tion, and Range score of subjects regarding knowledge Poor (0-17) 0 0 and Practice of PEM. n=60 Table 3 shoed that, most of the subjects 34 (56.7%) had Area of Mean Median Mode Sd Range average practice, 26 (43.3%) had Good practice scores Analysis Knowledge 20.60 19.5 19 4.03 14 and nobody with poor practice regarding prevention of score PEM. Practice 31.4 31.5 28 2.87 8 score Section-III Table No. 4: co-relation between knowledge and prac- Table 1 depicts that, Mean 20.60, Median 19.5, Mode 19, tice scores of mothers of under five children and their Standard deviation 4.03 and Range 14 for the Knowledge selected socio- demographic variables. scores and Mean 31.4, Median 31.5, Mode 28, Standard Area of Cal. val- Tab. deviation 2.87 and Range 8 for the practice scores respec- Mean df Result tively. analysis ue value
Knowledge 17.58 Non- 0.136 59 0.250 Graph 1: Mean, Median, Mode, Standard Deviation, and Practice 33.53 significant. Range score of subjects regarding knowledge and Practice of PEM. The results of the study depicted that, there is no correla- tion between knowledge and practice. Hence the H01 is accepted. And There is no association between knowledge 8 scores and their selected socio-demographic variables. 2.87
28 Practice Discussion 31.5 Range The results of the present study showed that, Mean 20.60, 31.4 S D Median 19.5, Mode 19, Standard deviation 4.03 and Mode Range 14 for the knowledge scores and Mean 31.4, Medi- 14 Median an 31.5, Mode 28, Standard deviation 2.87 and Range 8 4.03 Mean for the practise scores respectively. When we look at the Knowledge 19 19.5 central tendency of the tool lies between 19 – 21 which 20.6 shows the tool prepared on knowledge aspects regarding protein energy malnutrition by the investigator was feasi-
0 5 10 15 20 25 30 35 ble to conduct the study whereas in attitude scale, it lies
The Journal of Advanced Health Informatics Vol. 1 Issue. 4 July-Dec. 2018 between 28 – 31. As we compared to knowledge and prac- Limitations tice scale, the difference of central tendency is 2 – 3. The The findings of the study can not be generalized due same results were found in pilot study conducted by the to small study sample. investigator. Overall results of the study showed that, the Study is limited to only the mothers who are residing tool prepared by the investigator can be utilized to conduct at selected villages of Sarbhon PHC. other similar study. Conclusion. The study results showed that, the majority of the subjects Based on the findings of the study, the following conclu- were having average knowledge. As we compared to their sions are noted. socio- demographic variables, majority of the mothers The overall results of the study suggested there is an were illiterate and they were not able to follow the instruc- urgent need to educate the mothers towards protein tions. The same results were incorporated Alwar AJ energy malnutrition (PEM). (2004), saying that illiterates are the people who are not The study results revealed that the majority of the so- having formal education are having less knowledge than cio-demographic variables did not have the associa- the people who are educated. The results of the study tion between knowledge and practice regarding the showed that, 43.3% of the mothers had good practice prevention of protein energy malnutrition. scores. This may be the result of their practice or the expe- There is no correlation between the knowledge and riences gained by them in their life span. Even though practice regarding the prevention of protein energy mothers having good knowledge but they were having less malnutrition. 44 practice . The same results were incorporated Mrs.Yadav To educate the mother, the investigator developed an Sarika(2016) saying that the housewives were processing information booklet on PEM. better practice towards preparation of diet. Bibliography The results of the study depicted that, there is no correla- 1. Dr. Lawrence W. Protein.[online];[cited on tion between knowledge and practice. Hence the H01 is 1/07/2017]; December 2015; L.D.W Consultants; accepted. The same results were incorporated Bhat IA, Available from URL:http:/drlwilson.com/ articles/ Shah GN, Dhar GM and Mehnaz S (2001 saying that, illit- PROTEIN2.htm. erate or no formal education people were not having cor- 2. Noah S. Protein-Energy Malnutrition. Medscape relation between their knowledge and practice. [online];[cited on 1/07/2017]: Available from There is no association between knowledge scores and URL:http://emedicine.medscape.com/article/ 1104623 their selected sociodemographic variables. In other words, -overview. H02 is rejected in case of age, education, occupation, reli- 3. Venom J. Impact of malnutrition on immunity and gion, income, number of children in the family, age of last infection. [online]; [cited on 01/07/2017]: Journal of child, type of family and source of health information and Venomous Animals and Toxins including Tropical it is accepted in case of dietary pattern. Diseases;vol.15 no.3 Botucatu 2009.; Available from There is no association between practice scores and their URL: http://dx.doi.org/ 10.1590/S1678 selected sociodemographic variables. In other words, H02 4. Bhishm K. What are the factors contributing to Pro- is rejected in case of age, education, occupation, religion, tein-Energy Malnutrition (PEM)?. PRESERVE ARTI- income, number of children in the family, age of last CLES[online]. [cited on 01/07/2017]:Available from child, type of family, dietary pattern and source of health URL : http:// information . www.preservearticles.com/201012302096/factors- contributing-to-protein-energy-malnutrition.html. Recommendations 5. UNICEF report on hunger and related protein energy A similar study on large sample and wider setting can malnutrition [online];[cited on 24/06/2017]Available be undertaken by the investigator. from URL:http://unicef.in/Story/ 1124/Nutrition An experimental study on PEM can also be done to 6. Dudh Sanjeevini project. [Online]; [cited on improve the knowledge and practice. 22/04/2017]; Available from URL: http:// A similar study can be conducted in the hospital set- www.narendramodi.in/ cm-launches-%E2%80% ting as well. 98doodh-sa njiv ani% E2 %80%99-project-in-surat- A similar study can be conducted among fathers also 4588. along with mothers.
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RESEARCH ARTICLE Effectiveness of Planned Teaching Programme on Knowledge Regarding Organ Donation Among Under Graduate Students
Mrs. Meghana Goswami, Mr. Manjunath Beth, Ms. Anu Baby, Maniba Bhula Nursing College, Gopal Vidyanagar-Tarsadi, Bardoli
ARTICLE INFO ABSTRACT Article History: According to National Organ and Tissue Transplantation Organization (NOTTO), 2017 statistical analysis showed that Gujarat was on 5th rank in organ th Received on 24 Nov. 2018 donation in India. The main objective of the study was assessing the effective- Received in ness of PTP on knowledge regarding organ donation among under graduate stu- revised form 27thNov. 2018 dents. True experimental pre-test post-test control group design was adopted. 100 final year students selected from selected Arts and Commerce College by th Accepted on 30 Oct. 2018 using simple random sampling technique. . Data was collected between 15-2- 2018 to 22-2-2018, by the tool which consist the selected socio demographic Published online on 4th Dec. 2018 variables, self-administered structured knowledge questionnaire. The study find- Key Words: ings depicted that there was a significant difference between the pre-test and post-test level of the knowledge score of experiment group than the control PTP, Organ, Donation, Graduate, group. The calculated paired ‘t’ test value of knowledge score was 18.04, the Knowledge calculated unpaired ‘t’ test value of knowledge score was 12.89, which was Corresponding Author: greater than tabulated value. So the given PTP was effective to enhance the Mrs. Meghana Goswami knowledge of the undergraduate students. It also depicted that there was a sig- LECTURER, MBNC ,UTU, nificant association between pre-test knowledge score with their selected socio- demographic variables like parents education, habitant and heard about organ Go- pal Vidyanagar, Bardoli donation. The study concluded that there was a need of different instructional strategies to enhance the awareness regarding organ donation in the community.
