subharti journal of nursing reflection · effectiveness of self instructional module (sim) in terms...
TRANSCRIPT
Subharti Journal of Nursing Reflection Volume: 1, Issue: 2; September 2017
Page:1
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
Subharti Journal of Nursing Reflection Volume: 1, Issue: 2; September 2017
Page:2
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
Subharti Journal of Nursing Reflection Volume: 1, Issue: 2; September 2017
Page:3
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
Subharti Journal of Nursing Reflection Volume: 1, Issue: 2; September 2017
Page:4
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
Subharti Journal of Nursing Reflection Volume: 1, Issue: 2; September 2017
Page:5
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
Subharti Journal of Nursing Reflection Volume: 1, Issue: 2; September 2017
Page:6
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
Subharti Journal of Nursing Reflection Volume: 1, Issue: 2; September 2017
Page:7
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.
Subharti Journal of Nursing Reflection Volume: 1, Issue: 2; September 2017
Page:8
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.
Subharti Journal of Nursing Reflection Volume: 1, Issue: 2; September 2017
Page:9
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%
Subharti Journal of Nursing Reflection Volume: 1, Issue: 2; September 2017
Page:10
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
Subharti Journal of Nursing Reflection Volume: 1, Issue: 2; September 2017
Page:11
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.
Subharti Journal of Nursing Reflection Volume: 1, Issue: 2; September 2017
Page:12
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
Subharti Journal of Nursing Reflection Volume: 1, Issue: 2; September 2017
Page:13
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.
Subharti Journal of Nursing Reflection Volume: 1, Issue: 2; September 2017
Page:14
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.
Subharti Journal of Nursing Reflection Volume: 1, Issue: 2; September 2017
Page:15
4. Black Joyce.M,Jacob Esther Matassari. “Medical Surgical Nursing” Clinical
management and positive outcomes; 7thed.Elesiver publications, pg no: 2171,& 390
.2004.
Subharti Journal of Nursing Reflection Volume: 1, Issue: 2; September 2017
Page:16
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,
Panna Dhai Maa Subharti College of Nursing, Meerut. U.P, India
E-mail: [email protected]
GUIDE
Ex Capt. Geeta Parwanda,
Principal, Panna Dhai Maa Subharti College of Nursing, Meerut. U.P, India
Subharti Journal of Nursing Reflection Volume: 1, Issue: 2; September 2017
Page:17
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
Subharti Journal of Nursing Reflection Volume: 1, Issue: 2; September 2017
Page:18
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
Subharti Journal of Nursing Reflection Volume: 1, Issue: 2; September 2017
Page:19
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
Subharti Journal of Nursing Reflection Volume: 1, Issue: 2; September 2017
Page:20
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.
Subharti Journal of Nursing Reflection Volume: 1, Issue: 2; September 2017
Page:21
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
Subharti Journal of Nursing Reflection Volume: 1, Issue: 2; September 2017
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
Higher education 3 8
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
Subharti Journal of Nursing Reflection Volume: 1, Issue: 2; September 2017
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.
Subharti Journal of Nursing Reflection Volume: 1, Issue: 2; September 2017
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
Subharti Journal of Nursing Reflection Volume: 1, Issue: 2; September 2017
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.
E-mail: [email protected]
GUIDE
Mr. Sankappa,
Asst. Professor, Panna Dhai Maa Subharti College of Nursing, Meerut. U.P, India
Subharti Journal of Nursing Reflection Volume: 1, Issue: 2; September 2017
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
Subharti Journal of Nursing Reflection Volume: 1, Issue: 2; September 2017
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.
Subharti Journal of Nursing Reflection Volume: 1, Issue: 2; September 2017
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
M.Sc. Nursing, Medical and Surgical Nursing, Panna Dhai Maa Subharti Nursing College,
Meerut, U.P.
E-mail:
GUIDE
Prof. Kalpana Mandal
Dean, Panna Dhai Maa Subharti College of Nursing, Meerut. U.P, India
Subharti Journal of Nursing Reflection Volume: 1, Issue: 2; September 2017
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.
Subharti Journal of Nursing Reflection Volume: 1, Issue: 2; September 2017
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.
Subharti Journal of Nursing Reflection Volume: 1, Issue: 2; September 2017
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 .
Subharti Journal of Nursing Reflection Volume: 1, Issue: 2; September 2017
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)
Subharti Journal of Nursing Reflection Volume: 1, Issue: 2; September 2017
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.
