SUBHARTI JOURNAL OF NURSING REFLECTION · 1. Gibbs' reflective cycle or Gibbs' model of reflection (1988) consist of following six distinct stages. Description Feelings Evaluation

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: 1;September2016

Page:2

CONTENTS

Sl No: Topic Author Page No

1. Reflective Learning Prof. Geeta Parwanda 04-06

2. Value Based Education Mr. Tom Thomas 07-09

3. Challenges In Nursing Education Mrs. Tajnisha Banu 10-11

4. Inspiring Change In Nursing:

Challenges For Future Nurses

Mr. Arun Unnikrishnan 12-13

5. Effectiveness Of Planned Nursing

Intervention ( PNI) Regarding

Genetic Counselling In Terms Of

Knowledge And Attitude Among

Staff Nurses Working In Maternity

Unit In Selected Hospital At

Meerut

Ms. Annu Panchal 14-21

6. Effectiveness Of Self-Instructional

Module On Utilization Of

Contraceptive Devices In Terms

Of Knowledge And Attitude

Among Married Women

Mrs. Nisha Yadav 22-30

7. “A Study To Evaluate The

Effectiveness Of Video Assisted

Teaching Regarding Menopause In

Terms Of Knowledge And

Attitude Among Working Women

In Swami Vivekanand Subharti

University At Meerut”

Ms. Neha Tomar 31-40


Effectiveness Of Skill Competency

Programme Regarding Common

Obstetric Complications Among

Staff Nurses In Selected Hospitals

At Meerut. “

Mrs. Pooja Soni 41-50


Effectiveness Of Vatp In Terms Of

Knowledge & Attitude Regarding

Assistive Respiratory Home Care

Management Among Patients With

Copd Admitted In Selected

Hospital At Meerut.”

Ms. Rajni Emanwel 51-61


Page:3

10. 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 62-71


Effectiveness Of Video Assisted

Teaching On Knowledge And

Attitude Regarding Organ

Donation Among Selected Degree

College Students At Subharti

University Meerut”

Mrs. Sanju Solanki 72-85


Effectiveness Of Planned Teaching

Programme (Ptp) Regarding

Micronutrient Deficiency And Its

Prevention In Terms Of

Knowledge Among Adolescent

Girls In Selected Senior Secondary

Schools At Meerut”.

Ms. Khushboo Rani 86-95

13. A Study To Assess And Evaluate

The Effectiveness Of Structured

Teaching Program Regarding

Prevention And Management Of

Obstetric Near-Miss Events In

Terms Of Knowledge Among

Midwives In Selected Health

Centres, At Meerut.

Ms. Megha Mohan 96-106


Page:4

REFLECTIVE LEARNING

Introduction:

Modern society is becoming more

complex, information is becoming

available and changing more rapidly

promoting users to constantly rethink,

switch direction and change problem

solving strategies.

Reflective learning is ability to look

back over an experience and break it

down into its significant aspects, such

as any factors affecting success or

failure

Reflective learning enables us

To accept responsibility for

own personal growth

To see a clear link between the

effort put into development

activity and the benefits get out

of it.

To help see more value in each

learning experience, by

knowing why we’re doing it

and what’s in it for us

Reflecting on learning enables to link

professional development to practical

outcomes and widens the definition of

what counts as useful activity.

As a reflective learner, we’ll think

about how we’ll use new knowledge

and skills in future activities- so

learning is always linked to action, and

theory to practice. It’s also useful to

reflect on how you learn best. This

may be through private study,

networking with peers, formal courses,

mentoring, or a combination of

techniques.

Reflective practice is "the capacity to

reflect on action so as to engage in a

process of continuous learning".

According to one definition it involves

"paying critical attention to the practical

values and theories which inform everyday

actions, by examining practice reflectively

and reflexively. This leads to

developmental insight".

Reflective Practice was introduced by

Donald Schön in his book The Reflective

Practitioner in 1983, however, the

concepts underlying reflective practice

are much older. John Dewey was among

the first to write about Reflective Practice

with his exploration of experience,

interaction and reflection.

Reflective practice can be an important

tool in practice-based professional learning

settings where individuals learning from

their own professional experiences, rather

than from formal teaching or knowledge

transfer. It may be the most important

source of personal professional

development and improvement. Further, it

is also an important way to be able to bring

together theory and practice; through

reflection you are able to see and label

Prof. Geeta Parwanda, Principal, Panna Dhai Maa Subharti Nursing College,

Meerut


Page:5

schools of thought and theory within the

context of your work (2007, McBrien).