Copyright © UTUJAHI 2018. Mrs. Meghana Goswami. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Introduction organ and is in good health, then organ donation is Life is a dynamic process. You were born with the ability certainly an option. New-born as well as senior citizens to change someone’s life. We can’t help everyone but eve- have been organ donors. ryone can help someone. The gift of donated organ and tissue provides recipients with the opportunity to regain When you donate your organ you will save or give new health and productive period of life. The medical advance- life to the other person whom you will donate. After trans- ment and technology has begun to save lives and the most plantation person can live for many years if no complica- miraculous achievement of modern medicine is organ tion will found. The longest living kidney transplant is 34 transplantation which has the power to save the lives of years, longest surviving hear transplantation is 22 years, the client. There is no age limit for organ donation. The longest living liver transplant is 27 years and longest liv- donor has successfully procured organs from donors as ing lung transplant is 12 years. So by organ donation we young as a few days to adults in their 90s. A pa- can increase lifespan of the person whom the transplanta- tient's medical history is more important than the age tion done successfully. of the donor. If a person has a normal functioning
The Journal of Advanced Health Informatics Vol. 1 Issue. 4 July-Dec. 2018 Need for the Study Hypotheses: Organ donation is legal by law because the Government of H01: There is no significant difference between pre-test India has enacted "The Transplantation of Human Organs knowledge score and post- test knowledge score of under Act 1994." Act No.42, which has allowed organ donation graduate students of experimental group regarding organ and legalized brain death. According to National Organ donation. and Tissue Transplantation Organization (NOTTO) 2017 by statistical analysis in Gujarat organ donation status for H02 : There is no significant difference between pre-test knowledge score and post- test knowledge score of under 2014 were 80, in 2015 were 122, in 2016 were 136 and in graduate students of control group regarding organ dona- 2017 were 242. According to the data provided by differ- tion. ent reports mentioned it is clear that shortage of organ is a great threat to the medical field and while views of organ H03: There is no significant difference between post-test donation are positive there is a large gap between the knowledge score of under graduate students between ex- numbers of registered donors compared to those awaiting perimental and control group regarding organ donation. organ donations on a global level. Lack of awareness along with myths and misconceptions add to the low per- Ho4: There is no significant association between pre-test centage of organ donation. Young adults represent the knowledge score with their selected socio demographic future of the society and have a direct influence on family variables of under graduate students regarding organ do- members and friends. A favorable knowledge of the nation studying in selected colleges of Navsari. young adults in this matter not only means a positive per- sonnel attitude towards organ donation, but it can also be Conceptual framework the determining factor for authorizing donation when In the present study modified conceptual framework of faced with the death of a family member. Imogene King Goal attainment theory (1981) was adopt- ed. King’s latest model of nursing incorporates three dy- Statement of the problem namic interaction systems: personal, interpersonal, and A Study To Assess The Effectiveness Of Planned Teach- social, which lead to development of a theory of goal at- ing Programme (PTP) On Knowledge Regarding Organ tainment. Donation Among Under Graduate Students In Selected Colleges Of Navsari In Gujarat State Methodology Research Approach: Quantitative (Evaluative) Objectives of the study Research Design : True experimental design 1. To assess the socio-demographic variables of the un- Research method : Pre-test post-test control group dergraduate students. method 2. To assess the knowledge regarding organ donation Research setting : Naranlala College of Commerce among under graduate students studying in selected and Management (experimental group) S.S Agrawal colleges of Navsari . Commerce and Arts College (control group) at Navsa- 3. To find out the effectiveness of planned teaching pro- ri. gramme on knowledge regarding organ donation in Variables : Independent: PTP on Organ donation experimental group. Dependent: Knowledge 4. To compare the post-test knowledge score regarding Research population : Undergr aduate student organ donation among under graduate students study- from arts and commerce stream from Gujarat state. ing in selected colleges of Navsari between experi- Target population : Undergraduate students for mental and control group. experimental group from Naranlala college of com- 5. To find out the association between pre-test merce and management and for control group S.S knowledge scores with selected socio-demographic Agrawal commerce and arts college at Navsari variables of under graduate students regarding organ Sample : Final year under graduate students from Na- donation. ranlala college of commerce and management (experimental group) and of S.S Agrawal commerce Assumptions and arts college(control group) at Navsari. 1. Undergraduate students may not have adequate Sample size : 100 (50- experimental 50- control) knowledge towards organ donation. Sampling Technique : Probability sampling- Ran- 2. Planned Teaching Programme may not enhance the dom sampling (lottery method). knowledge among the under graduate students to- wards organ donation.
The Journal of Advanced Health Informatics Vol. 1 Issue. 4 July-Dec. 2018 Selection Criteria for Samples: In control group in pre-test majority of samples 38(68%) Inclusion criteria : Students had average knowledge, 12 (24%) had poor knowledge who were willing to participate. and no one had good knowledge, where as in post-test from Arts and Commerce stream. majority of samples 39(78%) had average knowledge and who are studying in third year. 11(22%) had poor knowledge and no one had good who know to read and write Gujarati and English. knowledge. Exclusion criteria : Students who are not present during the time of study. Graph 2: Pyramid diagram showing difference be- tween pre-test post-test knowledge score of control group Description of the tool regarding organ donation. Section I: Performa for collecting socio demographic data which include age, gender, course of the study, religion, types of family, parents education, place of residence, have you heard about organ donation, sources of infor- mation. Section II: Structured knowledge questionnaire regarding organ donation which comprises 30 questions related to knowledge regarding organ donation. Each right answer carries 1 mark and maximum score is 30 and minimum score is 0.
Results Major findings of the study were as below: Section 1: Socio-demographic variables Most of the samples 48 (48%) were belonged to 21-22 year, 59 (59%) were female, 57 (57%) were from Com- Table 1: Comparison of knowledge scor es regarding merce, 89 (89%) were Hindu, 61 (61%) were belonged to organ donation between experimental and control group. joint family, 57 (57%) were literate parents, 52 (52%) n1+n2= 100 from urban, 54 (54%) had not heard about organ donation, Knowledge Pre test Post test 21 (21%) had resources was mass media. score Exp. Cntl. Exp. Cntl. Section 2: Knowledge regarding organ donation f % f % f % f % Study findings showed that in pre-test majority of samples 35(70%) had average knowledge, 10 (20%) had poor Poor 10 20 12 24 3 6 11 22 knowledge and 5(10%) had good knowledge, where as in Average 35 76 38 68 4 8 39 78 post-test majority of samples 43(86%) had good Good 5 10 00 00 43 86 00 00 knowledge, 4(8%) had average knowledge and 3(6%) had poor knowledge in experimental group. Table 1 reveals that the post-test knowledge scores of ex- Graph 1: Cylindrical diagram showing difference be- perimental group was higher than the control group. tween pre-test post-test knowledge score of experimental group regarding organ donation. Table 2: Mean, Mean difference (d), Standard Error of Di ference (SED), Standard Error of Mean Difference (SEMD) and paired ‘t’ values of knowledge scores in ex- perimental group.
Knowle Mea Mea SE SE Paired ‘t’ df dge n n D MD test value score dif- feren Cal. Tab ce . Pre test 15 7.38 0.12 0.40 18.04 2.02 4 Post test 22.38 9
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Calculated paired ‘t’ value 18.04 was greater than tabulat- Discussion ed value 2.02 at 0.05 levels. Therefore, the PTP regarding The findings of the study supported by Mohan M.(2016) organ donation was effective to improve the knowledge of has revealed that post-test level of knowledge regarding samples in experimental group. the organ donation in experimental group that none of the students had inadequate knowledge, 15(37.5%) of the stu- Table 3: Mean, Mean difference (d), Standard Error of dents had moderately adequate knowledge and 25(62.5%) Difference (SED), Standard Error of Mean Difference of the students had adequate knowledge. Where as in the (SEMD) and paired ‘t’ values of knowledge scores in con- control group 27(67.5%) of the student had inadequate trol group. knowledge and 13(32.5%) of the students had moderately adequate knowledge and none of the students had ade- quate knowledge in the control group, which show that Knowle Mea Mea SE SE Paired ‘t’ df computer assisted instruction was effective to enhance the dge n n D MD test value score dif- knowledge of the individual regarding organ donation in feren Cal. Tab experimental group. The paired ‘t’ test value 19.86 at . ce p<0.005 level of significance for knowledge in experi- Pre test 13.22 0.38 0.01 0.54 0.69 2.02 4 mental group, whereas in control group and calculated Post test 13.60 9 paired ‘t’ test value 1.13. The knowledge calculated un- paired ‘t’ value 13.16 was greater than tabulated value Calculated paired ‘t’ value 0.69 was lower than tabulated 2.022, which indicate that Computer assisted instruction value 2.02 at 0.005level of significance. This indicates that on organ donation was effective to improve the knowledge there was no significant difference pre-test and post-test of the samples. knowledge score in control group. Nursing implications Table 4: Mean difference, standar d deviation of the The preent study had certain Nursing implication towards difference and standard error of the mean difference and the Nursing education, Nursing practice, nursing admin- independent ‘t’ value of post-test knowledge scores be- istration and Nursing research as follows. tween experimental and control Nursing Education The Nursing curriculum includes the awareness regarding Mean Unpaired ‘t’ val- Degree organ donation. As a Nurse practitioner she should know differ- SDD SEMD ues of free- the organ donation requirement, organ donor rate, pre req- ence Cal. Tab. dom (d) uisite for the organ donation and important things that 8.78 1.38 0.68 12.89 1.98 98 convey the family members or patients for the organ dona- tion, which increase the organ donor rate and increase the awareness regarding organ donation in the society.
