subharti journal of nursing reflection · effectiveness of self instructional module (sim) in terms...

Subharti Journal of Nursing Reflection Volume: 1, Issue: 2; September 2017

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SUBHARTI JOURNAL OF NURSING

REFLECTION

A journal of Panna Dhai Maa Subharti Nursing College,

Meerut

Contact Address:

Panna Dhai Maa Subharti Nursing College,

Subhartipuram, NH-58, Delhi Haridwar Meerut Bypass Road,

Meerut-250005


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CONTENTS

Sl No: Topic Author Page No

1.

A Descriptive Study To Assess

The Health Related Quality Of

Life In Terms Of Knowledge And

Attitude Among Patients With

Thalassemia Attending OPD In

Selected Hospitals At Meerut With

A View To Develop Information

Booklet

Mr. Amir Khan 4 – 15

2.

Effectiveness Of Self-Instructional

Module On Utilization Of

Contraceptive Devices In Terms

Of Knowledge And Attitude

Among Married Women

Mrs. Nisha Yadav 16 – 24

3.

A Study To Evaluate The

Effectiveness Of Structured

Teaching Programme (Stp)

Regarding Sedation Procedure In

Terms Of Knowledge And

Practice Among Icu Nurses In

Selected Hospital At Meerut.

Mr. Sumit Prajapathi 25 – 27

4.

“A Study To Assess & Evaluate

The Effectiveness Of Plan

Teaching Program On Prevention

Of Urinary Tract Infection During

Pregnancy Among Antenatal

Mothers In Terms Of Knowledge

, In Selected Community Centers

At Meerut ”

Ms. Priya Rai 28 – 33

5. “A Study To Evaluate The

Effectiveness Of Vatp In Terms Of

Ms. Rajni Emanwel 34 – 44


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Knowledge & Attitude Regarding

Assistive Respiratory Home Care

Management Among Patients With

Copd Admitted In Selected

Hospital At Meerut.”

6.

A Study To Evaluate The

Effectiveness Of Self Instructional

Module (Sim) In Terms Of

Knowledge And Attitude

Regarding Home Care

Management Among Patients With

Cancer Admitted Selected Hospital

At Meerut.

Ms. Kusum 45 – 55

7.

A study to assess and evaluate the

impact of concept mapping and

clinical teaching method

(Demonstration) on wound

dressing in terms of knowledge

and practice among B.Sc. Nursing

1st year students in selected

nursing college at Meerut

Ms. Jyoti Verma 56-58

8. Deep Vein Thrombosis Mr. Zubair 59-61

9. Smart Glasses for Nurses in

Critical care units

Mr. Hariprasath 62 – 64

10.

Patient Safety And Related

Standards By Joint

Commission On Accreditation Of

Health Care Organizations

(JCAHO)

Mr. Arun Unnikrishnan 64 - 67


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A DESCRIPTIVE STUDY TO ASSESS THE HEALTH RELATED QUALITY OF LIFE

IN TERMS OF KNOWLEDGE AND ATTITUDE AMONG PATIENTS WITH

THALASSEMIA ATTENDING OPD IN SELECTED HOSPITALS AT MEERUT WITH

A VIEW TO DEVELOP INFORMATION BOOKLET

ABSTRACT:

Objectives: (1) To assess the health related quality of life among patients with thalassemia. (2)

To assess the level of knowledge and attitude regarding health related quality of life among

patients with thalassemia. (3) To find out the association between knowledge and attitude scores

regarding health related quality of life among thalassemia patients with their selected

demographic variables. (4) To develop and validate information booklet regarding health related

quality of life for thalassemia patients. Research design for this study is descriptive research

design. The Target population was Thalassemia patient at hospital. Result: Result revealed that

samples, 8(26.66%) of them were having adequate knowledge and 22(73.33%) were having

inadequate knowledge regarding Knowledge on Thalassemia. Majority of them, 20(67%) were

having Less Favourable Attitude 10(33%) of them were having Unfavourable Attitude and (0%)

none of them were having Favourable Attitude. Conclusion: Information booklet was prepared

based on the findings of the study which is intended to improve the knowledge and attitude.

Keywords: Quality of life, Knowledge, Attitude, Thalassemia, Information booklet

Mr. Amir Khan,

MS.c Nursing Student, Dept. of Medical Surgical Nursing,

Panna Dhai Maa Subharti College of Nursing, Meerut. U.P, India

E-mail: [email protected]

GUIDE

Asso.Prof. Arul Malar,

HOD (Dept. of. Medical Surgical Nursing), Panna Dhai Maa Subharti College of Nursing,

Meerut. U.P, India

mailto:[email protected]


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INTRODUCTION

“Access to Safe & Effective Drugs in Thalassemia”

-Theme forInternational Thalassemia Day 2016

Blood is a specialized body fluid that delivers necessary substances to the body's cells such as

nutrients and oxygen and transports waste products away from those same cells. Blood is a

bodily fluid in humans and other animals that delivers necessary substances such as nutrients and

oxygen to the cells and transports metabolic waste products away from those same cells.

Thalassemias are inherited blood disorders characterized by abnormal hemoglobin production.

Symptoms depend on the type and can vary from none to severe. Often there is mild to

severe anemia (low red blood cells). Anemia can result in feeling tired and pale skin. There may

also be bone problems, an enlarged spleen, yellowish skin, dark urine, and among children slow

growth. Two main types, alpha thalassemia and beta thalassemia. The severity of alpha and beta

thalassemia depends on how many of the four genes for alpha globin or two genes for beta

globin are missing.

NEED FOR THE STUDY

Thalassemia affects approximately 4.4 of every 10,000 live births throughout the

world. It causes males and females to inherit the relevant gene mutations equally because

it follows an autosomal pattern of inheritance with no preference for gender.

Approximately 5% of the worldwide population has a variation in the alpha or beta part

of the hemoglobin molecule, although not all of these are symptomatic and some are

known as silent carriers. In fact, only 1.7% of the global population has signs as a result

of the gene mutations, known as a thalassemia trait. However, particular ethnic groups

are more likely to be affected and 5-30% of the population may be symptomatic among

these groups. (YolandaSmith,2015)

As of 2013, thalassemia occurs in about 280 million people, with about 439,000

having severe disease. It is most common among people of Italian,

Greek, MiddleEastern, SouthAsian, and African descent.Males and females have similar

rates of disease.It resulted in 16,800 deaths in 2015, down from 36,000 deaths in 1990

https://plus.google.com/111335971411224729009?rel=author


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Those who have minor degrees of thalassemia, similar to those with sickle-celltrait, have

some protection against malaria, explaining why they are more common in regions of the

world where malaria exists.

SCHEMATIC PRESENTAION OF THE RESEARCH DESIGN

VARIABLES;

Dependent variable: The dependent variable is the condition or characteristics that

appears or disappear as a result of independent variable. In the present study the dependent

variable is knowledge and attitude of the Thalessemia patient.

Extraneous Variables:

Demographic variables such as age, Gender, educational, occupation, religion, family

income, Duration of illness, Birth order, Source of Health information.

Semi-structured questionnaire schedule and rating scale

for assessing knowledge and attitude of thalassemia

patients attending the hospital.

Information’s regarding the attitude the quality of life on

the basis of four domain were collected from thalassemia

patients attend in hospital at Meerut by using a modified

short form health survey (SF-36 Questionnaire)

Information booklet was distributed to the samples

which have been prepared by researcher based on the

assessing knowledge and attitude and which can

improve their quality of life


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SETTING OF THE STUDY

The study was conducted in selected hospitals at meerut (Chathrapati Shivaji Subharti

Hospital, Lokpriya Hospital.

TARGET POPULATION

The Target populations was Thalassemia patient at hospital.

SAMPLE AND SAMPLING TECHNIQUES

Non - probability purposive sampling technique has been used in this study

Sample Size:In the study, sample size was 30 Thalesemia patients attending OPD’s in

selected Hospitals of Meerut.

.CRITERIA FOR SAMPLE SELECTION

Inclusion Criteria

Thalessemia patients who are attending OPD’s in selected Hospitals of Meerut

Thalessemia patients aged between 10-18 yrs

Both male and female Thalessemia patients

Thalessemia Patients who are willing to participate in the study.

Thalessemia Patients who can understand, read, write in Hindi or English.

Exclusion Criteria

Thalessemia patients aged below 10 yrs and above 18 yrs

Thalessemia Patients who are not willing to participate in the study.

Thalessemia Patients who can not understand, read, write in Hindi or English.

TOOLS AND METHODS OF DATA COLLECTION

Description and Development of Tool

Tool consists of a structured knowledge questionnaire on health related quality of

life. The tool is based on the extensive literature review and consists of Tool-I Tool-II

Tool-III Tool-IV

Following steps were involved in the development of tools-

1. Review of research and non- research literature and opinion of experts.


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2. Preparing blue print for structured knowledge questionnaire schedule.

3. Development structured knowledge questionnaire schedule and attitude scale.

4. Establishing scoring of tools.

5. Assessing items for content validity.

6. Tryout of tools.

7. Estimation of reliability, item analysis and discrimination value.

DEVELOPMENT OF INFORMATION BOOKLET

A Information booklet is developed regarding Thalessemia among Patient after extensive

study of literature and discussion with experts. The content of Information booklet was

developed under the following headings:

Section –A (General aspects of Thalassemia)

Section – B (Importance of Thalassemia)

Section – C (Type of Thalassemia)

Section-D (Advantage and disadvantage of Thalassemia)

Section – E (Myths of Thalassemia)

DATA COLLECTION PROCEDURE

Formal administrative permission was obtained from Respective Higher authority from the

college and hospital, Data was collected from 13.03.17 to 22.04.17

-introduction was given.

Thalassemia patient.

.

-one-test was done by administering structured knowledge

Questionnaire and attitude scaleand SF-36 for assessing the quality of life.

The data analysis was done by using descriptive and inferential statistics.

RESULT ANALYSIS

Among 30 thalassemia 3 (10%) of them were in between the age group of 0 -5 years,

10 (33%) of them were of 6 -10 yrs. 3 (10%) of them were in between 11 - 15yrs and 14

(46.6%) of them were belongs the age above 16 years.


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Out of 30 samples, 19 (63.3%) samples were male and 11 (36.6%) were Female.

Education showed that out of 30 samples, 4 (13.3%) of them were having non formal

education, 11 (36.6 %) of them were having primary education, 6 (20%) of them were

having secondary education, and 9 (30%) of them were having graduate.

Occupation showed that out of 30 samples, 8 (26,6%) of them were doing daily wages,

4 (13.3%) of them were having self employed, 7 (23.3%) of them were having business

and, 11 (36.6%) of them were having other work.

Out of 30 samples, 13 (43.3%) of them earning 50,000 th. In a year, 5 (16.6%) of them

are earning 10,0000, and, 12 (40%) of them are earning more than 10,0000.

In duration of illness out of 30 sample, 14 (46.6%) are having less than one year, 4

(13.3%) were 1 – 3 yrs, 3 (10%) were 3 – 5 yrs and 9 (30%) are more than 5 years.

In birth order out of 30 samples, 17 (56.6%) were is first, 9 (30%) out of them were are

second and third and 4 (13.3%) are fourth and more.

Result revealed that samples, 8(26.66%) of them were having adequate knowledge and 22(

73.33% ) were having inadequate knowledge regarding Knowledge on Thalassemia.

Majority of them, 20(67%) were having Less Favourable Attitude 10(33%) of them were

havingUnfavourable Attitude and (0%)none of them were having Favourable Attitude .