Important fact about reflection throughout

the practice is that the person not just look

back on past actions and events, but rather

take a conscious look at the emotions,

experiences, actions, and responses, and

use that to add to the existing knowledge

base to draw out new knowledge, meaning

and have a higher level of understanding

(2013, Paterson, Chapman) As such the

notion has achieved wide take-up,

particularly in professional development

for practitioners in the areas of education

and healthcare. The question of how best

to learn from experience has wider

relevance however, to any organizational

learning environment. In particular, people

in leadership positions have a tremendous

development opportunity if they engage in

reflective practice.

Benefits to Reflective Practice (DAVIS

2012)

Increased learning from an

experience for situation

Promotion of deep learning

Identification of personal and

professional strengths and areas for

improvement

Identification of educational needs

Acquisition of new knowledge and

skills

Further understanding of own

beliefs, attitudes and values

Encouragement of self-motivation

and self-directed learning

Models of reflective practice

The concept of Reflective Practice centers

around the idea of lifelong learning in

which a practitioner analyses experiences

in order to learn from them. However it is

important to note that events experience

and events retold hold their own

importance.

1. Gibbs' reflective cycle or Gibbs'

model of reflection (1988) consist of

following six distinct stages.

Description

Feelings

Evaluation

Analysis

Conclusions

Action plan.

2. Rolfe 2001

Adaptation of the Rolfe Reflective Model

Rolfe’s reflective model is based around

Borton’s 1970 developmental model. A

simplistic cycle composed of 3 questions

which asks the practitioner, What, So

What and Now What. Through this

analysis a description of the situation is

given which then leads into the scrutiny of

the situation and the construction of

knowledge that has been learnt through the

experience. Subsequent to this, ways in

which to personally improve and the

consequence of one’s response to the

experience are reflected on.

3. Gänshirt 2007

Based on Schön's theory and writings of

Otl Aicher, Christian Gänshirt proposes

the concept of the Design Cycle to

describe the reflective and repetitive

structure of design processes, assuming

that this structure is underlaying all such

processes. The Design Cycle is understood

as a circular time structure, which may

start with the thinking of an idea, then

http://en.wikipedia.org/wiki/File:Steph_Rol_Model.jpg


Page:6

expressing it by the use of visual and/or

verbal means of communication (design

tools), the sharing and perceiving of the

expressed idea, and starting a new cycle

with the critical rethinking of the perceived

idea.

Application of reflective learning for

health professional

Reflective Practice is associated with

learning from experience, and is viewed as

an important strategy for health

professionals who embrace lifelong

learning. Due to the ever changing context

of healthcare and the continual growth of

medical knowledge, there is a high level of

demand on healthcare professionals'

expertise. Due to this complex and

continually changing environment,

healthcare professionals could benefit from

a program of reflective practice. Price

(2004 ) recognizes that there are several

reasons why a healthcare practitioner

would engage in reflective practice: To

further understand yourself, motives,

perceptions, attitudes, values and feelings

associated with client care; To provide a

fresh outlook to practice situations and

challenge existing thoughts, feelings as

well as actions; To explore how the

practice situation may be approached

differently.

In the field of nursing there is concern that

actions may run the risk of habitualisation,

thus dehumanising patients and their

needs. In utilizing Reflective Practice,

nurses are able to plan their actions and

consciously monitor the action to ensure it

is beneficial to their patient.

The act of reflection is seen as a way of

promoting the development of

autonomous, qualified and self-directed

professionals. Engaging in Reflective

Practice is associated with the

improvement of the quality of care,

stimulating personal and professional

growth and closing the gap between theory

and practice. Activities to promote

reflection are now being incorporated into

undergraduate, postgrduate and continuing

medical education across a variety of

health professions Mann (2009) found

through her research that in practising

professionals the process of reflection

appears to be multifactorial and to include

different aspects. In addition to reflection

both on and during experiences that the

anticipation of a challenging situation also

stimulated reflection. Practicing

professionals vary in their tendency and

ability to reflect.

Thus reflective learning helps how to learn

and add new skill over time and evaluates

our learning experience.

References:

1. http://documents.hants.gov.uk/adultservices/workforce-

development/ProfDevCPDProjectResourcesNotesonReflection.doc

2. http://www.iosrjournals.org/iosr-jnhs/papers/vol4-issue4/Version-3/E04432833.pdf

3. https://www.ukessays.com/essays/business/individual-coaching-in-order-to-improve-

a-particular-aspect-of-employees-behavior-business-essay.php

4. http://www.childcentredpractice.co.uk/Websites/ccp1/Files/Content/1375756/reflective

%20practice%20model.doc


Page:7

Value Based Education (VBE)

“Education means all-round drawing out of the best in child and man – body, mind and

spirit.” (Mahatma Gandhi)

What is mean by education in

modern era? What are the criteria for

quality education? In this modern era, we

giving a proper education or do we receive

a quality education? Education is not only

the things we are learning but also it helps

to understand a positive human values,

sense of direction and vision about how to

create a stable moral society. The thing we

learned doesn’t makes any changes in our

behaviour, compassion, humility,

responsibility or attitude means we have to

improve the quality of education

Today the education system, not

only in India but in all countries, has taken

the wrong turn. No single person is

responsible for this situation. Parents have

failed to bring up their children properly.