Calculated unpaired ‘t’ value 12.89 was greater than tabu- Nursing Practice lated value 1.98. Hence H03 was rejected. This indicates Organ Donation is windfall to medical industry as it has that the gain in knowledge score was statistically signifi- helped in saving the lives of those who would have died cant at 0.05 levels. Therefore, PTP regarding organ dona- otherwise. There is a great need for human organs for tion was effective to improve the knowledge of samples. transplantation. Specially Medical Surgical Unit, ICU staffs are deal with critical patient so they can communi- Section 3: Association between knowledge regarding cate and provide information regarding organ donation to organ donation with their selected socio-demographic the family members and patients which helpful for the so- variables. ciety to decrease the death rate due to organ failure. As a The study findings depicted that the calculated chi-square Community Health Nurse she go for home visit and do the value was less than tabulated chi-square value in some awareness by conducting health education regarding organ demographic variables; whereas in parents education, hab- donation to the family members, adolescence and commu- itant and heard about organ donation calculated chi square nity people. value was more than tabulated value. Hence this indicates that there was an association between pre-test knowledge Nursing Administration score and some socio demographic variables at 0.005 level The Nursing administration should make necessary initia- of significance. tives of:
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Collaborate with governing bodies to formulate stand- References ard policies and to emphasize the policies to the socie- 1. Myers L. Judith, Patricia Gauntlett Beare. Text book ty. of Medical Surgical Nursing. 3rd edition. Mosby pub- Organize the seminars, workshop, conferences regard- lication; 1998. Page no.1108 – 1113 ing organ donation among the Nursing staffs and as 2. Harish kumar. Review on Death and organ donation. well as in student Nurses. Amritha journal of medicine. [online].Vol.24;Issue.2;April 2007;[cited on 25th Nursing Research june2017].Available from URL: www.guhs.ac.in/cdc/ Nursing research can be focused on various factors of or- onlinecdc/uploads/05_N076_13621.doc gan donation, which could help to assess the hindering 3. k.Lalitha.,R.Pushpamala,.M.Bramaramba.A study to factors for organ donation. It also focused on legal and assess the knowledge and attitude regarding organ ethical issues regarding organ donation, so it helpful for donation among under graduate students studying in a the staff nurse to communicate to the patients and relatives selected arts and science college, at Guntur. Asian for clear the doubt and safety for the nurse. Disseminates journal of Nursing education and research.[online]. the findings of the research through conferences, seminars Vol.4,No.2;April-june2014;P.195-202.[cited on 7th and publishing in the journals. Future research needs to June].Available from URL: :http://www.i-scholar.in/ examine the impact of financial incentives on rates of de- index.php/Ajner/article/view/138716 ceased and living donors. 4. Shastri. Parth. Once the leader, Gujarat now fifth in organ donation,Times of India;Julay 10,2018:pp 4; Recommendations Column no. 5-8. Similar study can be under taken a large sample to 5. Mrs. Deepa sakthivel. Review article on organ dona- generalize the findings. tion. International journal of advances in nursing A comparative study can be conducted to assess the management. A&V publication; Raipur, chhatisgrah. knowledge and attitude regarding organ donation be- Vol.3; Issu.2: April-June 2015: p.173-175. th tween rural and urban population. 6. organ donation in India[online].[cited on 7 A comparative study can be conducted to assess the june2017];Available from: http://donatelifeindia.org/ knowledge and attitude regarding organ donation be- about-organ-donation/organ-donation-in-india/ tween Medical and Non-Medical students. 7. Mohan M, a study to assess the effectiveness of Com- An exploratory study can be conducted to assess the puter Assisted Instruction on Knowledge and Attitude misconceptions regarding organ donation. regarding Organ Donation among the Arts Students at selected Arts and Science Colleges, Thanjavur Dis- th Limitation trict.[online].[cited on 8 july 2018];Available from This study was not generalized because of limited geo- URL: http://repository- graphical area and limited sample size that was 100 only. tnmgrmu.ac.in/3117/1/3001305301412451MohanaM. pdf Conclusion 8. Goyal M, Mehta RL, Article on Economic and health The main objective of the study was to assess the effec- consequences of selling a kidney in India" JAMA th tiveness of Planned Teaching Programme regarding organ [online];288 (13):p.1589–93.;[cited on 7 donation on knowledge among undergraduate students at june2017];Availabale from URL: https:// selected collages of Navsari in Gujarat state. The statisti- jhu.pure.elsevier.com/en/publications/ economic-and- cal analysis revealed that there was a significant difference health. between the pre-test and post-test level of the knowledge 9. American registry, Virginia, survey on age for organ th score of experiment group than the control group, thus donation;[online][cited on 7 june2017];Available indicated the given PTP regarding organ donation was from URL: www.organdonor.gov/dtcp/ nationalsur- effective. So different instructional media can be used to veyorgandonation. th enhance the knowledge of the people. However much 10. Organ donation need.[online];[cited on 15 awareness is taking regarding organ donation in the socie- june2017]. Available from URL: https:// ty and therefore various strategies must be initiated to ad- www.revolvy.com/page/Organ-donation dress the issue.
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The Journal of Advanced The Journal of Advanced Health Informatics Health Informatics JAHI
ISSN: e – 2456-9313 Available from URL: http://mbnc.edu.in/UTUJAHI.html
RESEARCH ARTICLE Effectiveness of Structured Teaching Programme [STP] on Knowledge regarding Women Empowerment among the Female Students
Ms. Sejal Suchal and Mr. Chanagiri Aurasang Maniba Bhula Nursing College, Gopal Vidyanagar-Tarsadi, Bardoli
ARTICLE INFO ABSTRACT Article History: Empowerment as action refers both to the process of self-empowerment and to professional support of people, which enables them to overcome their in- th Received on 24 Nov. 2018 capabilities. The true experimental study was undertaken to evaluate the effec- Received in tiveness of STP regarding knowledge on women empowerment among female revised form 27thNov. 2018 student studying at UTU, Maliba Campus, Bardoli, Surat, Gujarat. True experi- mental pre-test post-test control group design was adopted and a female student th Accepted on 30 Oct. 2018 was selected by using simple random sampling technique method. A total 60 number of female students were selected for the study, in that 30 sample experi- Published online on 6th Dec. 2018 mental group and 30 female students in control group. The findings of the study
indicate that the post-test knowledge score of experimental group were compar- Key Words: atively higher than the post-test knowledge score of the control group. The most STP, Women, Empowerment, Female of the female students were had good and average knowledge regarding women and Students empowerment after administering the Structured Teaching Programme. STP Corresponding Author: was effective in improving the knowledge of the female students and there was Ms. Sejal Suchal association between the marital status and knowledge scores of the female stu- dents whereas in rest of all the socio-demographic variables there was no associ- LECTURER, MBNC ,UTU, ation with the knowledge scores. Go pal Vidyanagar, Bardoli
Copyright © UTUJAHI 2018. Ms. Sejal Suchal. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Introduction The both men and women have their specific areas of Empowerment as action refers both to the process of self- strengths and weaknesses but understanding about them- empowerment and to professional support of people, selves is personal. If they understand each other they can which enables them to overcome their sense of powerless- have better relationship. But from the long time, the wom- ness and lack of influence, and to recognize and use their en on this earth were treated as a sort of thing. resources. Women empowerment refers to increasing the spiritual, political, social, educational, gender or economic Need for the Study strength of women. The empowerment of women is one of the central issues Women and men are different in four manners. They think in the process of development of countries all over the and act differently in some given conditions. Men are ego- World. The total population of India is 1.4 billion among ist, arrogant, assertive and dominative in nature. Women that female population is 58.6 Crore. The net reproductive that lack of confidence may explain why later surveys of rate in India is 1.8 % which is high. The comparative the program’s participants showed that fewer women Crime rate of violence against women all over world in eventually applied for finance positions. However, the 2012 is 196.7, in India 41.7 and in Gujarat 1.9 as per the women who did apply were just as likely to get offers as Indian penal code. the men.