ANALYSIS OF ASSOCIATION BETWEEN QUALITY OF LIFE OF THALASSEMIA

PATIENTS WITH THEIR SELECTED DEMOGRAPHIC VARIABLES.

Quality Of Life Score Frequancy Percentage

%

Poor Quality Of Life (>45%) 3 10%

Moderate Quality Of Life46-

60%)

15 50%

Good Quality Of Life (60-

100%)

12 40%


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Mean And Standard Deviation Regarding Scores Of Quality Of Life Of Thalassemia

Patient In Eight Dimension. (Physical Functioning Role Limitation Due To Physical

Health. Role Limitation Due To Emotional Health, Energy\ Fatigue, Emotional Well Being,

Social Functioning, Pain, General Health.

S.N Eight Dimension Of Quality Of Life Mean Standard Deviation

1 Physical Functioning 50 18.0

2 Role Limitation Due To Physical

Health

60 26.54

3 Role Limitation Due To Emotion

Health

64.44 24.65

4 Energy/ Fatigue

53.14 17.0

5 Emotional Well Being 55.5 13.5

6 Social Function 72.46 22.2

7 Pain 64.83 S20.03

8 General Health 57.62 12.6

Chi square test to determine the association between the selected demographic variables

and the knowledge scores regarding health related quality of life of thalassemia patient.

n=30

DEMOGR

APHIC

VARIBLE

S

Categories

Knowledge

score

AM BM D

F

Table

value

SIGNIFI

CANT/

NOT

SIGNIFI

CANT

CAL.V P<0.05

LEVEL

Age group 0-5 year 3 -

2.265 0.5193

3 7.82 NS*

6-10 year 6 4

11-15 year 2 1

Above 16 year 11 3

Gender

Male 14 5 0.003, 0.9946

1 3.84 NS

Female 8 3


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Education

Non formal

education

2 2

3.502 , 0.3205

3 7.82 NS*

Primary 8 3

Secondary 6 -

Graduate 6 3

Occupation Daily wages 6 2

2.406, 0.4925

3 7.82 NS*

Self employed 4 -

Business 4 3

Others 8 3

Religion Hindu 18 6

1.023, 0.7958

3, 7.82 NS*

Muslim 2 1

Christian 1 -

Sikh &other 1 1

Family

Income

50,000 11 3

0.839,

0.6574

2 5.82 NS*

10,0000 4 1

Above

10,0000

7 4

Duration

Of illness

Less one year 9 5

5.609, 0.1323

3 7.82

NS*

1 – 3 years 4 -

3 – 5 years 1 2-

Above 5 year

s

- -

Birth other First 8 1

1.725,

0.6315

3 7.82 NS*

Second & 12 5

Third 6 3

Fourth or

more

-

Knowledge

regarding

Thalassemi

a

Yes 2 - 1.493,

,

0.2217

1 3.84 NS*

There was no significant between knowledge and the knowledge scores regarding health related

quality of life of thalassemia patient with their selected demographic variables.

Chi square test to determine the association between the selected demographic variables

and the Attitude scores regarding health related quality of life of thalassemia patient.


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n=30

DEMOGR

APHIC

VARIBLES

Categories

Attitude score

AM BM DF table

value

SIGNIFIC

ANT

NOT

SIGNIFIC

ANT

CAL.V P<0.05

LEVEL

Age group 0-5 year 3 -

6.199, 0.1023 3

7.82

NS 6-10 year 6 4

11-15 year 1 2

Above 16 year 4 10

Gender

Male 9 10

0.010,

0.9289 1 3.84 NS Female 5 6

Education

Non formal

education 3 1

5.152, 0.1610 3 7.82 NS Primary 7 4

Secondary 2 4

Graduate 2 7

Occupation Daily wages 4 4

3.297 0.3481 3 7.82 NS Self employed 3 1

Business 4 3

Others 3 8

Religion Hindu 11 13

6.060, 0.1 087 3, 7.82 NS

Muslim 3 -

Christian - 1

Sikh &other - 2

Family

Income

50,000 10 4

6.540, 0.0380 2 5.99 S* 10,0000 1 4

Above 10,0000 3 8

Duration

Of illness

Less one year 9 5

5.032 0.1695 3 7.82 NS

1 – 3 years 2 2

3 – 5 years - 3

Above 5 years 3 6

Birth other First 8 9

2.046, 0.5630 3 7.82 NS

Second & 5 4

Third 1 1

Fourth or more - 2

Knowledge

regarding

Thalassemia

Yes 6 11

2.039

0.1533 1 3.84 NS


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There was a significant association between the Attitude scores regarding health related quality

of life of thalassemia patient and family income.

DISCUSSION:

Regarding Knowledge: These study findings revealed that majority of the thalassemia

patients, Among 30 samples, 22 in 73.33%.were having inadequate knowledge regarding

thalassemia.

John R, kilton rose at al (2012) a research study was conducted for quality of

life A cross-sectional correlational survey design and purposive sampling were used.

Thirty-two thalassemia major patients (mean age 17.5 years) and 32 mothers (mean age

40.5 years) were recruited. On a scale ranging from 0-20, the average of the patients'

disease knowledge about thalassemia major was 15.19 and the average of their mothers'

disease knowledge was 16.44. The scores for the patients' disease knowledge about

thalassemia major were positively correlated with follow-up visit adherence (r = 0.690, p

< 0.001) and with desferrioxamine infusion adherence (r = 0.791, p < 0.001). 95.6% of

variance in patients' knowledge was explained by a model that included mothers'

knowledge (beta = 0.901, p < 0.001), follow-up visit adherence (beta = 0.084, p = 0.140)

and annual household income (beta = 0.042, p < 0.387).This supportive study findings

revealed that the thalassemia patients were having average knowledge and it was

positively correlated with follow up Visit adherence.

This present study findings showed that majority of them were having inadequate

knowledge which affects their quality of life. So proper information has to be provided to

the sample which can help them to improve their quality of life.

Regarding quality of life: This present study, revealed that Majority of them 15 (50%) were

having moderate quality of life 12(40%) of them were having good quality of life and

3(10%) of them were having poor quality of life.

The present study revealed that for mean value of physical function was 50, role

limitations due to physical health 60, Body pain 64.83, energy, Fatigues 53.14, general health

57.62, social function 72.46, role limitations due to psychological reasons (emotional) 64.4

and mental health 60.


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Amani F et al (2015) conducted a study Quality of life among Ardabil patients with beta-

thalassemia major at Iran. Thalassemia as the most common genetic disorder worldwide is

regarded as a serious problem in public health issues in the Mediterranean region. Patients with

beta-thalassemia major experience physical, psychological and social problems that lead to

decreased quality of life. The aim of this study was to assess health-related quality of life and its

determinants among patients with major beta-thalassemia. Methods: This was a population-

based cross-sectional survey of quality of life. Population with thalassemia major (aged ≥ 2

years) of both genders who had records in Thalassemia Clinic of Bu-Ali Hospital, and those who

regularly refer for blood transfusion or follow-up visits. Data were collected from December

2013 to May 2014.The self-administered short form-36 (SF-36) questionnaire was used to

measure quality of life in patients with thalassemia. Data were analysed using descriptive

statistical tests (mean, SD, and frequency), and inferential statistical test (t-test) in SPSS.17

software. Results: Our samples were 20 men and 23 women. The median age was 20 years (2-

42). After reviewing the patients' quality of life, it was observed that the mean score for physical

function was 79.8, role limitations due to physical reasons 78.8, bodily pain 74.4, general health

59.1, fatigue or vitality 63.3, social function 70.21, role limitations due to psychological reasons

(emotional) 77.3 and mental health 65.4. On two scales, role physical (P = 0.33) and role

emotional (P = 0.13), the men showed significantly lower scores than the women.

Conclusion & Summary:

After analysis of the result, information booklet was prepared and distributed, which was

intended to improve the knowledge and attitude of thalassemia patients.

REFERENCES:

1. Polit. DF, Hungler. BP (2000) nursing research: principles and method. 6th edition

Philadelphia: Lippincott publishers;.

2. Suresh K. Sharma. (2008) nursing research and statistics, 1st edition, published by

Elsevier, a division of reed Elsevier India Pvt. Ltd.

3. Suzanne C, Smelter , Brunner and Suddarth’s (2008) , “Text book of Medical Surgical

nursing”, 11th edition, volume II ,Lippincott publication . Pp.1507-1515.


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4. Black Joyce.M,Jacob Esther Matassari. “Medical Surgical Nursing” Clinical

management and positive outcomes; 7thed.Elesiver publications, pg no: 2171,& 390

.2004.


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Effectiveness of Self-Instructional Module on Utilization of

Contraceptive Devices In Terms Of Knowledge and Attitude among

Married Women

ABSTRACT:

OBJECTIVES: (1) To develops and validates the self-instructional module on utilization of

contraceptive devices for married women. (2) To assess and evaluate the knowledge and attitude

of married women before and after administration of self-instructional module. (3) To determine

the relationship between post-test score knowledge and post- test attitude score of married

women. (4) To find out the association between the post-test knowledge and post- test attitude of

married women with their selected demographical variables. Research design: One group pre-

test post-test pre experimental design. Material: Non- Probability convenience sampling.

Sample Size: Sample size included in the study was 50 married women in selected rural

community area at Baleni. RESULTS: Most of the numbers of married women (28%) were of

the age group of 23-27. The majority of married women were Hindu i.e. (76%). The majority of

married women were house wives i.e. (88%) belonging to family income between 3000-5000

The study revealed that the mean post-test knowledge score was increased (27.36+ 2.562) than

mean pre-test knowledge score (19.18+ 4.587). The mean post-test attitude score was increased

(76.4+ 5.01) than the mean pre-test attitude score (67.06+ 5.26). CONCLUSION: The SIM was

found to be effective in increasing the knowledge and developing favourable attitude of the

married women regarding utilization of contraceptive devices.

KEYWORDS: Evaluate Effectiveness, Knowledge, Attitude, contraceptive devices, Self-

instructional module, and married women.

Mrs. Nisha Yadav,

MS.c Nursing Student, Dept. of Community Health Nursing,



GUIDE

Ex Capt. Geeta Parwanda,

Principal, Panna Dhai Maa Subharti College of Nursing, Meerut. U.P, India



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INTRODUCTION

“Control the size of population, care about Mother Earth.”

Gulani K.K. (2000) India’s population is increasing very explosively. It contributes one

fifth of the world’s population by having more than one billion people. Population explosion is

found to be the main reason for short ages of resources and neutralization of the impact of

progress made in various development sectors. Hundreds and millions of people still are very

poor, illiterate and unhealthy. It is because resources are limited, population is very large and

every year around 17 million new mouths are added.

According to WHO(2013), family planning has been defined as: “a way of thinking that

is adopted voluntarily, upon the basis of knowledge, attitudes, and responsible decision by

individuals and couples, in order to promote the health and family welfare of the group and thus

contribute effectively to the social development of a country.”

Family planning helps individuals and married one to expect the number of children they

want and the spacing and timing of their births. Contraceptive methods and the treatment of

involuntary infertility can be used to achieve this. A woman’s health and well-being depends on

her ability to space and limit her pregnancies.

BACKGROUND OF THE STUDY:

According to WHO(2013), family planning has been defined as: “a way of thinking that is

adopted voluntarily, upon the basis of knowledge, attitudes, and responsible decision by

individuals and couples, in order to promote the health and family welfare of the group and thus

contribute effectively to the social development of a country.”