The nation’s leaders do not set them a

good example. Even teachers have failed

in their responsibilities. The student of

today is concerned with acquiring wealth,

strength and position, but not good

qualities.

Meaning of value based education:

A value based education seeks to

promote an educational philosophy based

on valuing self and others, through the

consideration of a values vocabulary as the

basis of good educational practices. This

process is called values education.

Education opens our mind, but value based

education (VBE) gives us purity of heart

too; education extends our relationship

with the world, but value based education

link us with our own family members too;

education makes our living better, but

value based education makes our life better

too; education teaches us to complete with

others, but value based education

encourages us to be complete too;

educational makes us a good professional,

but value based education makes us whole

human too; education may bring

limitations but value based education is for

liberation. Value education is simply a

matter of developing appropriate

behaviour and habits involving certain

virtues and habits. It is the `training of the

heart' and consists in developing the right

feelings and emotions.

After all right education means –

“SA Vidya Ya Vimuktye”. It means that

knowledge is what helps us to attain

liberation.

Why is Value Based Education Needed?

In the discussion of this point first of all I

want to ask some questions to you;

Mr. Tom Thomas,

Lecturer, Shri Vinoba Bhave College Of Nursing

Slivassa

Email: [email protected]

mailto:[email protected]


Page:8

The quantity of education has

considerably increased, but the

quality has decreased. Why?

The number of educated people

has reached at a high level, but

murder, hatred, and selfishness

have spread out like wildfire

everywhere. Why?

Many institutions are opened,

but only few civilized people

are produced. Why?

Degrees are available for all,

but the dignity has gone down.

Why?

Trained people are produced

from many institutions, but

sincere people are very few.

Why?

Many books are written; much

research is done; many

professional achievements are

attained, but humanity is

threatened. Why?

From the following questions only

one solution is there, and that is the

education should be based on value.

Therefore, we needed VALUE BASED

EDUACTION.

How to implement Value Based

Education?

Talking about Value Based

Education is quite an easy job, but

implementing it is a daunting task, which

needs the strongest determination. First of

all we should all fully agree that without

value based education we can not have a

safe society, a develop country and a

harmonious family environment.

General education can be

transferred, but VBE should be

transformed. VBE is more teacher-based

than textbooks; it is more awakening, not

only informing. It is life-oriented, not

exam-oriented. Therefore, we need to

create a special environment in institutions

to transform VBE in students. First of all,

we need trained, committed and spiritually

motivated teachers for VBE. It is apparent

that all the festivals hold several values

such as environmental, social, scientific

and spiritual. It is therefore imperative to

integrate festivals into teaching / learning

process so as to make children realize

importance and values of the festivals. The

whole environment should be free

from stress, fear and confusion. Actually

VBE does not require any set text books;

rather than that, the whole institution

should be based on VBE.

My experience as a lecturer

and as a student, is that when a school or

college seriously develops the moral and

spiritual aspects of the curriculum is that

those positively contribute to the inner

world of thought, feelings and emotions

…The effect, of developing educational

values is that pupils take greater personal

responsibility for their learning

Value Based Education and nursing:

When we begin to look at nursing

exist is a health profession which is

concerned with promoting and maintaining

the health of the individual, families and

the public, preventing illness, helping

patient with recovery process relieving

suffering and so on. If the nurses are not

giving importance to humanity and the

emotional feeling of an individual or

family they can’t able to full fill the needs


Page:9

of the client and provide adequate support

to them. That’s why it is consider that one

of most important profession which

require value based education to make

them to keep humanity and understand the

emotions of their clients.

References:

1. Dr. Nevil Hawkes:

http://www.valuesbasededucation.com/downloads/articles/vbe.what_is_values_educat

ion.pdf

2. Md. Sarwar Hossain, Value Education- In the Present Scenario,

http://www.academia.edu/3762645/VALUE_EDUCATION_IN_THE_PRESENT_SC

ENARIO

3. Value Based Education;

http://www.uri.org/files/resource_files/Value%20Based%20Education%20by%20Dr.