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In 2013, the crime against women in Ahmedabad is 27.6 H04: There is a no significant association between mean per 1 lakh population. It includes rape, sexual assault all pre-test knowledge score and their selected socio- other crimes listed in Indian Penal Code. The National demographic variables of female students regarding wom- Crime Records Bureau reveal that a crime against a wom- en empowerment. an is committed every three minutes, a woman is raped every 29 minutes, a dowry death occurs every 77 minutes, Conceptual framework and one case of cruelty committed by either the husband The conceptual frame work was used based on modified or relative of the husband occurs every 9 minutes. Pender health promotion model (2010). This model con- sists of individual characteristics and experiences, behav- Women constitute almost 50% of the world’s population iour specific cognition and affect and behavioral outcome. but India has shown disproportionate sex ratio whereby female’s population has been comparatively lower than Methodology males. As far as their social status is concerned, they are Research Approach:-Quantitative approach not treated as equal to men in all the places. In the West- Research Design:- Experimental Resear ch design ern societies, the women have got equal right and status Research Method:-True-experimental one group pre- with men in all walks of life. But gender disabilities and test post-test control group design is adopted for the discriminations are found in India even today. The para- study. doxical situation has such that she was sometimes con- Research Setting:- UTU, Bardoli. cerned as Goddess and at other times merely as slave. Research population:- Female students studying in Statement of the problem UTU A study to Evaluate the Effectiveness of Structured Target population:- Female Students studying at Teaching Programme [STP] on Knowledge regarding Maliba Campus . Women Empowerment among the Female Students study- Sample - Female students studying in selected ing at Uka Tarsadia University [UTU], Maliba Campus, college of UTU. Bardoli, Surat, Gujarat Sample size: - 60 samples (30 exp. group and 30 con-
trol group) Objectives of the study 1. To assess the socio-demographic variables regarding Sampling Technique: Simple Random Sam- women empowerment among female students. pling 2. To assess the knowledge regarding women empower- ment among female students studying at UTU. Criteria for sample selection 3. To evaluate the effectiveness of structured teaching Inclusion criteria: Programme on knowledge regarding women empow- 1. who are willing to participate in this study. erment among female students studying at UTU in 2. who are comprehend English language. experimental group. 4. To compare the pre-test and post-test knowledge Exclusion criteria: Students who are not available scores regarding women empowerment among female during the time of data collection. students between experimental and control group. 5. To find out the association between the pretest Variables: Independent: Structured Teaching knowledge scores and their selected socio demograph- Programme ic variables of female students. Dependent: Knowledge of the female students.
Hypothesis Tools/instrument H01: There is no difference between pre-test and post-test Instrument : STP (Structured Teaching Programme) knowledge scores of female students regarding women It consists of Introduction, Social status of the women in empowerment in experimental group. society, Physical health of women, Women empowerment H02: There is no difference between pre-test and post-test -Meaning, Definition, Need for Women Empowerment, knowledge scores of female students regarding women Hindrances/ Obstacles of Women Empowerment, Ways to empowerment in control group. Empower Women , Challenges, Levels of empowerment, H03: There is no difference in post-test knowledge scores Legal Rights of Women, Important Women Empower- of female students regarding women empowerment be- ment Schemes in India, Women empowerment activities. tween experimental and control group.
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Tool : Structured Knowledge Questionnair e Schedule The tool is categorized into following sections; Section I: Socio-demographic data- age, course of study, types of family, religion, marital status, parent/husband education, family income, place of residence, head of fam- ily and source of information.
Section II: Structured Knowledge questionnaire regarding women empowerment in three parts.(Social status of women in society, women and health and women empow- erment).
Results of the study Section-A Table No 2: Mean, Median, Mode, Standard Devia- Out of 60 female students, the most of them were belong tion, and Range of knowledge score of female students to the age group of 18-20 year 55(92%), majority of the regarding knowledge on women empowerment in control female students participated in study were belong to Hin- group. n2=30 du religion 56 (93%), maximum of the female students belong to joint family 39(65%). Majority of them were Stand- Area of ard unmarried that was 59(98%) and their parent’s/husband analy- Mean Median Mode Range devia- education level was up to secondary education 24(40%), sis maximum family income was above 20,001 is 31 (52%). tion Highest numbers of female students were from urban Pre test 23.2 24 29 5.6 21 Post community 38(63%). Majority of female students acquir- 24.93 26 28 5.31 19 ing information from electronic media 25(42%) and maxi- test Differ- mum number of female students have background of pa- 1.73 2 1 0.29 02 ence triarchic family 51(85%). The table No. 2 shows that the mean difference between Section- B pre-test and post-test was 1.73, the median difference be- Table No 1: Mean, Median, Mode, Standard Devia- tween pre-test and post-test was 2, the mode difference tion, and Range of knowledge score of female students between the pre-test and post-test was 1, the standard de- regarding knowledge on women empowerment in experi- viation difference between pre-test and post-test was 0.29 mental group. and the range difference between pre-test and post-test n1= 30 was 2 in the control group.
Graph 2: Bar diagram shows the Mean, Median, Area of Standard Range Mean Median Mode analysis deviation Mode, Standard Deviation, and Range of knowledge score of female students regarding knowledge on women em- Pre test 24.46 24 23 3.4 15 powerment in Control group. Post test 30.6 31 30 3.3 14 Difference 6.14 7 7 0.1 01 Table No. 1 shows that the mean difference between pre- test and post-test was 6.14, the median difference between pre-test and post-test was 7, the mode difference between the pre-test and post-test was 7, the standard deviation difference between pre-test and post-test was 0.1 and the range difference between pre-test and post-test was 1 in the experimental group. Graph 1: Column diagram depicts the Mean, Median, Mode, and Standard Deviation of knowledge score of fe- male students on women empowerment in experimental group.