The world population which was around 2 billion (2000 million) in 1900, reached about 6 billion

by 2000. According to the 2001 census report, the population growth rate was still around 1.7

per cent, i.e., 17/1000/year, a rate at which our population could double in 33 years. Such an

alarming growth rate could lead to an absolute scarcity of food, shelter and clothing. Therefore,

the government was forced to take up serious measures to check this population growth rate.

METHODOLOGY

Research design: One group pre-test post-test pre- experimental research design


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Research Approach: Evaluative analytical approach

Population: The populations included in the study are the married women in selected rural

community area at Meerut

Sample Size: 50

Setting: The study was conducted in selected rural community area

Variables

Independent Variable: Self-instructional module on utilization of contraceptive devices.

Dependant Variable: Knowledge and attitude of the married women regarding contraceptive

devices.

Inclusion Criteria

Women who are in the age group of 19 – 38 years.

Married female who knows how to read and write Hindi.

Married women who are available at the time of data collection period.

Married women who are willing to participate

Exclusion criteria

Married women who had no formal education.

MATERIAL

The tool used for data collection was prepared by the researchers themselves after extensive

review of literature. The tool was then validated by experts in the field of community medicine,

community nursing faculty and statistics, English and Hindi languages. The tool has three parts.

Part I deals with the data related to demographic variables of the study participants. Part II of the

tool contained 34 items on various aspects such as awareness, contraceptive methods. Types,

uses, and importance, advantages and disadvantage. Part III of the tool 20 related contraceptive

devices.The items were multiple choice type statements. The correct answer got score ‘1’ and the

wrong answer got the score ‘0’. The minimum score is 0 and the maximum score is 34.

After the tryout on 10 married women. Reliability co-efficient of structure knowledge

questionnaire was calculated by using KR-20 formula and of Attitude scale by using Cornbach’s


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alpha. The reliability of knowledge questionnaire was found to be (r=0.9) and attitude scale was

0.72. Thus the tools were found to be reliable.

METHOD OF DATACOLLECTION

Formal administrative permission was obtained from “Pradhan from community area at

Baleni (Bagphat)”. Data was collected from 16thFebruary to 7th march 2016.

Self-introduction was given.

Introduction to the nature of study was given to obtain free and frank response.

Purposive sampling technique was used to select 50married women.

Confidentiality of their responses was assured and verbal consent was taken.

On the Day-one pre-test was done by administering structured knowledge questionnaire

and attitude scale.

After pre-test Self-instructional module was administered to the group.

On the Day-seven post-test was conducted from knowledge and attitude scale.

Analysis

The data obtained were analyzed in the terms of the objective of the study using

descriptive and inferential statistics. The plan of the data analysis was as follows.

Organize the data on master sheet.

Compute Mean; Mean percentage, standard deviation to describe the data.

Inferential statistics such as paired’ test. The paired ‘t’ test was used to find out the

differences in the scores of Knowledge and skill between pre-test and post-test. The findings of

the study were presented in the form of tables and figures

OBSERVATION & RESULTS

Section I: Finding of demographic of the married women

Majority of the subjects (28%) were in age group 23-27 years. religion wise majority of

the married women were Hindu i.e. 38(76%) . regarding occupation of married women

the majority of respondents of married women were house wife i.e. 44(88%). The

majority of the married women were living in extended family i.e. 22(44%). The large of

the respondents married women education were primary i.e. 17(34%). The larger no. of


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the married women husband income between 3000-5000/ i.e.20 (40%). The majority of

the married women were no. of living children i.e.18 (36%). Regarding previous

knowledge of exposure, the majority of married women having knowledge related to

contraceptive devices i.e. 31(62%).

Section II: Findings related to knowledge scores of the married women

The mean post-test knowledge score (27.36%) of the married women was higher than

their mean pre-test knowledge score (19.18). there was reduction in the standard

deviation from pre-test (4.58) to post-test (2.56). the findings also revealed that the post-

test knowledge scores were more homogenous (SD-2.56) than the pre-test knowledge

scores (SD-4.58), indicating that the group become more homogenous after

administration of self-instructional module.

Section III: Findings related to attitude scores of the married women

The mean post-test attitude score (76.4) of married women was higher than their mean

pre-test attitude score (67.06). There is a reduction in the standard deviation from pre-test

(5.26) to post-test (5.01). The mean and median are closer to each other in both pre-test

and post-test.

Section IV: Findings related to relationship between post-test knowledge and

post-test attitude

That the coefficient of correlation between post-test knowledge scores and post-test

attitude scores is .057 which is less than the table value (.294), it shows that there is not

significant negative relationship exists between mean post-test knowledge and mean post-

test attitude of the married women, which is a true relationship not by chance, hence the

null hypothesis H03 was failed to rejected and research hypothesis H3 was rejected.


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Association of Post-test knowledge score with Socio demographic variables(at

0.05 level significance)

S.

N

Demographic variables Sample Knowledge Chi sqr value Df

Level of

significance

at 0.05

Category

Below

Mean

Above

Mean

Cal.

Value Table

Value

1 Age in years

19-22 3 9

2.2 7.81 3 NS

23-27 7 7

28-32 8 6

33-38 4 6

2 Religion

Hindu 17 27

3.05 7.81 3 NS

Muslim 4 7

Christian 0 0

Sikh 1 0

3 Occupational

House wife 21 23

3.12 5.99 2 NS

Employed

(govt.&prit.) 0 1

Self employed 1 4

4 Family income

3000-5000/ 5 15

7.92 7.81 3 S

5001-8000/ 10 6

8001-11000/ 2 5

12000 or more 5 2

5 Type 0f family

Nuclear family 8 6

1.48 5.99 2 NS

Joint family 6 8

Extended family 8 14

6 Education

Primary 6 11

8.16 7.81 3 S

Secondary 5 0

Higher education 3 8

Graduation or more 8 9

7.

No. of living children

Nil 6 4

7.81

Two 2 7

Three 7 11 3.44 3 NS

Three &more than

three 7 6

8 Previous knowledge of

contraceptive methods

Yes 12 19

0.91 3.84 1 NS No 10 9


Page:22

Association of Post-test attitude score with Socio demographic variables(at 0.05

level significance)

S.N

Demographic

variables Sample Attitude chi sqr value Df

Level of

significance at

0.05

Category

Below

Mean

Above

Mean Cal.V

Table

V.

1 Age in years

19-22 10 2

8.96 7.81 3 S

23-27 4 10

28-32 5 9

33-38 5 5

2 Religion

Hindu 18 20

1.11 5.99 2 NS

Muslim 6 5

Christian 0 1

Sikh 0 0

3 Occupational

House wife 21 23

1.20 5.99 2 NS

Employed (govt.&prit.) 0 1

Self employed 3 2

4 Family

income

3000-5000/ 12 8

2.39 7.81 3 NS

5001-8000/ 7 9

8001-11000/ 2 5

12000 or more 3 4

5 Type 0f

family

Nuclear family 5 9

1.34 5.99 2 NS

Joint family 8 6

Extended family 11 11

6 Education

Primary 10 7

2.95 7.81 3 NS

Secondary 3 2


Graduation or more 8 9

No. of living

children

Nil 6 4

7.81

Two 4 5

7 Three 10 8 2.57 3 NS

Three &more than

three 4 9

8

Previous

knowledge of

contraceptive

methods

Yes 15 16

0.003 3.84 1 NS No 9 10


Page:23

DISCUSSIONS

The analysis result of the present study shows that the relationships between post-test

knowledge score and post-test attitude of married women regarding utilization of contraceptive

devices with r value of - .057 which was statically significant at P<0.05. Hence null hypothesis

H03 was failed to reject and research hypothesis H3 was rejected.

The finding of present study was supported Ajay Fernanda’s, Anita Anto1, et al 2014 on

Knowledge and Attitude Assessment on Family Planning Methods among Adults in South India:

A Correlation Study. The results 56% of the respondents’ are not willing to adopt permanent

family planning method. Regarding knowledge and attitude mean was found to be 63.96% and

72.05% respectively.

There was a positive relationship between knowledge and attitude score 0.321.The

overall findings of the study clearly showed that, adults had good knowledge and positive

attitude towards family planning methods.

LIMITATIONS:-

In this study, existing family planning was collected through likert scale questionnaire, as

per the samples statement. The assessment of physical and psychosocial problems was not

evaluated by researcher as no intervention was taken regarding the same. The researcher mainly

focused on the assessment of the knowledge and implemented the self-instructional module for

the improvement of knowledge regarding family planning.

RECOMMENDATIONS

The study can be replicated on a large sample to validate the findings and to make

generalizations.

A similar study can be done with an experimental research approach considering one

group pre-test- post-test.

A similar study can be conducted to compare the effectiveness of self-instructional

module with strategies like planned teaching programme.

A study can be conducted to carry out to identify the educational needs of the married

women.


Page:24

A study can be conducted on effectiveness of an information booklet on utilization of

contraceptive devices in terms of knowledge and attitude of married women.

A study can be conducted to assess the incidence of contraceptive devices among married

women.

REFERENCES

5. Polit. DF, Hungler. BP (2000) nursing research: principles and method. 6th edition

Philadelphia: Lippincott publishers;.

6. Suresh K. Sharma. (2008) nursing research and statistics, 1st edition, published by

Elsevier, a division of reed Elsevier India Pvt. Ltd.

7. AroraN.Mittal S, Emergency Contraception and prevention of induced abortion in India;

Journal of family planning Reproductive health care, 2010 Oct. 31(4) 29

8. Correia D.S, Ponter A.C. Adolescents:Contraceptive Knowledge and Use, A Brazilian

Study. Scientic World Journal. 2009 Jan 18(9):37-45.

9. WHO, family planning. Retrieved from, http://www.who.int/topics/family_planning/en/

10. Marriam on human society. Retrieved from http://www.merriam-

webster.com/dictionary/family%20planning

11. Malcolm potts 2012 population explosion. Retrieved from www.populationmatters.org

12. Ministry of health 2013 family welfare. Retrieved from

http://en.wikipedia.org/wiki/Ministry_of_Health_and_Family_Welfare

http://www.who.int/topics/family_planning/en/

http://www.merriam-webster.com/dictionary/family%20planning

http://www.merriam-webster.com/dictionary/family%20planning

http://en.wikipedia.org/wiki/Ministry_of_Health_and_Family_Welfare


Page:25

A STUDY TO EVALUATE THE EFFECTIVENESS OF STRUCTURED TEACHING

PROGRAMME (STP) REGARDING SEDATION PROCEDURE IN TERMS OF

KNOWLEDGE AND PRACTICE AMONG ICU NURSES IN SELECTED HOSPITAL

AT MEERUT.

BACK GROUND OF THE STUDY

Providing high-quality care in the intensive care units (ICUs) is a major goal of every

medical system. Nurses play a crucial role in achieving this goal. One of the most important

responsibilities of nurses is sedation and pain control of patients. The present study tried to

assess the effect of nurses’ practice of a sedation protocol on sedation and consciousness levels

and the doses of sedatives and analgesics in the ICU patients.

OBJECTIVES:-

1. To develop and validate a structured teaching programme regarding sedation

procedure for ICU nurses.

2. To evaluate the level of knowledge and practice before and after administration of

structured teaching programme regarding sedation procedure among ICU nurses.

Mr. Sumit Prajapati

M.Sc. Nursing, Medical and Surgical Nursing, Panna Dhai Maa Subharti Nursing College,

Meerut, U.P.


GUIDE

Mr. Sankappa,

Asst. Professor, Panna Dhai Maa Subharti College of Nursing, Meerut. U.P, India





Page:26

3. To find out the relationship between post test knowledge and practice regarding

sedation procedure among ICU nurses.