Subharti Journal of Nursing Reflection Volume: 1, Issue: 2; September 2017
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
M.Sc. Nursing, Medical and Surgical Nursing, Panna Dhai Maa Subharti Nursing College,
Meerut, U.P.
E-mail: [email protected]
GUIDE
Ex. Capt. Geeta Parwanda,
Principal, Panna Dhai Maa Subharti College of Nursing, Meerut. U.P, India
Subharti Journal of Nursing Reflection Volume: 1, Issue: 2; September 2017
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
Subharti Journal of Nursing Reflection Volume: 1, Issue: 2; September 2017
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.
Subharti Journal of Nursing Reflection Volume: 1, Issue: 2; September 2017
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.
Subharti Journal of Nursing Reflection Volume: 1, Issue: 2; September 2017
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
Subharti Journal of Nursing Reflection Volume: 1, Issue: 2; September 2017
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
Higher education 3 10
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
Subharti Journal of Nursing Reflection Volume: 1, Issue: 2; September 2017
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
Subharti Journal of Nursing Reflection Volume: 1, Issue: 2; September 2017
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
Subharti Journal of Nursing Reflection Volume: 1, Issue: 2; September 2017
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
Subharti Journal of Nursing Reflection Volume: 1, Issue: 2; September 2017
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.
Subharti Journal of Nursing Reflection Volume: 1, Issue: 2; September 2017
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.
Subharti Journal of Nursing Reflection Volume: 1, Issue: 2; September 2017
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
E-mail: [email protected]
GUIDE
Mrs. Arul Malar
HOD Medical surgical Nursing
Panna Dhai Maa Subharti College of Nursing, Meerut. U.P, India
Subharti Journal of Nursing Reflection Volume: 1, Issue: 2; September 2017
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:
Subharti Journal of Nursing Reflection Volume: 1, Issue: 2; September 2017
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.
Subharti Journal of Nursing Reflection Volume: 1, Issue: 2; September 2017
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.
Subharti Journal of Nursing Reflection Volume: 1, Issue: 2; September 2017
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%
Subharti Journal of Nursing Reflection Volume: 1, Issue: 2; September 2017
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%
Subharti Journal of Nursing Reflection Volume: 1, Issue: 2; September 2017
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%
Subharti Journal of Nursing Reflection Volume: 1, Issue: 2; September 2017
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
Subharti Journal of Nursing Reflection Volume: 1, Issue: 2; September 2017
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
Subharti Journal of Nursing Reflection Volume: 1, Issue: 2; September 2017
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
Subharti Journal of Nursing Reflection Volume: 1, Issue: 2; September 2017
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.
Subharti Journal of Nursing Reflection Volume: 1, Issue: 2; September 2017
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
M.Sc Nursing, Dept. of Medical Surgical Nursing,
Panna Dhai Maa Subharti Nursing College, Meerut (U.P)– India
E-mail: [email protected]
GUIDE
Mrs. Arul Malar
HOD Medical surgical Nursing
Panna Dhai Maa Subharti College of Nursing, Meerut. U.P, India
Subharti Journal of Nursing Reflection Volume: 1, Issue: 2; September 2017
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
Subharti Journal of Nursing Reflection Volume: 1, Issue: 2; September 2017
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.
Subharti Journal of Nursing Reflection Volume: 1, Issue: 2; September 2017
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
M.Sc Nursing, Dept. of Medical Surgical Nursing,
Panna Dhai Maa Subharti Nursing College, Meerut (U.P)– India
E-mail: [email protected]
Subharti Journal of Nursing Reflection Volume: 1, Issue: 2; September 2017
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
Subharti Journal of Nursing Reflection Volume: 1, Issue: 2; September 2017
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.
Subharti Journal of Nursing Reflection Volume: 1, Issue: 2; September 2017
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
Subharti Journal of Nursing Reflection Volume: 1, Issue: 2; September 2017
Page:63
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
Subharti Journal of Nursing Reflection Volume: 1, Issue: 2; September 2017
Page:64
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,
Panna Dhai Maa Subharti Nursing College, Meerut (U.P)– India
E-mail: [email protected]
Subharti Journal of Nursing Reflection Volume: 1, Issue: 2; September 2017
Page:65
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
Subharti Journal of Nursing Reflection Volume: 1, Issue: 2; September 2017
Page:66
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.
Subharti Journal of Nursing Reflection Volume: 1, Issue: 2; September 2017
Page:67
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