The Journal of Advanced Health Informatics Vol. 1 Issue. 4 July-Dec. 2018 Mean Paired ‘t’ val- Section- C Standard differ- ues D Table No 3: knowledge scor es of female students re- deviation SEMD ence F garding knowledge on women empowerment in experi- difference Cal. Tab. (d) mental and control group. n1 + n2=60 6.13 3.30 0.60 10.15 2.05 29
Pre test Post test Table No. 4 revealed that, the calculated paired-‘t’ test Knowledge Exp. Cntl. Exp. Cntl. value (t cal. = 10.15) was greater than tabulated value (t tab= Group. Group Group. Group score 2.05). Hence H01 was rejected. This indicates that the gain f % f % f % f % in knowledge score was statistically higher than the pre- Good 01 3 01 3 17 57 4 13 test knowledge scores at p< 0.05 level of significant. (31-45) Therefore, the structured teaching programme (STP) on Average (16 2 -30) 29 97 25 83 13 43 6 87 women empowerment was effective to improve the Poor 0 knowledge of female students. (0-15) 00 00 04 14 00 00 0 00 Table No 5: Mean difference (d), Standard Error of
Table No. 3 reveals that the post-test knowledge scores of difference (SEd) and paired‘t’ values of knowledge scores experimental group were higher than the control group. of female students in control group. n2=30
Mean Paired ‘t’ val- Standard Graph 3: Cone diagram shows the percentage distribu- differ- ues D deviation SEMD tion of knowledge scores of female students regarding ence F difference Cal. Tab. knowledge on women empowerment experimental group (d) and control group 1.73 3.84 0.70 2.47 2.05 29
Table No.5 revealed that calculated paired ‘t’ test value (tcal = 2.47) was greater than tabulated value (t tab= 2.05). Hence H02 was rejected. This indicates that the gain in knowledge score was statistically significant at p< 0.05 level of significant. Therefore, the extraneous variables have their impact on improving the knowledge of female students. Table No 6: Mean difference (d), Standard Error of difference (SEd.) and unpaired-‘t’ values of knowledge scores of female students in experimental and control group. N=n1+n2= 60
Inde- pende Post test nt/ Tab. SE Knowledge MD SED Un- Val- DF MD The study results showed that the post-test knowledge scores paire ue score of experimental group were comparatively higher d than the post-test knowledge score of the control group. ‘t’ test The most of the female students were had good and aver- Exp. group age knowledge regarding women empowerment after ad- Control 5.66 1.98 1.14 5.85 1.671 58 group ministering the Structured Teaching Programme. Table No. 6 depicted that the calculated value (5.85) was Section- D: Testing hypotheses on knowledge scor es of significantly higher than the tabulated value (1.671) at female students regarding women empowerment. p<0.05 level of significant. Hence H03 was rejected. It clearly indicates that STP on women empowerment pre- Table No 4: Mean difference (d), Standard Error of pared by the researcher has improved the knowledge of difference (SEd) and paired‘t’ values of knowledge scores the female students. of female students in experimental group. n1=30 Section- E The study result depicted that there is association between
The Journal of Advanced Health Informatics Vol. 1 Issue. 4 July-Dec. 2018 marital status and knowledge score of female students. In Nursing implication: The findings of this present rest of all cases age, course of study, types of family, reli- study have implicated in nursing practice, nursing admin- gion, parent/husband education, family income, place of istration, nursing education and nursing research. residence, head of family and source of information there Conclusion is no association with the knowledge score of female stu- Based on the findings of the study, the following conclu- dents. sions were noted. The study finally concluded that… Discussion The post-test knowledge score of experimental group The result of the study showed that in experimental the were comparatively higher than the post-test calculated paired-‘t’ test value (t cal. = 10.15) is greater knowledge score of the control group. than tabulated value (t tab= 2.05). Hence H01 is rejected. All the null hypotheses formulated by researcher were This indicates that the gain in knowledge score is statisti- rejected in case of experimental group and accepted in cally higher than the pre-test knowledge scores at p< 0.05 case of control group. This indicates that the STP is effec- levels. Therefore, the structured teaching programme tive in increasing the knowledge level of female students (STP) on women empowerment is effective to improve the regarding women empowerment. Whereas in association knowledge of female students. the hypotheses formulated by the researcher was rejected Whereas in control group even though the calculated in marital status and there is no association between paired‘t’ value (tcal = 2.47) is greater than tabulated value knowledge scores and their other socio-demographic vari- (t tab= 2.05). Hence H02 is rejected. This indicates that the ables. gain in knowledge score is statistically significant at p< 0.05 levels. Therefore, the extraneous variables have their References impact on improving the knowledge of female students. 1. Vincent Patil. Women empowerment, [Online], IOSR The researcher did the unpaired t test between posttest of Journal of Nursing and Health Science (IOSR-JNHS experimental and control group and the result of the study e-ISSN: 2320–1959.p- ISSN: 2320–1940 Volume 6, showed that, the calculated value (5.85) is significantly Issue 2 Ver. IX (Mar. - Apr. 2017), PP 01-05. [Cited higher than the tabulated value (1.671) at p<0.05. Hence on 2/03/2017]; Available from URL: H03 is rejected. It clearly indicates that STP on women www.iosrjournals.org empowerment prepared by the researcher has improved 2. Rajeshwari M. Shettar. A Study on Issues and Chal- the knowledge of the female students. lenges of Women Empowerment in India. [online], Similar study was conducted by Hafejee Asma, Jet Firdos IOSR Journal of Business and Management (IOSR- et.al. (2015) found that, pretest and posttest knowledge JBM); Volume 17, Issue 4.Ver. I (Apr. 2015), P. 13- scores of adolescent girls regarding women empowerment 19. [cited on 29/06/2017] Available from URL: that indicates the information booklet has enhanced the www.iosrjournals.org; www.Iosrjournals.Org/ knowledge of higher secondary school girl. empowerment.html. 3. Kabir, Naila. Women empowerment, [online] [Cited Limitations of the study on 2/01/2017] :Available from URL: https:// 1. The results of the study cannot be generalized due to en.wikipedia.org/wiki/Empowerment small setting area and small sample size 4. Shodhganga. Women empowerment abstracts 2. A study is limited to specific time duration 1 year only [online], [cited on 3/01/2017] Available from URL: http://shodhganga.inflibnet.ac.in/bitstream/ Recommendations 10603 /3816/7/07_chapter%202.pdf Keeping in view the finding of the present study, the fol- 5. Mrs. Rekharani Sinh, Et.al. Effect of planned teach- lowing recommendations have been made for study. ing on the knowledge of college students regarding 1. This study can be done on a larger sample to general- female foeticide. [Online] , IJANM international ize the results of the study. Journal of advance in nursing management; Volume 2. By using STP on women empowerment in higher sec- 5, Issue 2. (Apr-june 2017), P. 146. [cited on ondary school the nurse educator may insist and pro- 22/01/2018], Available from vide information to adolescent girls regarding women URL:www.anvpublication.org. empowerment. 6. Hemalatha., women empowerment(2011); [Online], 3. Community health nurse should organize health edu- International Journal of Science and Research (IJSR) cation camps to facilitate the adequate information and ISSN : 2319-7064 Index Copernicus Value (2015): encourage the female student on women empower- 78.96 | Impact Factor (2015): 6.391,[Cited on ment. 12/04/2018], Available from URL: http:// www.ijar.com
The Journal of Advanced Health Informatics Vol. 1 Issue. 4 July-Dec. 2018
The Journal of Advanced The Journal of Advanced Health Informatics Health Informatics JAHI
ISSN: e – 2456-9313 Available from URL: http://mbnc.edu.in/UTUJAHI.html
RESEARCH ARTICLE Effectiveness of Structured Teaching Programme (STP) On Knowledge Re- garding Breast Self-Examination (BSE) Towards Prevention of Breast Cancer among the Working Women
Ms. Khushbu Bavsar, Mr. Manjunath Beth and Ms. Anu Baby Maniba Bhula Nursing College, Gopal Vidyanagar-Tarsadi, Bardoli
ARTICLE INFO ABSTRACT Article History: The most prevalent cancer in the world is that of the breast being responsible for 10.4% of the global burden. Among Indian women, Breast cancer is the second th Received on 10 Dec. 2018 most common cancer after cancer of the uterine cervix and is already the lead- Received in ing cancer in certain metropolitan cities such as Mumbai, Delhi, Nagpur and revised form 27thNov. 2018 Trivandrum. The main objective of the study is to assess the effectiveness of STP on knowledge regarding Breast self-Examination towards the prevention of th Accepted on 05 Dec. 2018 Breast Cancer among the working women of utu. Quasi experimental non ran- domized control group design was adopted. Data was collected between Published online on 19th Dec. 2018 28/02/2018 to 03/03/2018. Data was collected through self-administered struc- Key Words: tured knowledge questionnaire. The study findings depicted that there was a significant difference between the pre-test and post-test level of the STP, Working, Women, Breast, Can- knowledge score of experiment group than the control group. The calculat- cer, Examination ed paired ‘t’ test value of knowledge score was 10.07, the calculated unpaired Corresponding Author: ‘t’ test value of knowledge score was 7.79, which was greater than tabu- Ms. Khushbu Bhavsar lated value. So the STP was effective to enhance the knowledge of working LECTURER MBNC ,UTU women. It also depicted that there was a significant association between pre test knowledge score with their socio-demographic variable like education status. Go- pal Vidyanagar, Bardoli
Copyright © UTUJAHI 2018. Ms. Khushbu Bhavsar. This is an open access article distributed under the Creative Commons Attribution Li- cense, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Introduction Breast cancer is the most common cancer in women both Breast self-examination on the other hand is simple, self- in the developed and less developed world. It is 95 over generated and repeatable at monthly intervals and cost 5,08,000 women died in 2011 due to breast cancer (Global free. BSE involves regular monthly systematic examina- Health Estimates, WHO 2013). Although breast cancer is tion of the breasts and auxiliary area, both visually and by thought to be a disease of the developed world, almost palpation, for any signs of abnormality. It has been ob- 50% of breast cancer cases and 58% of deaths occur in served that how a woman learns about breast self- less developed countries (GLOBOCAN 2008). examination can determine the frequency with which she performs it, and therefore it is important for every woman Statement of the Problem to adopt the correct method of performing breast self- A Quasi Experimental Study To Assess The Effectiveness examination as demonstrated by a nurse or physician for Of Structured Teaching Programme (STP) On Knowledge the prevention of breast cancer. About 1 in 8 women Regarding Breast Self-examination (BSE) Towards Pre- (12%) will develop breast cancer in her lifetime. The vention of Breast Cancer Among the Working Women of American Cancer Society estimated that in 2013, about Uka Tarsadia University (UTU), Bardoli, Surat District In 232,340 women would be diagnosed with invasive breast Gujarat State cancer and about 39,620 would die from the disease.