4. To find out the association between the mean post-test knowledge and practice

score regarding sedation procedure and their selected demographic variables

among ICU nurses.

RESEARCH METHODOLOGY

The evaluative study was conducted using pre experimental (1 group pre test and post

test) research design The independent variable was structured teaching programme and the

dependent variable was knowledge and practice of the ICU staff nurses regarding sedation

procedure The total sample size was 30 . The setting of the study was at selected hospitals

Meerut. Non-probability purposive sampling technique is used to select the subjects. The tool

used for the study, was structured knowledge Questionnaire and observational checklist to assess

the knowledge and practice of the ICU nurses. Content validity of the tools was given to experts

and tool was found to be reliable and feasible. The main study was conducted from 18th

February

to 6th march 2016.

RESULT

The data analyzed and interpreted in terms of objectives formulated descriptive and inferential

statistics used for the data analysis. The difference between the mean pre-test and the mean post-

test knowledge and practice scores was found to be statistically significant (‘t’29 =5.0) at 0.05

level of significance, was greater than the table value (2.05) and the difference between the mean

pre-test and the mean post-test practice scores was found to be statistically significant (‘t’29 =9.8)

at 0.05 level of significance, was greater than the table value (2.05).This indicates that the


Page:27

structured teaching programme was significantly effective in increasing the knowledge and

practice of ICU staff nurses on sedation procedure.

CONCLUSION

Hence, structured teaching programme is an effective strategy for providing

information and improving the knowledge of subjects. Educating the ICU staff nurses

would help them to handle the problems by supporting them as a counsellor as well as an

educationist.

Keyword:-knowledge and practice of ICU Nurses, Structured teaching programme and

observational check list.


Page:28

“A STUDY TO ASSESS & EVALUATE THE EFFECTIVENESS OF PLAN TEACHING

PROGRAM ON PREVENTION OF URINARY TRACT INFECTION DURING

PREGNANCY AMONG ANTENATAL MOTHERS IN TERMS OF KNOWLEDGE , IN

SELECTED COMMUNITY CENTERS AT MEERUT ”

INTRODUCTION:

Urinary Tract Infection is a common problem in pregnant women. Around 8.3 million

pregnancy cases are reported every year. It is because of changes in the urinary tract. The uterus

sits directly on top of the bladder. As the uterus grows, its increased weight can block the

drainage of urine from the bladder causing infection. The most common organisms that implicate

UTI is E.coli (80%), staphylococcus Aureus . Urinary catherization is a common risk factor for

UTI. Depending on the site of infection UTI can produce different symptoms such as burning

micturition, feeling of urgency, lower abdominal pain, fever, urinary incontinence, urine looks

cloudy and so on.

Ms. Priya Rai


Meerut, U.P.

E-mail:

GUIDE

Prof. Kalpana Mandal

Dean, Panna Dhai Maa Subharti College of Nursing, Meerut. U.P, India



Page:29

BACKGROUND OF THE STUDY

Healthy living is not a difficult step. Illness can really mean a downturn in our lives. But

regular medical checkups can easily prevent serious medical problems and help us live a healthy

life.

Shirish N Daftary (2009), Reported that a mother is a biological and social female

parent of an offspring. Pregnancy is one of the most special and most critical phase in a women’s

life. Pregnancy is carrying developing offspring within the body or womb or being about to

produce new life. Pregnancy is an earlier result of fertilization and begins with implantation.

Then zygote undergoes series of changes and develops as a new diploid organism. It is

scientifically stated as “gravidity”. A woman who is pregnant for the first time is a primigravida

and women in subsequent pregnancies as a multi gravida.

WHO and UNICEF( 2010), Estimated that about 70% of women in the developing

countries are attended at least once during pregnancy by skilled health personnel. The rate is

lowest in south Asia that is 54%. In India, only 15% of mothers receive complete antenatal care

and only 58% receive iron or folic tablets or syrup. A study mentioned the most of the

primigravida women (88.2%) were more likely to have poor knowledge in the relation to

antenatal care compared to 11.8% of women whose gravida was less than five. National Family

Health survey in India (2000-2010) found that reasons for not seeking antenatal care include

those who do not think antenatal check-up that necessary (60%) or customary(4%), inability to

meet the cost of visiting a health care facility(15%), and not being allowed by their families to

have these checkup (99%), lack of knowledge on antenatal care and poor access to health centre

were the other reason cited .

OBJECTIVES:

1. To develop & validate planned teaching program on prevention of urinary tract infection for

Antenatal mothers.


Page:30

2. To assess and evaluate the knowledge of antenatal mothers in experimental group regarding

prevention of urinary tract infection before & after administration of planned teaching program.

3. To compare the knowledge of antenatal mothers in experimental group & control group

regarding prevention of urinary tract infection.

4. To find out the association between post test knowledge scores of antenatal mothers in

experimental group with selected demographic variables .

METHODOLOGY:

The research approach adopted for the study was evaluative approach. The research design

selected for the study was Quasi-experimental pre-test post-test control group design. The

sample was selected through non-probability purposive sampling technique. The sample of the

study consisted of 60 antenatal ( 30 in experimental and 30 in control group ) working in selected

hospitals at Meerut . Pre-test knowledge of experimental group and control group antenatal

mothers was assessed on the day . Planned teaching program was administered on prevention of

urinary tract infection on day first to the experimental group antenatal mothers. The post test was

taken on seventh day in both experimental and control group.

The tool used for data collection was: structure interview schedule method

Part I – Demographic variables

Part –II – 30 Knowledge questions of MCQ type.

The data collection was done, analyzed and interpreted in terms of objectives of the study.

The data was analyzed by using descriptive and inferential statistics.


Page:31

MAJOR FINDING OF THE STUDY : The data represented in table 1 shown maximum

of the sample in experimental group and control group were in the age group (19 -30) years i.e.

both 60% .As per the education pattern in experimental group and control group were having

primary- secondary i.e. 15(50%) and 16(53%) . Maximum number of the sample in experimental

group 22(73%) , Hindu and in control group majority 28(93%) were Muslim. Regarding dietary

pattern most of the sample in experimental group and control group were non – vegetarian

15(50%) and 28(93%) respectively . As per the monthly income in experimental group and

control group were having (7000 – 9000) income 21(70%) and 17(57%) respectively. As per the

occupation majority of sample in experimental group and control group were housewife i.e. 26

(86.66%) and 29 (96.67%). Majority of the sample in the experimental group and control group

family types were joint family i.e. 26(87%) and 28(93%). Maximum number of the sample in

experimental group and control group were having no experience of earlier urinary tract

infection, i.e. 21(70% ) and 20 (66.67%) . As per the smoking pattern in experimental group and

control group were non smoker i.e. 30(100% ) both . Regarding experience of constipation most

of the sample in experimental group and control group were having no constipation i.e. 24(80%)

and 20 (67%). Most of the sample in the experimental group and control group source of

information regarding urinary tract infection were health personnel, 17(57% ) and 22( 73%)

respectively .


Page:32

Column graph showing the percentage of post – test knowledge score of control group.

The mean post-test knowledge score (16.6 ) of antenatal mothers were significantly

higher than mean pre-test knowledge score (9.13 ) on Prevention of Urinary Tract Infection . 96.

67 % of antenatal mothers having good knowledge after administration of PTP in experimental

group. Post test knowledge score of experimental group and control group of antenatal mothers

were found to be statistically significant as calculated value of ‘ t’ ( 9.968*) for df 58 [ ‘t’ =

2.05] at 0.05 level significance. Hence research hypothesis H1, H2 was accepted and null

hypothesis H01 and H02 was rejected. There was only on significant association found with type

of center in the demographic variable with the post –test knowledge score of experimental group

antenatal mothers. Hence research hypothesis H3 was accepted for this demographic variable

association and null hypothesis H03 was rejected. Hence research hypothesis H4 was not

accepted for this demographic variable association and null hypothesis H04 was rejected .

CONCLUSION:

Below Average (0-10

)

Average (11-20) Good Knowledge (21-

30)

76.66 23.34

10 66.66

23.34

Knowledge Score of Experimental group and Control group

Control Group (N = 30) Experimental Group (N = 30)


Page:33

The study concluded that there was knowledge deficit in antenatal mothers regarding

prevention of urinary tract infection before intervention and planned teaching program was an

effective method to improve the knowledge of antenatal mothers.

KEYWORDS: Effectiveness, Antenatal Mothers, Prevention Of Urinary Tract Infection ,

Hospitals , community health center.

References:

1. Myles,(2007), “Text book for midwives”, XIV edition, Diane m Fraser, Margaret,

Churchill living stone Elesvier Publication , Pp: 123-138 ,206-207, 371-372.

2. Polit and Back, (2011) “ Nursing Research; principals and method” ,11th edition ,jp

Lippincott co, pp.12,13,36,38.

3. Suzanne C, Smelter , Brunner and Suddarth’s (2008) , “Text book of Medical Surgical

nursing”, 11th edition, volume II ,Lippincott publication . pp.1507-1515.

4. Shirish N Daftary Chakravarthi(2009) “A Text book of Manual of Obstetrics” 2nd

Edition

published by Elsevier Page No. 465, 615.

JOURNALS

1. Dr. Rajshekhar. D. Kerure , Dr.Umashanker (2013) , Prevalence of Asymptomatic

Bacteriuria among Pregnant women in a tertiary care hospital International Journal of

Scientific and Research Publications , Volume 3, Issue 11, ISSN 2250-3153 , ,

www.ijsrp.org , http://www.ijsrp.org/research-paper-1113/ijsrp-p2334.pdf.

2. Ramesh hotchandani , kk aggarwal , ( 2014 )Urinary Tract Infections in Women ,

Original Article , http://medind.nic.in/iaa/t12/i9/iaat12i9p187.pdf.

http://www.ijsrp.org/

http://www.ijsrp.org/research-paper-1113/ijsrp-p2334.pdf

http://medind.nic.in/iaa/t12/i9/iaat12i9p187.pdf


Page:34

“A STUDY TO EVALUATE THE EFFECTIVENESS OF VATP IN TERMS OF

KNOWLEDGE & ATTITUDE REGARDING ASSISTIVE RESPIRATORY HOME

CARE MANAGEMENT AMONG PATIENTS WITH COPD ADMITTED IN SELECTED

HOSPITAL AT MEERUT.”

ABSTRACT

Objectives: To prepare and validate VATP regarding assistive respiratory home care

management of COPD patients. To assess and evaluate knowledge & attitude before and after

the administration of VATP. To determine the relationship between post-test of knowledge &

attitude among COPD patients regarding assistive respiratory home care management. To find

out the association between post test knowledge & attitude among COPD patients with their

selected demographic variables. Research design: Pre-experimental design. Material: Non-

Probability purposive sampling Sample: COPD patient. Result: The calculated paired t value

was 13.37 greater then table value 1.699 at 0.05 level of significance which shows that there was

a significant improvement in the level of knowledge. The calculated paired t value was 21.39

greater then table value 1.699 at 0.05 level of significance which indicates that COPD have

favourable attitude, There was a significant relationship between post test knowledge and

attitude which was statically signification. Conclusion: The result reveals that VATP was

effective in increasing the knowledge and developing favourable attitude among COPD Patients.

Keywords: Knowledge, Attitude, COPD, Video assisted teaching Programme, Interview.

Ms. Rajni Emanwel


Meerut, U.P.


GUIDE

Ex. Capt. Geeta Parwanda,

Principal, Panna Dhai Maa Subharti College of Nursing, Meerut. U.P, India



Page:35

INTRODUCTION:

Chronic obstructive pulmonary disease (COPD) is a major public health problem in India.