%20Yogi.pdf


Page:10

CHALLENGES IN NURSING EDUCATION

Aligning Education with the

Practice Environment

As a critical component of the

healthcare industry, the nursing profession

must keep pace with changes in the

healthcare system to insure the continued

delivery of high quality, safe, and effective

patient-centered care. To stay current, new

nurses must be educated and equipped

with relevant and appropriate

competencies, knowledge, skills, and

attitudes. In order to plan for the future, it

is first necessary to assess requirements for

the workforce, based on expectations of

the work environment, and develop the

education required for nurses to fill those

roles.“Healthcare is facing dramatic

changes. An aging population, growing

diversity, the global health care system,

bio-medical advances, and new areas of

knowledge (i.e. genetics, environmental

health) will reshape how we provide care

in the future. To address these changes,

nurses will require more knowledge than

ever before

Use of healthcare information technology

(IT) is expected to continue to grow

significantly. The medical knowledge base

is currently doubling every 5 to 8 years

and that rate of growth is expected to

increase. Technology will assist nurses in

providing safer patient care environments

but will also require them to monitor,

synthesize, and manage greater amounts of

information for the patients entrusted to

their care. The demanding role of the nurse

of the future will require that an RN

possess an expanded knowledge base and

mastery of competencies that will allow

this individual to manage a highly

complex patient care journey in

collaboration and partnership with an

interdisciplinary team.

The American Health Care Association

(AHCA) represents nursing home and

assisted living facilities. Specific issues

that AHCA identified relating to nursing

training include:

Long-term care providers do not

believe that undergraduate nursing

programs are preparing nurses for

successful employment in long-

term care;

Both undergraduate and graduate

nurses need skill sets identified and

agreed upon by educators and

practitioners; and

More emphasis is needed on

community-based nursing and the

spectrum of care services available

to patients.

Faculty Development Challenges

Quality education depends on well-

prepared faculty members. Faculty

development and faculty vacancies are

critical challenges in nursing education.

The nursing shortage poses a significant

threat to healthcare delivery in the future.

Insufficient capacity in nursing schools is a

major contributor to the shortage of nurses

and the shortage of nursing faculty is a

major cause of the capacity constraints In

addition to increasing the number of

faculty members, those educators need the

training to enable them to incorporate

evidence-based teaching practices more

effectively and teach nursing students the

skills that will be required in the 21st

Mrs. Tajnisha Banu,

Reader, Panna Dhai Maa Subharti Nursing College, Meerut.


Page:11

century’s healthcare environment. Nursing

schools require faculty who are experts in

nursing education and who must possess

the knowledge to serve in an advanced

practice role. Furthermore, deans of

schools of nursing are needed to

complement these experts and act to create

systems that value and reward expertise in

nursing education.

Both now and in the future, nursing

schools will require faculty who have the

expertise to teach the content that students

will need for effective patient care in

practice environments. These faculties

don’t necessarily need to be experts’ in

particular clinical areas but must have

solid, foundations of understanding and be

able to demonstrate good teaching skills.

As evidenced by the persistent faculty

shortage, this is a difficult issue to address.

Among the major underlying causes

contributing to the nursing faculty shortage

are the aging of faculty, increasing

demands to be involved in non-teaching

university activities, and comparatively

low salaries. Various approaches for

addressing these challenges are discussed

in Section 3 of this report.

Nursing as Part of an Integrated

Healthcare Workforce

There is increasing evidence that inter-

professional healthcare practice

approaches can be effective in improving

patient outcomes and reducing healthcare

costs; however, there are a number of

barriers to establishing effective integrated

teams, including a lack of mutual

understanding of roles and lack of

interdisciplinary training among providers.

To operate effectively as part of these

teams, students need to be trained to

provide inter-professional care and to

participate as a member of inter-

professional teams.

References:

1. http://www.jhsph.edu/academics/residency-programs/prevmed_student_resource/

2. https://www.nursingtimes.net/roles/nurse-managers/without-time-to-think-the-fire-of-

innovation-dies-out/5046487.fullarticle

3. Nursing education : http://sameer-education.blogspot.in/2010/07/nursing-

education.html


Page:12

INSPIRING CHANGE IN NURSING: CHALLENGES FOR FUTURE

NURSES

Introduction:

Change is a universal phenomenon. All

profession will achieve higher reputation

and standard by undergoing various

challenging changes. Presently nursing

profession is facing a lot of challenges in

developing countries like India to achieve

desirable changes to come to the standards

of developed countries. So let us discuss

future changes for the betterment of the

profession.

1. Fulfilling the client demands: In

future the demand and expectation of

clients will be increasing which

makes work force crisis. So the

nurses have to upgrade their

knowledge and skill to maintain

uniform standards of nursing care to

satisfy the increasing demands of

clients. But shortage of nurses and

heavy work load, frequent change in

nursing shifts makes the nurses tired

and along with that inadequate in-

service education facility also makes

it difficult for the nurses to upgrade

their knowledge.

2. Utilization of more advanced

technology in nursing care: Using

advanced technology will be time

saving, more effective in client care

and also brings accuracy in

documentation. But it needs time and

timely up gradation of technological

knowledge which will be too

difficult along with heavy workload

of nurses.