The Journal of Advanced Health Informatics Vol. 1 Issue. 4 July-Dec. 2018 Objectives of the study Methodology 1. To assess the socio-demographic variables of working Research Approach: Quantitative (Evaluative) Research women. Design : Quasi experimental research design. Research 2. To assess the knowledge among working women re- method : Non randomized control group method. garding Breast Self-examination towards prevention Research setting : Shrimad Rajchandra Institute of of breast cancer. Management & Computer Application, C. G. Bhakta In- 3. To assess the effectiveness of STP on knowledge stitute of Biotechnology and B. V. Patel Institute of Busi- among working women regarding Breast Self- ness Management, Computer & Information Technol- examination towards prevention of breast cancer in ogyand Department of Commerce. (experimental group) experimental group. and Chhotubhai Gopalbhai Patel Institute of Technology 4. To find out the difference between pre test and post (control group). test knowledge score of working women regarding Variables : Breast Self-examination towards prevention of Breast Independent: STP on Breast Self-examination. cancer in both experimental and control group. Dependent: Knowledge. 5. To find out the association between pretest knowledge Research population : Working Women of Uka Tar- score with their selected socio-demographic variable sadia University. in experimental and control group. Target population : Shrimad Rajchandra Institute of Management & Computer Application, C. G. Bhakta In- Assumptions stitute of Biotechnology and B. V. Patel Institute of Busi- It is assumed that all the working women may not have ness Management, Computer & Information Technology inadequate knowledge regarding breast self-examination and Department of Commerce. for experimental group towards prevention of breast Cancer. and for Control group sample selected from Chhotubhai Gopalbhai Patel Institute of Technology. Hypotheses Sample : working women of various institution of Uka Tarsadia University, Maliba Campus, Bardoli. H01: There is no significant difference between pre test and post test knowledge score of working women regard- Sample size : 100 (50- experimental 50- control) ing Breast Self-examination towards prevention of breast Sampling Technique : Non-probability convenient cancer in experimental group. sampling technique. Selection Criteria for Samples: H02: There is no significant difference between pre test and post test knowledge score of working women regard- Inclusion criteria: ing Breast Self-examination towards prevention of breast Women who are working in teaching area of UTU, Bar- cancer in control group. doli. 1. Who are willing to participate. H03: There is no significant difference in post test knowledge scores between experimental and control 2. Women who understand English. group of working women regarding Breast Self- Exclusion criteria : examination towards prevention of breast cancer. 1. Who is not available during data collection. 2. Medical and Paramedical Fields. H04: There is no significant association between pre test knowledge scores with their selected socio-demographic Description of the tool Section I: Perfor ma for collecting socio demo- variable of working women. graphic data which include age, Education Status,
Conceptual framework Marital Status, History of breast cancer in family, In the Present study modified conceptual framework of Previous knowledge regarding breast cancer, sources health belief model developed by Hochbaum (1958). The of information about breast cancer, Use of contracep- health belief model is psychological model that attempts tives and bad habits. to explain and predict health behaviors were adopted. Section II: Structured knowledge questionnair e re- This is done by focusing on the knowledge and belief of garding Breast self-examination which comprises 25 individuals. The model contains principle components that questions related to knowledge regarding breast self- interact to bring out the desired behavior which are indi- examination. Each right answer carries 1 mark and vidual perception, modifiable factors, cue to action and maximum score is 25 and minimum score is 0. likelihood of action.
The Journal of Advanced Health Informatics Vol. 1 Issue. 4 July-Dec. 2018 Results Table : 1 Comparison of knowledge scor es of working Major findings of the study were as below: women in experimental and control group. Section 1: Socio-demographic variables. n1+n2=100 Most of the subjects 81(81%) were belong to age group of 21-30 years, 80(80%) subjects were postgraduates, 51 Knowl Pre-Test Post Test (51%) subjects were single, 52(52%) subjects were stay- edge Exp. Cont. Exp. Cont. ing in joint family, 90(90%) subjects were don’t have his- Score Group Group Group Group tory of breast cancer in family, 60(60%) subjects were F % F % F % F % Good have previous knowledge regarding breast cancer, 44 21 42 13 26 48 96 16 32 (44%) subjects were getting information from other (21-30) sources, 95(95%) subjects were not using any type of con- Aver- traceptives and 100(100%) subjects don’t have any bad age (11 29 58 37 74 02 4 34 68 habits. -20) Poor Section 2: Knowledge regarding Breast self------examination. (00-10) Study finding shows that in Pre test majority knowledge scores of the subjects 29(16%) had average knowledge; 21 Table 1 reveals that post test knowledge scores of experi- (42%) had good knowledge and no one had poor mental group is higher than the post test knowledge scores knowledge, where as in post test majority of subjects 48 of control group. (96%) had good knowledge; 02 (4%) had average knowledge and no one had poor knowledge in experi- Table: 2 Mean differ ence (d), Standard Error of dif- mental group.students on women empowerment in experi- ference (SEMD) and paired‘t’ values of Experimental mental group. group knowledge scores of working women. Graph: 1: Cylinder Bar diagram shows difference be- n1=50 tween pre test post test knowledge scores regarding knowledge of experimental group regarding breast self- Paired ‘t’ values Mean difference SEMD df examination. (d) Cal Tab
3.70 0.36 10.07 1.67 49
Table 2 reveals that calculated paired‘t’ value (t cal = 10.07) was greater than tabulated value (t tab= 1.67). Therefore, the structured teaching programme (STP) on breast self-examination towards the prevention breast can- cer is effective to improve the knowledge of working women.
Table: 3 Mean difference (d), Standard Error of differ- ence (SEMD) and paired‘t’ values of Control group knowledge scores of working women. Graph: 2 Pyramid diagram shows different between n2=50 pre test post test knowledge scores of control group. Paired ‘t’ values Mean difference SEMD df (d) Cal Tab
0.26 0.17 1.52 1.67 49
Table.3 reveals that calculated paired‘t’ value (t cal = 1.52) was less than tabulated value (t tab= 1.67) indicate that there was no effectiveness in knowledge level in control group without STP.