Although several International guidelines for diagnosis and management of COPD are available,

yet there are lot of gaps in recognition and management of COPD in India due to vast

differences in availability and affordability of healthcare facilities across the country. The Indian

Chest Society (ICS) and the National College of Chest Physicians (NCCP) of India have joined

hands to come out with these evidence-based guidelines to help the physicians at all levels of

healthcare to diagnose and manage COPD in a scientific manner.

Chronic obstructive Pulmonary Disease (COPD) is not one single disease but an

umbrella term used to describe chronic lung diseases that cause limitations in lung airflow. The

more familiar terms 'chronic bronchitis' and 'emphysema' are no longer used, but are now

included within the COPD diagnosis.The most common symptoms of COPD are breathlessness,

or a 'need for air', excessive sputum production, and a chronic cough. However, COPD is not

just simply a "smoker's cough", but a under-diagnosed, life threatening lung disease that may

progressively lead to death.

COPD is the fourth leading cause of the death worldwide, and it will become 3 rd

leading

cause of the disease by 2020.As per the estimation done by the WHO around 2.74 million

deaths occurs due to COPD, which is 5% of the total death worldwide. Out of this death rate

around 90% of the death occurs due to smoking. This shows that smokers are at the high risk of

developing COPD in their life span. The main reason for this much higher mortality is lack of

awareness of the disease worldwide. COPD is the disease which develops gradually and

generally it is very silent in the initial stages of the disease, so when the people come to know

about the severity and risk of the disease they loss their

50% of the lung functions.

METHODOLOGY

Research design: pre- experimental design

Research Approach: Evaluative research approach

Population: COPD patients

Sample Size: 30


Page:36

Setting: selected hospitals at Meerut

Variables

Independent Variable: VATP regarding assistive respiratory home care management

Dependant Variable: The dependent variable is the condition or characteristics that appears or

disappear as a result of independent variable. In the present study, dependent variables are

Knowledge & attitude of COPD patients.

Inclusion Criteria: (a)Patients who were having Mild to Moderate type of COPD patients. (b)

Patients who were suffering from COPD since 1-5 yrs. (c) Patient those who were available

during the data collection period.

Exclusion Criteria: (a)Patients who had severe to very severe type of COPD. (b) Patients who

were on ventilator. (c) Patient who were not willing to participate in the study.

MATERIAL

The tool used for data collection was prepared by the researchers themselves after extensive

review of literature. The tool was then validated by experts in the field of Physiotherapy,

Medicine, nursing and statistics, English and Hindi languages. The tool has two parts. Part I

deals with the data related to demographic variables of the study participants. Part II of the tool

contained 30 items. The items were multiple choice type statements. The correct answer got

score ‘1’ and the wrong answer got the score ‘0’. The minimum score is 0 and the maximum

score is 30.

METHOD OF DATACOLLECTION

A written consent obtained prior to subjects’ recruitment in the study. They were made

comfortable and oriented to the study. Pre-test was given on the day one followed by VATP.

Posttest data was collected after 5 days in the same settings.

Analysis

The present study was designed to assess the knowledge and attitude of COPD patients. Analysis

and interpretation of data are based on the objectives of study.


Page:37

OBSERVATION & RESULTS

Distribution of participants according to demographic variables, Regarding age group maximum

numbers of COPD Patients 22 (73.4%) were in the age group between of 50-60 years, 7 (

23.3%) were in the age group of between 50-54yrs.

Regarding gender majority numbers of COPD Patients 25 (83.4%) were male, and 5 (16.6%)

were female.

Regarding educational status showed that most of the COPD patients 17 (56.7%) were had no

formal education, 9 (30%) were had primary education, 3 (10%), were had higher education.

Regarding occupation most of the COPD patients 13 (43.4%) were others (retired pensioner

coolie), 11 (36%) were unemployed, 2 (6.6%) were doing business 3 (10%) were private

employee.

Regarding marital status majority of the COPD patients 28 (93.4%) weremarried and 2 (6.66%)

were unmarried.

Types of the family showed that majority numbers of the COPD patients 26 (86.6%) were living

in joint family and 4 (13.4%) were living in nuclear family.

Regarding income of the COPD patients 13 (43.3%) of them were having monthly income 5001-

8000Rs. 11 (36.6%) were having monthly income above Rs. 8001

Most of the COPD patient 15 (50%) were not a smoker or alcoholic, 14(46.6%) were smoker.

Regarding source of the information about COPD majority of the COPD patients 26 (86.6%)

was obtained information from the health personnel, 3 (10%) from the family members or

friends.

Most of the COPD patients 16 (53.4%) were non vegetarian 8, (26.6%) were vegetarian and 6

(20%) were Eggetarian.

Majority of the COPD patients 27 (90%) were don’t have family history of COPD and 3 (10%)

were had family history of COPD.

Most of the COPD patients 10 (33.3%) were having duration of illness less than 2 yrs, 8

(26.6%) were having illness of 3-4yrs, 6(20%) were having illness of 2-3 yrs and 6(20%) were

having illness of 4-5yrs.


Page:38

The pre test mean knowledge score was 17.23 with the S.D. of 3.15. The post test mean

knowledge score was 21.96 with the S.D. of 2.25. The post test mean knowledge score was

higher than the pre test knowledge score.The paired‘t’ test value was 13.35 was greater than the

table value 1.699 which was statistically significant at P < 0.05. It can be inferred that the VATP

regarding Assistive respiratory home care management among patients with COPD was

effective in improving the knowledge which was statistically significant at P < 0.05.

The pre test mean attitude score was 47.51 with the S.D. of 3.766. The post test mean attitude

score was 60.10 with the S.D. of 3.703. The post test mean attitude score was higher than the pre

test attitude score. The paired‘t’ test value was (21.39) was greater than the table value 1.699

which was statistically significant at P < 0.05.

It can be inferred that the VATP on attitude regarding Assistive respiratory home care

management among patients with COPD was effective in developing favourable attitude which

was statistically significant at P < 0.05.

There was a significant relationship between post test knowledge and post test attitude with ‘r’

value of 0.42 which was statically signification at P < 0.05. It also implies that knowledge and

attitude were directly proportional to each other.

Frequency and Percentage Distribution of Demographic Characteristics of the COPD

patients n =30

S.NO SAMPLE

CHARACTERSTICS

FREQUENCY

(f)

PERCENTAGE

(%)

1.

AGE IN YEARS

45-49 1 3.3

50-54 7 23.3


Page:39

55-60 22 73.4

2. GENDER

Female 5 16.6

Male 25 83.4

3. Education

No formal education 17 56.6

Primary 9 30

Secondary 1 3.3


4. OCCUPATION

Unemployed 11 36

Business 2 6.6

Govt. Employee 1 3.3

Private employee 3 10

Others ( Retired,

Pensioner, Coolie)

13 43.3

5. MARITAL STATUS:

Married 28 93.44

Unmarried 2 6.66

6. TYPES OF FAMILY

Nuclear family 4 13.4

Joint family 26 86.6

7. INCOME MONTHLY

Rs 2,000-5,000/- 6 20


Page:40

Rs 5001-8,000/- 13 43.3

Rs 8,001 Above 11 36.6

8. PERSONAL HISTORY

Alcohol 1 3.33

Smoker 14 46.66

Non alcoholic/ non smoker 15 50

9. SOURCE OF

INFORMATION ABOUT

COPD.

By T V / Radio 1 3.4

By health personnel 26 86.6

By family members or

friends

3 10

10. DIETARY PATTERN

Vegetarian 8 26.6

Non- Vegetarian 16 53.4

Eggetarian 6 20

11. FAMILY HISTORY OF

COPD

Yes 3 10

No 27 90

12. DURATION OF

ILLNESS

Less than 2years 10 33.3

2-3 years 6 20


Page:41

EFFECTIVENESS OF VATP ON KNOWLEDGE REGARDING ASSISTIVE

RESPIRATORY HOME CARE MANAGEMENT AMONG PATIENTS WITH COPD

n= 30

Knowledge

test

Mean Standard

deviation (S.D.)

Mean

Difference

SDD SED Paired ‘t’

value

Pre test 17.23 3.15

4.73 1.98 0.36 13.35

Post test 21.96 2.25

EFFECTIVENESS OF VATP ON ATTITUDE REGARDING ASSISTIVE

RESPIRATORY HOME CARE MANAGEMENT AMONG PATIENTS WITH COPD

n=30

FINDING RELATED TO CORELATION BETWEEN POST TEST LEVEL

KNOWLEDGE AND ATTITUDE

Table no. -10: Correlation between post test level of knowledge and attitude.

n=30

Scores Mean SD ‘r’ value ‘P’ value

3-4 years 8 26.6

4-5 years 6 20

Attitude

test

Mean Standard

deviation

(S.D.)

Mean

Differen

ce

SDM SEM

D

Paired ‘t’

value

Pretest 47.51 3.766 12.59 3.1

0.57

21.39

Post test 60.10 3.703


Page:42

Post knowledge 47.57 2.25 0.42 0.05

Post Attitude 60.10 3.703

DISCUSSION

Result rveals that pre test mean knowledge score was 17.23 with the S.D .of 3.15. The

post test mean of knowledge score was 21.96 with the S.D. of 2.25. The paired‘t’ test value was

13.35 was greater than the table value 1.699 was statistically significant at P < 0.05.

The pre test mean attitude score was 47.51 with the S.D .of 3.766. The post test mean attitude

score was 60.10 with the S.D. of 3.703. The paired‘t’ test value was (21.39) was greater than the

table value 1.699 which was statically significant at P < 0.05.

The present study was supported by Chronic obstructive pulmonary disease is a major cause of

morbidity and mortality worldwide and global health concern. COPD self care knowledge is a

cornerstone for self-management of chronic illness. A descriptive, cross sectional design and

purposive sampling was applied in which 182 patients were interviewed by using semi-structure

interviews schedule at Chitwan Medical College, Teaching Hospital, Bharatpur. The study

findings revealed that 36.8% of the respondents were between age group 61-70 years, 54.4%

respondents were male, 59.9% were from Chitwan district, majority of the respondents (62.1%)

were outpatient, 48.4% had a history of COPD more than 5 years, 83.2% were hospitalized 1-2

times in last year, 63.2% had no history of COPD in family members and all respondents got

information from health personnel. Most of all respondents (90.7%) had poor level of knowledge

on self care of COPD. The respondents’ level of knowledge on self care is statistically

significant with family history (p=0.048), educational status (p=0.000), and types of patient

(p=0.017). So, there should be need of health education program for COPD patients about self

care to improve knowledge.

In present study correlation between knowledge and attitude with‘ r’ value of 0.42 which was

statically signification at P < 0.05.

The finding of present study was supported by the assess knowledge, attitude, correct metered

dose inhaler (MDI) use and compliance with self management among patients with chronic

obstructive pulmonary disease (COPD). Methods: The participants of this study consisted of 109


Page:43

COPD patients who were outpatients in C and K hospital located in G city from March 1 to

September 30th, 2010. Data were measured using self-administered questionnaires and

observational checklist. The data were analyzed using SPSS/WIN 18.0 program that included

mean, standard deviation, ANOVA test, and Pearson's correlation. Results: There were

significant relationships between knowledge and attitude (r=.33, p<.001), between knowledge

and correct MDI use (r=.37, p<.001), and between knowledge and self-management compliance

(r=.28, p=.003). There was significant relationship between attitude and self-management

compliance (r=.33. p<.001).

LIMITATIONS

This study was limited to small no of (30) this limit generalization of this finding.