3. Balancing nurse patient ratio:

Presently the nurse patient ratio is

1:5 which is not adequate to provide

standard nursing care. Thus in future

the ratio should be 1:3, which create

crisis due to shortage of skilled,

qualified and experienced nursing

personnel. Mostly nurses are

overburdened and this practice

should be stopped, so that proper

client care can be provided by the

nurses maintaining the standards.

4. Power of authority and decision

making: In present scenario, nurse

administrators are not having the

independent decision making power.

The decisions come from higher

authorities and nurses have to follow

it, which should be changed.

Improving the administrator power

of nurse administrators will upgrade

the status of nurses, increase the

standard of profession and also helps

Arun Unnikrishnan,

Asst. Professor, Panna Dhai Maa Subharti Nursing College, Meerut

Email: [email protected]



Page:13

to make more suitable policies and

making appropriate decisions for the

betterment of the profession. But it

creates criticism and pressure from

higher authorities and lack of co-

operation from sub-ordinates and

other departments.

5. Political leadership: nursing

organizations should be strengthened

and they contest in elections. If

nurses are elected as members of

parliament or decorate higher posts

in the medical/health departments,

the demands of nurses will be

fulfilled by making new and

beneficial policies for nurses. Thus

the status of nurses will be increased.

But they have to struggle for survival

against the present political parties

and their dramas due to lack of

support, money, power and lack of

experience.

6. Involving politics in nursing

educational institutions: Like other

colleges, political involvement of

nursing students should be important

to obtain basic political knowledge

to involve in politics in the future.

The college management and other

political groups may not support the

nurse’s involvement in politics

which will be a challenge to

overcome.

7. Independent nursing practice: In

remote areas nurses can effectively

work as a nurse practitioner, which

will be beneficial for the society. But

the higher authorities are not

approving it and medical people are

trying to suppress it. Even though

INC has started many nurse

practitioner courses, time will show

how effective it is in Indian

Scenario, which is mostly dominated

by doctors. Nurses will have to

struggle a lot to freely work as a

nurse practitioner. Even the

mentality of the society should also

be change for the acceptance of

nurse practitioners.

8. Evidence based practice: Though it

is beneficial for the fast recovery,

satisfaction and cost effective client

care, the nurses are not getting

opportunity to apply it due to the in

acceptance from higher authority.

Nurses are not able to practice based

on evidences found from research

due to the authoritative nature of the

doctors and management which

makes it a challenge in India.

Conclusion:

Though inspiring change in nursing is

effective for client satisfaction as well as

upgrading the profession, the nurse

leaders have to overcome a lot of

challenges to achieve it. Thus we can

expect that our leaders will courageously

face these challenges and bring effective

changes in our profession.

Reference:

1. http://www.nursetogether.co

m/9-common-problems-

nursing-profession

Subharti Journal of Nursing Reflection Volume: 1, Issue: 1; September 2016

Page:14

Effectiveness of Planned Nursing Intervention ( PNI) Regarding Genetic

Counselling in Terms Of Knowledge And Attitude Among Staff Nurses

Working In Maternity Unit In Selected Hospital At Meerut

ABSTRACT:

Aim: To assess the effectiveness of planned nursing intervention regarding genetic counselling

in terms of knowledge and attitude among staff nurses working in maternity unit in selected

hospital at Meerut. Material and Methodology:-. An evaluative research approach was adopted

under the study. The study was conducted in selected hospital at Meerut. Purposive sampling

technique was used to select the staff nurses. The sample comprised of 40 staff nurses of

maternity unit. The tools developed and utilized for the study was structured knowledge

questionnaires and structured attitude scale on genetic counselling was developed. A planned

nursing intervention was prepared to regarding genetic counselling for staff nurses. Reliability of

knowledge questions was established by (KR-20) Formula (r=0.80), and reliability of attitude

scale was established by Cornbach’s alpha (r=1.0) in pilot study was done to find out the

feasibility of the study. Results:- The study revealed that the mean post-test knowledge score

(35.07± 3.93) of staff nurses regarding genetic counselling were higher than the mean pre-test

knowledge (17.83±5.00).The mean post test attitude scores (83.35±6.55) is higher than the mean

pre-test attitude scores (54.27±8.71). The correlation co-efficient between post-test knowledge

and post-test attitude scores of staff nurses was 0.678 which indicated a significant positive

relationship between knowledge and attitude among staff nurses regarding genetic counselling.

Work place and attendance in any skilled training programme was found to be significant with

the level of knowledge of staff nurses. Conclusion:- The study concludes that the planned

nursing intervention was an effective strategy in improving knowledge and attitude of staff

nurses regarding genetic counselling. More educational strategies can be undertaken to enhance

the knowledge of staff nurses and improve the attitude of staff nurses towards the genetic

counselling.