The Journal of Advanced Health Informatics Vol. 1 Issue. 4 July-Dec. 2018
Table:4 Mean difference (d), Standard Error of differ- Nursing Research ence (SEMD) and Unpaired-‘t’ values of knowledge One of the aims of nursing research is to expand and scores of subjects in experimental and control group. broaden the scope of nursing. The finding of this study serves the professionals and the students to conduct further Unpaired ‘t’ val- studies. This study motivates the beginner researcher to ues Mean difference conduct with different variables on large scale. The better SEMD df (d) generalization of the study results can be made by replica- Cal Tab tion of the study. Dissemination of finding through confer- ence and professional journals will make application of 2.88 0.49 7.79 1.66 98 research to be effective. Recommendations Table 4 reveals that the calculated unpaired‘t’ values (t cal On the basis of findings of the study following recommen- =7.79) was greater than tabulated value (t tab =1.66). This dations are obtained for further research: indicates that there was significant deference in post test 1. Similar study can be conducted on large sample to knowledge score between experimental and control group generalize the findings. at 0.05 level of significance. Therefore, Structured teach- 2. A comparative study can be conducted to assess the ing programme (STP) on Breast self-examination was ef- knowledge and practice regarding breast self- fective to improve the knowledge of subjects. examination between rural and urban community women. Section 3: Association between knowledge regarding 3. Video assisted teaching can be use as other instruc- beast self-examination with their selected socio- tional media for increase knowledge and attitude re- demographic variables. garding breast self-examination. This study finding reveals that the calculated chi-square value was less than tabulated chi-square value in most of Limitations Socio-demographic variables whereas, in case of Educa- 1. The study included working women who all are in tion the calculated chi-square value greater than the tabu- teaching area. lated value. Hence this indicates that there was an associa- tion between pre-test knowledge score and some socio Conclusion demographic variables at 0.005 level of significance. The statistical analysis revealed that there was a signifi- cant difference between the pre-test and post-test level of Discussion the knowledge score of experiment group than the con- The findings of the study was supported by Manali trol group, thus study indicate that the given STP re- Solanki (2012) has revealed that post test level of garding Breast self-examination was effective. So differ- knowledge regarding breast self-examination in experi- ent instructional media can be used to enhance the mental group that majority of subjects 48(96%) had good knowledge of the people. knowledge; 02 (4%) had average knowledge and no one had poor knowledge where in control group majority of References subjects 34(68%) had average knowledge; and 16 (32%) 1. National Breast cancer foundation, INC [Online]; had good knowledge, which shows that structured teach- [Cited on 3/7/2017 ] , Available from ing praogramme was effective to enhance the knowledge URL http://www.webmd.com/women/guide/breast- of the individual regarding breast self-examination in ex- cancer- arm-yourself-with perimental group. For experimental group the paired ‘t’ 2. Ms.Anitha Denial, Nirali Patel, Jalpa Patel, Neha test value t cal = 10.07 was greater than tabulated value t Joshi, Nazneen Pathan, Assess the effectiveness of tab= 1.67. Whereas in control group calculated paired‘t’ Structured teaching programme on year knowledge value t cal = 1.52 was less than tabulated value t tab= 1.67 and attitude regarding Breast Self-examination among Therefore, the structured teaching programme (STP) on student of first year of G.N.M., [offline], breast self-examination towards the prevention breast can- [Unpublished Thesis]. cer is effective to improve the knowledge of working 3. Ms. Manali Solanki, Assess the Effectiveness of a women. planned teaching programme On Prevention of Breast Nursing Implications cancer in terms of Knowledge and Attitude of women This study had certain nursing implication towards Living in the urban community Of Ahmedabad, the nursing education, nursing practice, nursing admin- [offline], [Unpublished Thesis]. istration and nursing research as follows.
The Journal of Advanced Health Informatics Vol. 1 Issue. 4 July-Dec. 2018
The Journal of Advanced The Journal of Advanced Health Informatics Health Informatics JAHI
ISSN: e – 2456-9313 Available from URL: http://mbnc.edu.in/UTUJAHI.html
RESEARCH ARTICLE Effectiveness of Structured Teaching Programme on Knowledge Regarding Biomedical Waste Management among the Staff Nurses
Ms. Ekta Pandya, Mr. Manjunath Beth and Ms. Anu Baby Maniba Bhula Nursing College, Gopal Vidyanagar-Tarsadi, Bardoli
ARTICLE INFO ABSTRACT Article History: A pre-experimental study to assess the effectiveness of structured teach- ing programme on knowledge regarding biomedical waste management Received on 10thDec. 2018 among the staff nurses working in selected hospitals Surat, Gujarat State. Received in Total 60 samples were selected by using convenient sampling method. A th revised form 14 Dec. 2018 STP on biomedical waste management was prepared and administered. Accepted on 18th Dec. 2018 Descriptive and inferential statistics were used to analyze the data. The mean pre-test knowledge score was 8.7 and the mean post - test Published online on 22nd Dec. 2018 knowledge score was 14.9. significance of the difference between pre-test
and post-test knowledge was statistically tested using paired ‘t’ test and it Key Words: was found significant at 0.05 level. There is an association between pre- STP, Knowledge, Bio-medical test knowledge score and selected socio-demographic variables such as, Waste, Staff Nurse job Experience, there is an association between pre-test attitude score and Corresponding Author: selected socio-demographic variables such as gender. There was increase Ms. Ekta Pandya in the knowledge of staff nurses regarding biomedical waste manage- LECTURER, MBNC ,UTU, ment. Hence, it was concluded that STP was effective in improving the Go pal Vidyanagar, Bardoli knowledge of staff nurses.
Copyright © UTUJAHI 2018. Ms. Ekta Pandya. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Introduction Statement of the Problem All human activities and living things on earth produce A pre-experimental study to assess the effectiveness waste in some form or other. Normally, aerobic and anaer- of structured teaching programme on knowledge re- obic process in the environment degrades such products. garding biomedical waste management among the These wastes, both biodegradable and non-biodegradable staff nurses working in selected hospitals Surat, Gu- hardly had any impact on the environment until the inven- jarat state tion of plastic by the modern man. Inadequate and inap- propriate knowledge of handling of healthcare waste may Objectives of the study have serious health consequences and a significant impact To assess the Socio-demographic variables of staff on the environment as well. It is estimated that annually nurses working in selected hospitals Surat, Gujarat about 0.33 million tons of hospital waste is generated in state. To assess the knowledge of the staff nurses regarding India and, the waste generation rate ranges from 0.5 to 2.0 biomedical waste management. kg per day. Over 1.4 million peoples worldwide are suf- To assess the effectiveness of structured teaching pro- fering from Hospital Acquired Infection. The investigator gramme on knowledge regarding biomedical waste found that a teaching aid can improve the knowledge level manage among the staff nurses working in selected of staff nurses regarding biomedical waste management. hospitals Surat, Gujarat state.
The Journal of Advanced Health Informatics Vol. 1 Issue. 4 July-Dec. 2018
To find out the association between pre-test DISCRIPTION OF TOOL knowledge score of staff nurse with their socio demo- The Investigator prepared a structured knowledge ques- graphic variables. tionnaires to assess the knowledge regarding biomedical waste management. The research tools consist of three Hypotheses sections H01: There is no significant difference between mean pre- Section-I: Demographic Data test and post-test knowledge score of staff nurses re- The section contained 9 items for obtaining the infor- garding biomedical waste management. mation regarding staff nurses age, gender, qualification, H02: There is no significant association between pre-test job experience, Languages known, Department of work- knowledge score with their selected socio demographic ing, Area of working in hospital, any previous exposure to variables regarding biomedical waste management in-service education on Biomedical waste management, among the staff nurses working in selected hospitals Sources of getting information on Biomedical waste man- Surat, Gujarat state”. agement. Section-II: Knowledge questionnaire on biomedical Conceptual framework waste management. In present study, Conceptual framework used based on Investigator developed the structured knowledge question- General system model of Ludwig Von Bertalanffy in naires to assess the knowledge of staff nurses who are 1968. working at Mahavir hospital, Apple hospital, Metas Ad- ventist hospitals Surat. This section consisted of 20 multi- Methodology ple choice questions related to knowledge regarding Research Approach:-Quantitative approach BMW and each right item carries 1mark. Maximum score Research Design:- Pre-experimental Research design of questionnaires is 20 and minimum score is 0. The tool Research Method:-Pre-experimental one group pre-test was developed in English and Gujarati language. post-test design is adopted for the study. Research Setting:- Apple, Mahavir, Nd Metas Adventist Description of STP hospitals Surat, Gujarat state. Investigator developed the structured teaching programme Research population:- Staff nurses working in Apple, by extensive research and non-research literature