CONCLUSION

The result of the study reveals that VATP was effective in increasing the knowledge and

developing favourable attitude among COPD Patients.

REFERRENCES

Book

1. Brunner and Siddhartha ’s “Textbook of medical surgical Nursing ” Eleventh edition

pg.no 1209.

2. Black Joyce.M,Jacob Esther Matassari. “Medical Surgical Nursing” Clinical

management and positive outcomes ;7th

ed.Elesiver publications, pg no :2171,& 390

.2004.

3. Basavanthappa BT, 2006, Research Metholodology, 2nd

edition J.P. Brothers Medical

Publishers Pvt.

JOURNAL :

1. Singh JM, etalCorticosteroid therapy for patients with acute exacerbations of chronic

obstructive pulmonary disease: a systematic review. Arch Intern Med.

2002;162(22):2527–2536.

2. JemalA,etal. Trends in the leading causes of death in the United States, 1970–

2002.JAMA. 2005;294(10):1255–1259.


Page:44

3. Stephens MB,eta. Diagnosis of chronic obstructive pulmonary disease.Am Fam

Physician. 2008;78(1):87–92.

4. Cazzola M, et al., for the American Thoracic Society, European Respiratory Society Task

Force on Outcomes of COPD. Outcomes for COPD pharmacological trials: from lung

function to bio-markers. EurRespir J. 2008;31(2):416–469

5. .Centers for Disease Control and Prevention. Annual smoking-attributable mortality,

years of potential life lost, and productivity losses—United States, 1997–2001. MMWR.

2005;54(250):625-628.

6. HoyertDL,etal. Deaths: preliminary data for 2011. Natl Vital Stat Rep. 2012;61(6):1-65.

Hyattsville, MD: National Center for Health Statistics.2012.

7. Centers for Disease Control and Prevention. Chronic obstructive pulmonary disease

among adults—United States, 2011.MMWR. 2012;61(46):938-943.


Page:45

A STUDY TO EVALUATE THE EFFECTIVENESS OF SELF INSTRUCTIONAL

MODULE (SIM) IN TERMS OF KNOWLEDGE AND ATTITUDE REGARDING HOME

CARE MANAGEMENT AMONG PATIENTS WITH CANCER ADMITTED

SELECTED HOSPITAL AT MEERUT.

ABSTRACT:

Objectives: (1) To prepare and validate of SIM regarding home care management among cancer

patient. (2) To evaluate the level of knowledge and attitude regarding home care management

among patient with cancer before and after administration of SIM. (3) To find out the

correlation between post test knowledge and post test attitude score regarding home care

management among patient with cancer.(4) To find out the association between selected

demographic variables with post test knowledge and post test attitude score regarding home care

management among patient with cancer. Research design: Pre experimental research design.

Material: Non probability Purposive Sampling, Sample: 50 cancer patients , Result: The mean

difference knowledge score and attitude score was found to be statistically significant as evident

from (‘t’ - 3.65 ,p<0.05,df-49) , (‘t’ - 3.00 <0.05,df-49). There is a significant association

between knowledge and modality of cancer treatment and attitude score with personal history.

Conclusion: result revealed that there is proper home care management in needed for

subsiding the side effects of cancer treatment (chemotherapy and radiation therapy).

Keywords: Evaluate Effectiveness, Self instructional module, knowledge, attitude, home care

management, patients with cancer.

Ms. Kusum

M.Sc Nursing, Dept. of Medical Surgical Nursing,

Panna Dhai Maa Subharti Nursing College, Meerut (U.P)– India


GUIDE

Mrs. Arul Malar

HOD Medical surgical Nursing




Page:46

INTRODUCTION:

In India, cancers account for about 3.3% of the disease burden and about 9% of all deaths.

Fairly conservative assumptions show that the number of people living with cancer will rise

by nearly one-quarter from 2001 to 2016. Cancer is the term used to define the diseases

which abnormal cells divide uncontrollably and ability to 'invade' tissues within the body and

are spread through the blood stream and lymph system. Recently, cancer morbidity rates are

increasing and most of the individuals are actively undergoing treatment and they were

having lack of awareness about management of adverse effects. So this study, aims to

improve the knowledge and attitude regarding home care management by self instructional

module.

METHODOLOGY

Research design: Pre experimental research design

Research Approach: Evaluative approach

Population: cancer patients

Sample Size: 50

Setting: Selected Hospital at Meerut

Variables

Independent Variable: self instructional module regarding home care management among patient

with cancer is the independent variables.

Dependant Variable: In this study, knowledge and attitude on home care management among

patient with cancer is the dependent variables.

Inclusion Criteria: Patients who are receiving cancer treatment ( chemotherapy and radiation therapy)

Patients who is willing to participate in this study.

Patients who are able to read and understand Hindi

Exclusion Criteria:


Page:47

Patients who are not receiving cancer treatment

Patients who are in advance stage of cancer

Patient with psychiatric problem will not be included.

Material:

Tool- 1- demographic variables

Tool -2- Structured interview schedule to assess the knowledge regarding home care

management among patient with cancer

Tool-3-Grindler modified attitude scale regarding cancer, treatment regimen and home

care management

The knowledge score was categorized by: Good Knowledge: 18-25, Average Knowledge: 9-17,

Below Average Knowledge: 0-8.

Method of data collection :

A ethical permission was obtained from ethical committee concerned to particular setting.

A written permission was obtained from concerned authorities of Valentis cancer Hospital,

Meerut for conducting the research project. The data collection was done from 17th

Feb to 8th

March. The total sample was 50 and sample selected by using non probability purposive

sampling technique. The purpose of the study was explained to the samples and the willingness

to participate in the study was assured by taking written consent from each samples.

On the day – 1, Pre-Test was conducted to assess the cancer patients for knowledge and

attitude regarding home management for cancer patients. Followed by pre test self instructional

modules was administered to sample regarding home care management. It consists of Unit-I

Introduction, Unit-II Myths regarding cancer, Unit –III treatment modality, Unit-IV Home care

management.

On 5th

day Post-Test was conducted to assess the cancer patients for knowledge and

attitude regarding Home management. The average time taken by the cancer patients to fill the

questionnaire was 15-20 min.


Page:48

Observation and result

Among 50 samples of cancer patients 21 of them were in between the age group of 55-

56 years (42%), 15 of them were of 43-54 yrs (30%), 11 of them were in 31-42yrs

(22%), 3 of them were in 19-30years (6%) .

50 samples, 21(42%) samples were female and 29(58%) were male.

Educational status showed that out of 50 samples, 19 of them (38%) were having Up to

8th, 15 of them (30%) were secondary education, 7 of them (14%) were having

intermediate, 9 of them (18%) were having graduate and above.

Occupational showed that out of 50 samples, 17 of them (34%) were self employed, 11

of them (22%) were employed(Govt./Pvt), 1 of them (2%) were pensioner, 21 of them

(42%) were others (housewife)

Among 50 samples, 33 of them (66%) of them were vegetarian, 16 (32%) of them were

non vegetarian and 1 (2%) of them were egitarian.

Table showed that the personal history out of 50 samples, 36 out of them (72%) were

habit of non alcoholic /non smoker, 1 out of them (2%) were habit of tobacco chewing, 6

out of them (12%) were habit of alcoholic, 7 out of them (14%) habit of smoker.

Family history of cancer showed that out of 50 samples, 47 out of them (94%) were no

history of cancer in family, 3 out of them (6%) were family history of cancer.

age of onset of cancer treatment out of 50 samples, 21 out of them were in between the

age of 55-56 years (42%), 15 of them were of 43-54 yrs (30%), 11 of them were in 31-

42yrs (22%), 3 of them were in 19-30years (6%) .

Modality of treatment for cancer table showed that out of 50 samples, 22 out of them

(44%) were depend on the combination of chemotherapy and radiation, 13 out of them

(26%) were depend on the chemotherapy, 12 out of them (24%) were depend on the

radiation therapy.


Page:49

Source of information about home care management for cancer out of 50 samples, 46

(92%) was obtained by health personnel (physician /nurse or any other), and 8 (4%)

was obtained by family members or friends.

The mean post test knowledge scores (18.2) and S.D (2.94), is higher than the mean pre

test knowledge scores (15.32) and S.D (4.45), with a mean difference 2.88. The obtained

mean difference was found to be statistically significant as evident from ‘t’ value 3.65

which is greater than the table value of 2.02 at 0.05 level of significance.

The mean post test attitude scores (92.28), is higher than the mean pre test attitude scores

(86.62), the standard deviation of pre test is 10.02 while that of post test is 9.97, with a

mean difference 5.26. The obtained mean difference was found to be statistically

significant as evident from ‘t’ value 3.00 which is greater than the table value of 2.02 at

0.05 level of significance.

TABLE-1

Frequency and distribution of demographic characteristics of the subjects

regarding home care management among patients with cancer.

S.NO SAMPLE CHARACTERISTICS FREQUENCY

DISTRIBUTION (f)

PERCENTAGE

DISTRIBUTION (%)

1.

a)

b)

c)

d)

Age in years

19-30yrs

31-42 yrs

43-54 yrs

55-65yrs

3

11

15

21

6%

22%

30%

42%

2.

a)

Gender

Female

21

42%


Page:50

b) Male

29 58%

3.

a)

b)

c)

d)

Education

Up to 8th

Secondary education

Intermediate

Graduate and above

19

15

7

9

38%

30%

14%

18%

4.

a)

b)

c)

d)

Occupation

Self employed

Employed

Pensioner

Others (housewife)

17

11

1

21

34%

22%

2%

42%

5.

a)

b)

c)

Dietary pattern

Vegetarian

Non –vegetarian

Egitarian

33

16

1

66%

32%

2%

6.

a)

b)

c)

d)

Personal history

Tobacco chewing

Alcoholic

Smoker

Non alcoholic / non smoker

1

6

7

36

2%

12%

14%

72%


Page:51

7.

a)

b)

Family history of cancer

Yes , specify

No

3

47

6%

94%

8.

a)

b)

c)

d)

Age of onset of cancer treatment

19-30yrs

31-42 yrs

43-54 yrs

55-65yrs

3

11

15

21

6%

22%

30%

42%

9.

a)

b)

c)

Modality of treatment receiving

for cancer

Chemotherapy

Radiation therapy

Combination of chemotherapy and

radiation

13

12

22

26%

24%

44%

10.

a)

b)

c)

Source of information about

home care management about

home care management for

cancer.

By family members or friends

By newspaper, journal, magazine

By T.V/Radio (Mass Media)

By health personnel

4

0

0

8%

0%

0%


Page:52

d) (Physician/Nurse or any other 46

92%

Table no.2 Mean, Median, standard deviation (S.D.) and ‘t’ value computation to

determine the difference between mean pre test and post test knowledge scores regarding

home care management among patients with cancer.

Discussion :

The mean post test knowledge scores (18.2) and S.D (2.94), is higher than the mean pre test

knowledge scores (15.32) and S.D (4.45), with a mean difference 2.88. The mean post test

attitude scores (92.28), is higher than the mean pre test attitude scores (86.62), the standard

deviation of pre test is 10.02 while that of post test is 9.97, with a mean difference 5.26 .The

study has also revealed that subjects had average knowledge in almost all the components

included under the structured interview schedule like: general aspects of cancer, side effects of

treatment regimen, home remedies for side effects of cancer treatment. Hence null hypothesis

H01 was rejected and research hypothesis H1 was accepted.