Keywords:- Evaluate, Effectiveness, Knowledge, Attitude, Genetic counselling, Planned

nursing intervention, Staff nurses, Maternity Unit.

Ms. Annu Panchal,

MS.c Nursing Student, Dept. of OBG Nursing,

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

E-mail: [email protected]

GUIDE

Prof. Kalpana Mandal,

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



Page:15

INTRODUCTION

God could not be everywhere, so he created mothers. Mother is the precious

person for any baby because of her unconditioned love and heartfelt care. Mother and

baby are interdependent. Pregnancy period could be the most exciting time because she used to

dream a healthy baby. No mother in the world likes her baby to get any kind of genetic

disorder. The happiness of a family depends on the health of the children. In order to prevent

these disorders , there are measures that help include avoidance of teratogenic exposures and

radiation, smoking, drinking alcohol, medical treatment of maternal illnesses, good nutrition,

and routine obstetrical care.

Indians represent one-sixth of the world population and India consists of ethnically,

geographically and genetically diverse populations with several thousand endogamous groups. In

some community the load of genetic disorder is relatively high due to consanguineous marriage

practiced in the community. This database has been created to keep track of mutations in the

causal genes for genetic diseases common in India and help the Physicians, Geneticists and other

professionals related to genetic disorders to retrieve and use the information for the benefit of the

families affected with the disorders.

The prevalence incidences of genetic disorders globally, at least 7.6 million children are

born annually with severe genetic or congenital malformations. The genetic and congenital

disorder is the second most common cause of infant and childhood mortality and occurs with a

prevalence of 25-60 per 1000 births. The higher prevalence of genetic diseases in a particular

community may, however, be due to some social or cultural factors. Such factors include

tradition of consanguineous marriage, which results in a higher rate of autosomal recessive

conditions including congenital malformations, stillbirths, or mental retardation. Furthermore,

maternal age greater than 35 years is associated with higher frequencies of chromosomal

abnormalities in the offspring

The study aims at assessing the knowledge regarding genetic counselling among staff

nurses of selected hospital. The main objectives of the study were to assess and evaluate the

knowledge and attitude of the staff nurses regarding genetic counselling before and after the

administration of planned nursing intervention (PNI). To determine the relationship between post

test knowledge and attitude of the staff nurses regarding genetic counselling. To find out the

association between post test knowledge and attitude with selected demographic variables.

Background: Though a newborn brings in its wake untold happiness to those around, there are

some unfortunate babies whose birth is clouded with sadness and worry for the parents because

of the birth defects. Most birth defects are present within the first three months of pregnancy,

when the organs are forming. Some birth defects require long-term medical treatment.

Prevalence and incidences of genetic disorders globally, at least 7.6 million children are born

annually with severe genetic or congenital malformations. The genetic and congenital disorder is


Page:16

the second most common cause of infant and childhood mortality and occurs with a prevalence

of 25-60 per 1000 births. The higher prevalence of genetic diseases in a particular community

may, however, be due to some social or cultural factors.

METHODOLOGY

Research design: Pre-Experimental research design:- One group pretest-posttest design is

consider as most suitable design.

Research Approach: Evaluative approach

Population: The staff nurses working in maternity unit in selected hospitals at Meerut

Sample Size: 40 staff nurses of maternity unit.

Setting: The study was conducted in selected Hospital at Meerut.

Variables

Independent Variable: planned nursing intervention regarding genetic counseling.

Dependant Variable: knowledge and attitude of staff nurses regarding genetic counseling

Inclusion Criteria:

a) Staff nurses who are working in maternity unit. b) Staff nurses who are curious to participate

in the study and working in maternity unit. c) Staff nurses who are present at the time of data

collection and registered staff nurse.

Exclusion Criteria: a) Staff nurses who are on leave and sick during the time of data collection.

b) Staff nurses of other unit are not included 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 nursing and

obstetrician and paediatrician, Hindi and English languages. The tool has two parts. Part A deals

with the data related to demographic variables of the study participants. Part B- Structured

questionnaire on knowledge of staff nurses regarding genetic counselling. It consists of 42

multiple choice items. The correct answer got score ‘1’ and the wrong answer got the score ‘0’.

The minimum score is 0 and the maximum score is 42. The levels of knowledge are categorized


Page:17

as Score (0-14) -Below average knowledge, Score (15-28) -Average knowledge, Score (29-42) -

Good knowledge. The attitude scale consisted of 20 items concerning attitude related to the

genetic counselling. The levels of attitude are categorized as Score (20-46) -Unfavourable, Score

(47-73)-Favourable attitude, Score (74-100) - Highly favourable attitude. The reliability of the

structured attitude scale was calculated by using Cronbach’s alpha formula. The reliability was

found to be 1.0, which means that the tool was reliable.