and took Mahavir, Nd Metas Adventist hospital Surat, Gujarat the opinion of expert before planning the structured teach- state . ing programme the central and specific objectives were Target population:- Staff nur ses working in ICU, sur- formulated. STP included Introduction, Definition, gical ward, emergency ward medical ward of selected hos- Types, Need for safety treatment and disposal, Sources, pitals. Classification and the Steps in the management of bio- Sample - Selected staff nurses who are fulfil the inclu- medical waste. The tool was developed in English and sion criteria. Gujarati language. Sample size: - 60 staff nur ses. Results Selection criteria for sample Section-I: Description of socio-demographic variables I. Inclusion criteria In this study majority of 48 (80%) out of 60 staff nurses Staff nurses who are willing to participate in study. were between the age group of 21-30 year and minority1 Registered staff nurses. (2%) were between the age group of above 50years. Ma- Staff nurses who are working in medical ward, surgi- jority of subjects 49(2%) are female staff nurses out of 60 cal ward, ICU, emergency ward. staff nurses and minority11(18%) are male staff nurses. II. Exclusion criteria Majority of staff nurses 35(58%) had general nurse mid- Staff nurses who are not present at the time of data wives qualification and minority 1(2%) had Master of collections. Nursing qualification. Majority of subject 25(42%) had Staff nurses who are working at managerial level. job experience above 4 years and minority 5(8%) had job experience 3-4 years. Majority of staff nurses 38(63%) are Variables known to English language and minority 21(35%) are 1) Independent variable: Structured teaching pro- known to Gujarati language. Majority of staff 27(45%) are gramme on biomedical waste management. working in medical ward and minority 4(8%) are working 2) Dependent variable: knowledge and attitude regard- in emergency ward. All staff nurses 60 (100%) are work- ing biomedical waste management. ing in private sectors. Majority 48(80%) had previous ex- posure to in-service education and minority12(20%) had
The Journal of Advanced Health Informatics Vol. 1 Issue. 4 July-Dec. 2018 no any previous exposure to in-service education on bio- Section IV: Findings r elated to association between pre medical waste management. Majority of 29(48%) staff -test knowledge score with their selected socio demo- nurse got the information on biomedical waste manage- graphic variables. ment through conference, 12(20%) got the information In knowledge job experience is significant association through television/internet, 2(33%) got the information with the pre-test knowledge score for that H02 is rejected. through newspaper/magazine and 17(28%) got the infor- Remaining association between socio demographic varia- mation through peer group. bles and pre-test knowledge score H02 is accepted. SECTION-II: Knowledge of staff nurses regarding bio- medical waste management. Limitations In pre-test majority of staff nurses 75% having average The study was conducted for a small geographical knowledge, 23.3% having poor knowledge and only 7% area so generalization of study may not take place. having good knowledge about biomedical waste manage- The study did not use any control group, hence there ment. After administrating of STP their knowledge score were possibilities of threats to internal validity. was increased. Post-test knowledge score were majority of Investigators did not assess the practice of staff nurses staff nurses 28.3% having average knowledge,71.7% hav- regarding biomedical waste management. ing good knowledge and no one having poor knowledge. Recommendations Graph 1: Distr ibution of staff nurses according to pre- A similar study can be undertaken for a larger sample test and post-test knowledge score. for a longer period of time thus broad generalization can be made. An experimental study can be undertaken with a con- trol group for comparison of the result. A similar study can be replicated in different settings. Systematic review can be conducted regarding this study.
CONCLUSION Based on the findings of the study, the conclusion to be noted that: There was significant difference between pre and post - test knowledge score. There was paired-t test value are greater than the tabu- lated value for knowledge so for that here structured Section-III: Effectiveness of structured teaching pro- teaching programme was effective. gramme. The calculated chi-square value of knowledge score Table-1: Shows comparison between pre-test and post- was greater than tabulated value for job experience so test knowledge score of staff nurses regarding biomedical H02 rejected for this sociodemographic variable. waste management. n=60 References Knowle Mea MD SD SE Paired ‘t’ test KaushikRajyaguru, Hiralchaudhary, VarshaGamit, A dge n MD Study to assess the Knowledge Regarding Biomedical Cal. Tab df V. V. Waste Management Among the 2nd year GNM stu- Pre-test 8.7 6.13 0.57 0.22 26.83 2.00 5 dents of ManibaBhula nursing college; ManibaBhila Post test 14.9 9 Nursing College, BardoliDistric, Surat. Pg NO (1-33), 2015-16.
Table no 1 reveals that calculated paired‘t’ value (t cal = Health Research.[online]. Vol 1; March-2013; Pg no 26.83) is greater than tabulated value (t tab= 2.000). Hence 32-40. Cited on: 14-6-17 URL: http:// H01 is rejected. Hence STP on biomedical waste manage- www.oralhealth.ro/volumes/2013/volume-1/ ment was effective to improve the knowledge of subjects. Paper317.pdf Latika. N. Purohit, Prashant V Kariya. Trends of nos- ocromial infections in a private Hospitals of Surat, Gujarat. National Journal of Medical Research. surat Gujarat. Vol 6; Issue 1: Jan – Mar 2016; Pg no 95-97.
The Journal of Advanced Health Informatics Vol. 1 Issue. 4 July-Dec. 2018
Table:4 Mean difference (d), Standard Error of differ- Nursing Research ence (SEMD) and Unpaired-‘t’ values of knowledge One of the aims of nursing research is to expand and scores of subjects in experimental and control group. broaden the scope of nursing. The finding of this study serves the professionals and the students to conduct further Unpaired ‘t’ val- studies. This study motivates the beginner researcher to ues Mean difference conduct with different variables on large scale. The better SEMD df (d) generalization of the study results can be made by replica- Cal Tab tion of the study. Dissemination of finding through confer- ence and professional journals will make application of 2.88 0.49 7.79 1.66 98 research to be effective. Recommendations Table 4 reveals that the calculated unpaired‘t’ values (t cal On the basis of findings of the study following recommen- =7.79) was greater than tabulated value (t tab =1.66). This dations are obtained for further research: indicates that there was significant deference in post test 1. Similar study can be conducted on large sample to knowledge score between experimental and control group generalize the findings. at 0.05 level of significance. Therefore, Structured teach- 2. A comparative study can be conducted to assess the ing programme (STP) on Breast self-examination was ef- knowledge and practice regarding breast self- fective to improve the knowledge of subjects. examination between rural and urban community women. Section 3: Association between knowledge regarding 3. Video assisted teaching can be use as other instruc- beast self-examination with their selected socio- tional media for increase knowledge and attitude re- demographic variables. garding breast self-examination. This study finding reveals that the calculated chi-square value was less than tabulated chi-square value in most of Limitations Socio-demographic variables whereas, in case of Educa- 1. The study included working women who all are in tion the calculated chi-square value greater than the tabu- teaching area. lated value. Hence this indicates that there was an associa- tion between pre-test knowledge score and some socio Conclusion demographic variables at 0.005 level of significance. The statistical analysis revealed that there was a signifi- cant difference between the pre-test and post-test level of Discussion the knowledge score of experiment group than the con- The findings of the study was supported by Manali trol group, thus study indicate that the given STP re- Solanki (2012) has revealed that post test level of garding Breast self-examination was effective. So differ- knowledge regarding breast self-examination in experi- ent instructional media can be used to enhance the mental group that majority of subjects 48(96%) had good knowledge of the people. knowledge; 02 (4%) had average knowledge and no one had poor knowledge where in control group majority of References subjects 34(68%) had average knowledge; and 16 (32%) 1. National Breast cancer foundation, INC [Online]; had good knowledge, which shows that structured teach- [Cited on 3/7/2017 ] , Available from ing praogramme was effective to enhance the knowledge URL http://www.webmd.com/women/guide/breast- of the individual regarding breast self-examination in ex- cancer- arm-yourself-with perimental group. For experimental group the paired ‘t’ 2. Ms.Anitha Denial, Nirali Patel, Jalpa Patel, Neha test value t cal = 10.07 was greater than tabulated value t Joshi, Nazneen Pathan, Assess the effectiveness of tab= 1.67. Whereas in control group calculated paired‘t’ Structured teaching programme on year knowledge value t cal = 1.52 was less than tabulated value t tab= 1.67 and attitude regarding Breast Self-examination among Therefore, the structured teaching programme (STP) on student of first year of G.N.M., [offline], breast self-examination towards the prevention breast can- [Unpublished Thesis]. cer is effective to improve the knowledge of working 3. Ms. Manali Solanki, Assess the Effectiveness of a women. planned teaching programme On Prevention of Breast Nursing Implications cancer in terms of Knowledge and Attitude of women This study had certain nursing implication towards Living in the urban community Of Ahmedabad, the nursing education, nursing practice, nursing admin- [offline], [Unpublished Thesis]. istration and nursing research as follows.