The above finding were supported by Prathiba Sivakumar.et al; October 2015 a study

on effectiveness self instructional module on knowledge regarding side effects of

chemotherapeutic drugs and its self care measures among patients receiving chemotherapy at

selected hospital , Chennai. Objectives of study were assess the knowledge regarding side effects

Knowledge scores regarding

home care management

among cancer patients

Mean SD Mean

Differ

e-

Ence

SDD SEMD Paired ‘t’ value

Pre test 15.32 4.45 2.88 5.57 0.78 3.654

Post test 18.2 2.94


Page:53

of chemotherapy and self care measures. Quasi experimental research design was used. Sample

size was 100. Non–probability, purposive sampling technique was used. 30 structured

questionnaires regarding side effects of chemotherapy and self care measures on adverse effects

of chemotherapy was administered to the sample. The result was 80% had inadequate

knowledge, 20.0% had moderately adequate knowledge in experimental group. 90% had

inadequate knowledge, 10.0% had moderately adequate knowledge in control group. The mean

value 0.23, the SD value was 0.430 and t value 2.392 which shows there was significant

difference between the pre test and post tesThe result of this study showed that the group

experienced adequate knowledge on having self instructional module.

Another study conducted by Eldeek B et. al; (2014 ) This study was conducted to assess

knowledge, perception, and attitudes regarding cancer and treatment among healthy relatives of

cancer patients who attended an outpatient cancer clinic with their relatives who suffer from

cancers. The participants recruited in this cross-sectional, interview-based study were 846 (557

female and 289 male subjects), Saudi Arabia. Most of the participants answered that they

believed the causes of cancer were genetic (44.90 %), followed by environmental factors (30.10

%), diet (26.90 %), other causes (26.90 %), envy (26.90 %), and black magic (17.60 This study

demonstrated that still a large number of healthy participants had deficient perceptions and poor

attitudes about important issues concerning cancers such as different mode of treatments,

alternative treatment, biological causes, and prognosis, particularly among male respondents.

Prevention aspects education strategies should be considered, including targeted approaches that

aim to reduce disparities in cancer perception among the general population.

LIMITATION

The study is limited to:

Samples who were not enquired whether home care was adopted for managing the side

effects of cancer treatment according to self instructional module.

CONCLUSION:

The present study revealed that there is the proper home care management in needed for

subsiding the side effects of cancer treatment (chemotherapy and radiation therapy). Researcher

also observed that patients and their family members faced a tremendous stressed up situation

while dealing with cancer treatment and self instructional module was helped them to improve

http://www.ncbi.nlm.nih.gov/pubmed/?term=Eldeek%20B%5BAuthor%5D&cauthor=true&cauthor_uid=24715252


Page:54

knowledge regarding home care management. In future, bring the better outcome of the patient

educational programme should be conducted by the hospital to improve knowledge about home

remedies for side effects of cancer treatment.

REFERNECES:

1. Basavanthappa BT, 2006, Research Metholodology, 2nd

edition J.P. Brothers Medical

Publishers Pvt.

2. Black Joyce.M,Jacob Esther Matassari. Medical Surgical Nursing : Clinical management and

positive outcomes ;7th

ed.Elesiver publications, pg no :2171,217,335389 & 390 .2004.

3. Charistine, Miaskowski, Patriciabuchsel. Oncology nursing assessment ad clinical care. I ed.

Mosby publication; 1999; 305-306.

4. Dinshaw KA,Rao DN,Ganesh B.Tata Memorial hospital cancer Regestry Annual

Report,Mumbai,India:1999.

5. Jaypee Brothers, Medical Surgical Nursing, B.T. Bhasavanthappa, medical Publishers, New

Dehli 1st ed. Pg no 111,160 & 123, 2003.

6. Joyce.M. Black, Jane, Hokanson hawks Medical Surgical Nursing 7th

ed, pg no 351 395 365

& 375, 2005

7. K.S.Negi (2008) Biostatistics with latest MCQs, Published by A.I.T.B.S publishers, India 2th

edition.

8. Linda.S. Williams.paula.D.Hopper. Medical Surgical Nursing 2nd

ed pg no 123, 133, 135 &

137, 1999.

9. Lewis L.Sharon, Heitkemper Margaret; Medical Surgical Nursing, 2011, Elsevier, Noida.

10. Vincent. T. Devita, Journal. Samuel hellman steven A. Rosenberg, principles and practice of

oncology. 7th ed. Lippincat pg no 2139, 2799, 49 & 50, 2005


Page:55

11. Mehlesen MY, Jensun AB, Zachariae B. Psychocial problems and needs among cancer

clients. Ugeskr Laeger2007 Apr; 169(18): 1682-7.

12. Smeltzer, Suzanne C & Bare, Brinda G; 2010, “ Textbook of Medical Surgical Nursing”vol

– 1, 12th edition.Lippincott.Williams & Wilkins, Missouri.

13. Stewart BS ,Kleihues P,eds.Cancer of female reproductive tract; In world Cancer

Report.World Helth Organiza .Interanational agency for research in cancer ,Lyon ,France :

IARC 2003

14. Suresh K.Sharma, Nursing Research and Statistics, 1st

edition(2008), published by Elservier,

a division of reed Elsevier India Pvt.Ltd.


Page:56

“A STUDY TO ASSESS AND EVALUATE THE IMPACT OF CONCEPT MAPPING

AND CLINICAL TEACHING METHOD (DEMONSTRATION) ON WOUND

DRESSING IN TERMS OF KNOWLEDGE AND PRACTICE AMONG B.Sc. NURSING

1ST

YEAR STUDENTS IN SELECTED NURSING COLLEGE AT MEERUT”.

INTRODUCTION:

Concept mapping is a teaching strategy that is used to encourage students to learn the valuable

and needed tools of critical thinking and problem-solving. It is an educational tool used to

diagram relationships among concepts. In the nursing educational setting, concept mapping can

help foster critical thinking skills in students by showing connections between ideas or concepts

they are currently studying.

OBJECTIVES:

1. To develop and validate concept mapping teaching method regarding wound dressing.

2. To assess and evaluate the impact of concept mapping and clinical teaching method

(Demonstration) on wound dressing in terms of knowledge and practice among B.Sc.

nursing 1.st year student in experimental group.

3. To assess and evaluate the impact of clinical teaching method( Demonstration) on

wound dressing in terms of knowledge and practice among B.Sc. nursing 1.st year

student in control group.

Ms. Jyoti Verma




GUIDE

Mrs. Arul Malar

HOD Medical surgical Nursing




Page:57

4. To find out the association between post-test knowledge and practice score on wound

dressing among B.Sc. nursing 1st student with their selected demographic variables in

experimental group.

5. To Finding the correlation coefficient between the post-test knowledge and post practice

score regarding wound dressing procedure in experimental and control group.

Research methodology:

A study was conducted using quantitative research approach at Panna Dhai Maa nursing college

and college of nursing S.V.B.P Hospital at Meerut. Nonrandomized control group (Quasi-

experimental) design has been adopted.

The conceptual framework utilized in this study Imogene kings theory.

The total size of sample was 106. Before conducting the study written consent was obtained from

the samples. Total enumeration sampling technique was used.

Data collection was done using semi structured questionnaire and modified JHPIEGO NGO

observation checklist.

Major findings of the study

The findings revealed that in experimental group, among 56 samples in pre- test knowledge

29(51.78%) were having average knowledge where in posttest 39(69.64%) were having excellent

knowledge score. In post-test knowledge score (16.30±2.45) was higher than the mean pre-test

knowledge score (9.37±2.8) with the mean difference of 7.02. In pre-test practice 48(85.71%)

were having average practice where in posttest 31(55.35%) were having excellent practice score.

In post-test practice score 15.55 was higher than the mean pre-test practice score 6.89 with a

mean difference 8.66.

In control group, among 50 samples in pre-test knowledge 6(12%) were having good knowledge;

where in post-test 2(4%) were having excellent knowledge score. In posttest practice 2(4%) were

having good practice, where in post-test 11(22%) were having excellent practice score. In post-

test knowledge score (10.78) was higher than the mean pre-test knowledge score (8.1) with the


Page:58

mean difference of 2.68. In post-test practice score 13.4 was higher than the mean pre-test

practice score 7.8 with a mean difference 5.6.

Conclusion:

The present study scores proved that modern teaching strategy of concept mapping method is

more effective to improve the knowledge and critical thinking of the nursing student in

experimental group. In this control group, clinical teaching method (demonstration) has

improved the practice skills of the students regarding wound dressing procedure at the same time

post test knowledge score also was increased due to the influence of demonstration.


Page:59

DEEP VEIN THROMBOSIS

Deep vein thrombosis (DVT) refers to the formation of one or more blood clots (a blood clot is

also known as a “thrombus,” while multiple clots are called “thrombi”) in one of the body’s large

veins, most commonly in the lower limbs (e.g., lower leg or calf)

The word immobility and orthopaedic patients were closely related. Immobility refers to

the inability to move about freely. In orthopaedic patients the treatment of choice following

surgery or injury are varying in rest and motion. Orthopaedic patients will have impairment in

mobility results from prescribed restriction of movement in the form of bed rest, physical

restriction of movement or impairment of motor skeletal function. The effect of immobilization

leads to many complications related to different systems in our body. Periods of immobility or

prolonged bed rest can cause major physiological, psychological and social effects. The patients

with acute medical condition in hospital may be for few days but patients with orthopaedic

condition may be for many days. When patients are immobilized following injury or trauma

there is high risk for deep vein thrombosis due to limited range of motion.

Venous thrombosis is the process of clot (thrombus) formation within the veins. Although

this can occur in any venous system, the predominant clinical events occur in the vessels of the

leg, giving rise to deep vein thrombosis, or in the lungs, resulting in a pulmonary embolism. The

causes of venous thromboembolism can be hereditary or acquired. Venous stasis is usually by

immobilisation or absence of the calf muscle pump. Venous stasis in the elderly can be produced

by immobility (hospitalisation, surgery, stroke), increased venous pressure and medical

conditions such as Older age, Major surgery and orthopaedic surgery, Cancers, especially of the

bone, ovary, brain, pancreas, and lymphomas, Inactivity and immobilization, as with orthopaedic

Mr. Zubair






Page:60

casts, sitting, travel, bed rest, and hospitalization, Pregnancy and the postpartum period, Trauma,

minor leg injury, and lower limb amputation, Previous Venous thrombo embolism ,Combined

Oral contraceptives, Hormonal replacement therapy, Central venous catheters, Some

autoimmune diseases, Nephrotic syndrome, obesity, Polycythemia, Chemotherapy considered to

be risk factors.

A deep vein thrombosis commonly presents with pain, erythema, tenderness, and swelling of

the affected limb. Findings on palpation include a palpable cord, warmth, ipsilateral oedema, or

superficial venous dilation. These have a high prevalence both in the community and in the

hospitals, and bringing a considerable burden of morbidity and possible mortality.

Deep venous thrombosis (deep vein thrombosis) occurs frequently as a postoperative

complication, particularly after orthopaedic surgery, and increasing number of patients were

referred to the outpatient clinic of vascular surgery. Deep vein thrombosis has been diagnosed

by venography, but there have recently been a number of reports suggesting the efficacy of lower

limb vein ultrasonography in diagnosis of deep vein thrombosis .

The primary objectives for the treatment of deep venous thrombosis (DVT) are to prevent

pulmonary embolism (PE), reduce morbidity, and prevent or minimize the risk of developing the

post thrombotic syndrome (PTS).The mainstay of medical therapy has been anticoagulation since

the introduction of heparin .Other anticoagulation drugs have subsequently been added to the

treatment armamentarium over the years, such as vitamin K antagonists and low-molecular-

weight heparin (LMWH).