METHOD OF DATA COLLECTION

A formal administrative approval from college & Hospital was obtained. A written consent

obtained prior to subjects’ recruitment in the study. They were made comfortable and oriented to

the study. Introduction to the nature of study was given to obtain cooperative response.

Purposive sampling was used to select 40 staff nurses of maternity unit. Confidentiality of their

responses was assured. Pre test of knowledge and attitude was done by administering structured

knowledge questionnaire and attitude scale on day one. On the Day two: Planned nursing

intervention i.e. Planned teaching programme was administered to the group. On the Day seven:

Post test of knowledge and attitude were administered.

Analysis

The present study was designed to assess the knowledge and attitude among staff nurses

regarding genetic counselling. Analysis and interpretation of data are based on the objectives of

study.

OBSERVATION & RESULTS

The distribution of study subjects according to their demographic variables reveals that most of

the subjects i.e. 15(37.5%) were in the age group of 26-30 years. Majority of the subjects i.e.

40(100%) were under the female category. Maximum numbers of subjects i.e. 19(47.5%) were

belongs to senior secondary qualification. Majority of subjects i.e. 35(87.5%) were qualified with

diploma in general nursing midwifery. Most of the subjects i.e. 21(52.5%) were belong to

neonatal unit. Maximum number of subjects i.e. 13(32.5%) had 0-1 year and 1-3 year working

experience and majority of subject i.e. 34(85%) attended any skilled training programme.

The distribution of study participants according to their levels of knowledge regarding genetic

counselling in pre-test 11(27.5%) had below average knowledge and 29(72.5%) had average

knowledge whereas in post- test it was seen that 40(100%) had good knowledge. Hence it can be


Page:18

inferred that the planned nursing intervention was effective in enhancing the knowledge of staff

nurses.

Findings of the Frequency and Percentage Distribution of Pre Test And Post Test

Knowledge Of Staff Nurses Regarding Genetic Counselling

n=40

Knowledge

Level

Pre test Post test

Frequency Percentage% Frequency Percentage%

Below average (0-14) 11 27.5 0 0

Average (15-28) 29 72.5 0 0

Good (29-42) 0 0 40 100

Maximum Score= 42

Table 2 reveals that in pre-test 29(72.5%) were having favourable attitude and 11(27.5%) were

having unfavourable attitude whereas in post- test it was seen that the majority of the sample i.e.

40(100%) were having highly favourable attitude regarding genetic counselling among staff

nurses and none of them had unfavourable attitude and average attitude.

Findings of the frequency and percentage distribution of pre test and post test

attitude of staff nurses regarding genetic counselling

n=40

Attitude

Score

Pre test Post test

Frequency Percentage Frequency Percentage

Unfavourable (20-46) 11 27.5 0 0.0

Favourable (47-73) 29 72.5 0 0

Highly favourable (74-100) 0 0.0 40 100

Maximum Score= 100


Page:19

Correlation Co-efficient between Post test Knowledge and Post test

Attitude Score of staff nurses

n=40

Variables Mean SD ‘r’

Post-test knowledge

scores

35.07 3.93 0.678

Post-test attitude

scores

83.35 6.55

Significance at 0.05 level

Table 3 depicted that the correlation co-efficient between post-test knowledge and post-

test attitude scores of staff nurses was 0.678 which indicated a significant positive relationship

between knowledge and attitude among staff nurses regarding genetic counselling. Therefore,

research hypothesis H04 was accepted and the null hypothesis H4 was rejected. It can be inferred

that the planned nursing intervention regarding genetic counselling was effective to develop

highly favourable attitude of the staff nurses towards genetic counselling.

DISCUSSION

On the basis of the objectives of the study and the revealed findings discussion can

be framed as follows:

In relation of the second objective, the finding of the present study shows that the mean

post-test knowledge (35.07) of staff nurses regarding genetic counselling were higher than the

mean pre-test knowledge (17.83). The findings also revealed that post-test knowledge were more

homogenous (SD 3.93) than the pre-test knowledge (SD 5.00), indicating that the group became

more homogenous after the administration of planned nursing intervention.

These findings were consistent with the Swank C (2007)study that is to evaluate the

effectiveness of a self-instructional module in increasing nurses’ knowledge of genetics a study

was conducted on 65 registered nurses working at reproductive health centres using a pre-

test/post-test study design. There was significant increase of 20.8% in participants’ mean


Page:20

knowledge score on the post-test (M = 89.0%, SD = 8%, range = 67%-100%) as compared with

the pre-test (M = 69.0%, SD = 12%, range = 42%-92%), based on paired t-test analysis (t =

11.74, SE = 0.426, p < 0.0001). This study reveals that the pre-test knowledge was inadequate

and post-test knowledge was adequate by using SIM regarding genetic counselling.