Deep vein thrombosis is an easily preventable complication of immobility. Prophylactic

measures used for prevention of deep vein thrombosis are lifestyle modifications, mechanical

and pharmacological methods. Patients needing hospitalization should be encouraged to remain

ambulant, as far as possible. Those waiting for elective surgery should be advised to discontinue

smoking, oral contraceptive pills and hormone replacement therapy for at least 4–6 weeks in

order to reduce the risk for venous thromboembolism.

All patients who are admitted should be screened for their risk for deep vein thrombosis.

Some common risk factors for deep vein thrombosis are orthpaedic surgery, pelvic surgery,

prolonged surgery, immobilization, coagulation disorders, cancer, sepsis etc. Based on the


Page:61

presence or absence of these risk factors, which carry varying weight age, patients can be

stratified into high, moderate and low risk for deep vein thrombosis. Those at high or very high

risk should receive prophylaxis—both mechanical and pharmacological Mechanical measures

such as elastic graduated compression stockings, intermittent pneumatic compression and venous

foot pumps should be used in bed-ridden patients and those undergoing surgery

.Pharmacological prophylaxis involves the use of heparin in low doses which are associated with

no or little increase in the risk of clinically important bleeding and do not warrant monitoring the

coagulation profile. Pharmacological prophylaxis may be started pre- or postoperatively. It

should be continued for at least seven days or until the patient is ambulant. Patients at high risk

of bleeding and those with contraindications to heparin should receive mechanical prophylaxis

only. Deep vein thrombosis prophylaxis is effective—it reduces the risk of deep vein thrombosis

by two-thirds. Deep vein thrombosis prophylaxis has been identified as the number one measure

to improve the safety of hospitalized patients.

The surgery heightens the body's tendency for coagulation or clotting. In addition, when

the leg is manipulated during surgery there may be irritation to the walls of the major blood

vessels in the leg. Finally, during and after surgery the lower extremity is not used as much and,

therefore, the normal blood flow rate is decreased. The leg muscles usually help venous blood

return to the heart when they are used. Prevention of deep vein thrombosis is very important

among orthopaedic client.

A deep vein thrombosis is the part of a group of problems together known as venous

thrombo-embolism(VTE).Blood normally flows quickly through veins, and does not usually clot.

Blood flow in leg veins is helped along by leg movements, because muscle action squeezes the

veins. Sometimes a deep vein thrombosis occurs for no apparent reason. Immobility causes

blood flow in the veins to be slow. Slow-flowing blood is more likely to clot than normal-

flowing blood Many healthcare providers are under the false impression that this life-threatening

illness is not a problem in their hospital or among their patients. While it is true that an

individual doctor will normally see relatively few patients with this disease, it is clear that deep

vein thrombosis is an important public health problem.


Page:62

SMART GLASSES FOR NURSES IN CRITICAL CARE UNITS

Introduction:

The Intensive Care Unit (ICU) of a hospital is a noisy environment. Because the patients there

are in need of critical care, they are constantly monitored and treated with the help of machines

that sound alarms if something is wrong. However, it turns out that a lot of the alarms are

unnecessary and studies have shown that false alarms, or those that require no action on behalf of

the nurses, range between 80 - 99%. The excessive amounts of alarms have given rise to a

phenomenon known as alarm fatigue which means that nurses get desensitized to alarms and

start to tune them out. This can cause them to miss critical alarms, which is a serious threat to

patient safety. The use of smart glasses in intensive care unit will be to localize alarms by

eliminating problems with overhearing colleagues’ alarms and to create a calmness for the nurses

by reducing their cognitive load through a clear alarm hierarchy.

Concept of Nurse View

The Nurse view, is a pair of smart glasses that aim to replace the communication devices of

today’s hospitals. It works by providing the user with a heads-up display, which allows it to

deliver alarms to only the person who needs it, going unnoticed by everyone else. The heads-up

display uses Zeiss Smart Glass technology which allows for a design similar to that of regular

glasses. It also allows the glasses to work with regular prescriptions, so there’s no need for users

with visual impairment to wear lenses underneath.

Mr. Hariprasath P

Asst. Professor, Department of Clinical Nursing

Faculty of Public Health and Medical Sciences

Mettu University, Mettu

Ethiopia, East Africa


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Audio is also available for critical alarms through bone conduction technology embedded in one

of the temples, which makes sure that the sound is only heard by the intended receiver and not

the entire ward. The glasses improve up traditional hospital communication devices in three

innovative ways:

Localized Alarms

Alarms are localized to each individual nurse, eliminating overhearing of colleagues’ alarms, by

delivering them via a state of the art heads up display.

Alarm Hierarchy

An alarm hierarchy is created by compressing non-critical alarms into icons in the Dashboard,

located in the users’ periphery, where they are easily available at a glance but don’t demand the

immediate attention of the user.

Touchless Interaction

The user can interact with the device without touching it, by covering a proximity sensor on the

side of it with their hand, which improves on hygiene and usability.

Interaction of Nurse view

The main way of interacting with Nurse view is by holding your hand in front of the proximity

sensor on the side of the device. The interactions are kept simple and functionality is

intentionally limited to the main functionality. The critical alarms pop up in the user’s field of

view with a subtle animation to grab the user’s attention. If the user covers the proximity sensor,

the alarm is acknowledged. If the alarm is not acknowledged within a few seconds an auditory

beep is heard through the bone conducting transducer. This is a redundancy feature in case the

user, for whatever reason, should not notice the visual alarm.

Non-critical alarms, or reminders from user input, appear in the Dashboard located right at the

edge of the user’s periphery. These alarms are color coded based on how much time is left with


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green having more time left than orange. They are also sorted in order of urgency with the most

urgent being prioritized first and least urgent will be at last.

The user can then expand these alarms to get more information at a glance, by covering the

proximity sensor. As long as the sensor is covered, the expanded view is shown, and when the

user lowers their hand, it animates back to the normal collapsed view. In the expanded view

alarms are shown in order of urgency with the topmost being the most urgent, as most things also

progress from top to bottom.

Conclusion

Because the ICU is a loud environment in a public space, sound should only be used as a

redundant means of communicating alarms. Make use of the user’s periphery for alarms that are

not critical. This will ensure that the nurses are not interrupted more than absolutely necessary. If

an alarm does not require the immediate action of a nurse, it should not demand their immediate

attention.

PATIENT SAFETY AND RELATED STANDARDS BY JOINT COMMISSION ON

ACCREDITATION OF HEALTH CARE ORGANIZATIONS (JCAHO)

Introduction:

Patient safety is one of the important aspects in health care. It is important to maintain all the

safety measures and it is patients right to receive all safety techniques during hospital stay. Each

health professionals including nurses should be aware of it. WHO, JCAHO etc have made certain

standards and goals for patient safety.

Mr. Arun Unnikrishnan

Asst. Professor, Dept. of Child Health Nursing,





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JCAHO - National patient safety goals:

In April 2002, the Joint Commission (JCAHO) appointed a panel of physicians, nurses,

pharmacists, and other patient safety experts to advise the organization on developing its first

set of national patient safety goals.

The first six goals and measures were announced after final voting at the ( July 18-19) JCAHO

Board of Commissioners meeting. Each goal includes one or two evidence- or expertise-based

recommendations. In the following years, certain goals are to be retained, while others are

replaced as a result of emerging new priorities. To ensure a greater focus on safe practices, no

more than six goals and their associated recommendations will be established for any given

year. The first six goals are listed below.

1. Improve the accuracy of patient identification.

2. Improve the effectiveness of communication among caregivers.

3. Improve the safety of using high-alert medications.

4. Eliminate wrong-site, wrong-patient, wrong-procedure surgery.

5. Improve the safety of using infusion pumps.

6. Improve the effectiveness of clinical alarm systems.

JCAHO – patient safety standards

The standards emphasize the need to integrate all patient safety activities, both existing and

newly created, with an identified focus of accountability within the organization's leadership.

A number of the existing standards or intent statements have been revised by adding the

phrase "to improve patient safety" to reflect this integration. They now require certain

activities, e.g., security, equipment safety, infection control. The revisions encompass staff and

visitors as well as patients.

Patient safety-related standards

Almost 50 percent of Joint Commission standards are directly related to safety, addressing

such issues as medication use, infection control, surgery and anesthesia, transfusions, restraint


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and seclusion, staffing and staff competence, fire safety, medical equipment, emergency

management, and security.

Additional patient safety standards went into effect for hospitals in 2001, and similar

standards went into effect for behavioral health care and long term care organizations in 2003,

and for ambulatory care and home care organizations in 2004. These standards address a

number of significant patient safety issues, including the implementation of patient safety

programs; the response to adverse events when they occur; the prevention of accidental harm

through the prospective analysis and redesign of vulnerable patient systems (e.g. the ordering,

preparation and dispensing of medications); and the organization's responsibility to tell a

patient about the outcomes of the care provided to the patient.

Other JCAHO standards have an indirect impact on safety programs such as:

Leadership: Effective reduction of unintended adverse patient outcomes in a healthcare

organization requires an environment that encourages recognition and acknowledgment of

risks to patient safety and medical/health care errors. The standards require the following:

Improving Organizational Performance: This standard emphasizes the need to

design processes that draw on a variety of information sources, including information about

potential risks such as sentinel events. They also require attention to family perceptions of risk

and staff willingness to report medical/health errors. Monitoring standards explicit ly require

organizations to analyze hazardous conditions and set priorities to proactively reduce patient

risk.

Management of Information: The language strengthens the requirement's accurate,

timely and complete verbal and written communications. It focuses on aggregation of patient

safety–related data and information, the application of knowledge-based information to patient

safety–related issues; and the effective communication among participants in carrying out

healthcare processes.

Patient Rights and Organization Ethics: One standard relates to family communications:

Patients and, when appropriate, their families are informed about the outcomes of care,

including unanticipated outcomes.


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Other Functions: Other chapters include appropriate emphasis on patient safety, with

particular attention to standards for Education, Continuum of Care, and Management of

Human Resources. For example, Human Resources adds a requirement that ongoing in-service

and other education and training support an interdisciplinary approach to patient care.

JCAHO - environment of care and patient safety

JCAHO impact on environmental safety: JCAHO initiatives related to safety, have

implications for the entire healthcare organization's "culture of safety." A number of the

recommendations impact the hospital's safety committee or environment of care (EC) as well

as infection control committees.

Prevention of adverse effects is one goal of the EC committee, and the team assists in

establishing and communicating procedures that promote safe practice and prevent adverse

effects of all types to patients, staff, and visitors. The scope of the committee includes an

organization-wide process called the "information collection and evaluation system" to

improve the environment of care. This process includes all types of unexpected occurrences

such as patient falls or other injuries requiring intervention and improvement.

Medical safety relationships: The safety committee interacts with medical staff committees

that may have direct oversight of more clinically oriented issues. A serious occurrence or

sentinel event could very well involve a product recall and/or a medical device alert, and

merits additional comment within the context of patient safety.

CONCLUSION:

Standards are important in all sectors. While dealing with the patients, the health care sector

should be more alert regarding the patient safety. JCAHO guidelines help the health care

professionals to maintain standards and provide proper care safeguarding the patient safety.

Reference:

1. JCAHO patient safety goals. Website: www.jointcommission.org

2. Premier, Transforming Health Care Together:

https://www.premierinc.com/safety/topics/patient_safety/index_3.jsp#new patient safety

standards

http://www.jointcommission.org/

https://www.premierinc.com/safety/topics/patient_safety/index_3.jsp#new patient safety standards

https://www.premierinc.com/safety/topics/patient_safety/index_3.jsp#new patient safety standards

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