The present study findings regarding genetic counselling pre-test post-test knowledge

also consistent with Shobhy SI (2010) and A Gharaibeh (2008).

In relation of the third objective, the finding of the present study shows that the

correlation co-efficient between post-test knowledge and post-test attitude scores of staff nurses

was 0.678 which indicated a significant positive relationship between knowledge and attitude

among staff nurses regarding genetic counselling. It can be inferred that the planned nursing

intervention regarding genetic counselling was effective to develop highly favourable attitude of

the staff nurses towards genetic counselling. These findings consistent with Lalithapriya M

(2008) A study was conducted in Salem on the knowledge of students regarding assisted

reproductive technology. The result of the study revealed that there was significant relationship

between post test knowledge of the subjects and selected demographic variables. The mean

percentage knowledge score in pre-test was 39.8% and that of post-test was 74.5%, which shows

that the PTP was effective in increasing the knowledge. So the researcher recommended that

similar studies can be conducted for the clinical staff.

LIMITATION

The finding of the present study cannot be generalized due to small sample size 40 only which

limits the generalization of the study. The study sample was selected non-randomized purposive

sampling technique which limits the generalization of the findings. The study design lacks a

control group, hence the results of the study can not be generalized.

CONCLUSIONS:-

On the basis of the above findings of the study following conclusions could be drawn. Most the

staff nurses had average knowledge and unfavourable attitude towards genetic counselling. The

planned nursing intervention was effective in enhancing good knowledge of the staff nurses and

highly favourable attitude towards genetic counselling. There was a positive relationship found


Page:21

between post-test knowledge and attitude of the staff nurses. There was a significant association

between post-test knowledge of staff nurses with working in neonatal unit

REFERENCES:-

1) G. P. Pal, “ Medical genetics” Published by- A.I.T.B.S. Publishers, India, Edition- 1st,

Page No. 173-175.

2) Kamal Jyoti, “ Genetics for Nurses”, Published by- Kumar Publishing House, Edition-

5th , Page No. 229-241.

3) Suresh K Sharma, “ Human Genetic in Nursing”, Published by- Jaypee Brothers

Medical Publishers (P) Ltd, Page No. 336-340

4) American Academy of Pediatrics, Clinical Practice, Guidance, Diagnosis and

Evaluation of Child with attention deficit hyperactivity disorder pediatric. 2000; 105;5,

1158

5) Am J Med Genet A et al, “Genetic counselling utilization by families with offspring

affected by birth defects” in 2007;143A:1045–1052.

6) Angadi SA, Dandagi SR et al, “A descriptive study on knowledge regarding

teratogenic effect of drugs among staff nurses working in maternity and paediartic

wards of k.l.e’s dr. prabhakar kore charitable hospital, belgaum, Karnataka”, Vol 2,

Issue 12, 2014.

7) Brian T Bateman et al, “Statins and congenital malformations: cohort study”, Published

17 March 2015.

8) Christianson, Howson and Modell, “March of dimes global report on birth defects”,

World Health Organization[ 2013].

9) JK Science, “Pattern of Congenital Anomalies in Newborn”, 2009 [Vol. 11 No. 1,

January-March 2009]

10) Muntaha Al-Alwani1, Ahmed Sameer Alnuaimi et al, “Prevalence of Major Fetal

Defects”, Open Journal of Obstetrics and Gynecology, 2014, 4.

11) National Institute of Health.(n.d.).Specific genetic disorders.Retrieved December 8,

202008, from the National Human Genome Research Institute Web site:

http://www.genome.gov/10001204

http://www.genome.gov/10001204


Page:22

Effectiveness of Self-Instructional Module on Utilization of

Contraceptive Devices In Terms Of Knowledge and Attitude Among

Married Women

ABSTRACT:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

married women regarding utilization of contraceptive devices.

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

instructional module, and married women.

Mrs. Nisha Yadav,

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



GUIDE

Ex Capt. Geeta Parwanda,

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



Page:23

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


Page:24

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


Page:25

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


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


Page:26

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.

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


Page:27

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

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


Page:28

23-27 4 10

28-32 5 9

33-38 5 5

2 Religion

Hindu 18 20

1.11 5.99 2 NS

Muslim 6 5

Christian 0 1

Sikh 0 0

3 Occupational

House wife 21 23

1.20 5.99 2 NS

Employed (govt.&prit.) 0 1

Self employed 3 2

4 Family

income

3000-5000/ 12 8

2.39 7.81 3 NS

5001-8000/ 7 9

8001-11000/ 2 5

12000 or more 3 4

5 Type 0f

family

Nuclear family 5 9

1.34 5.99 2 NS

Joint family 8 6

Extended family 11 11

6 Education

Primary 10 7

2.95 7.81 3 NS

Secondary 3 2


Graduation or more 8 9

No. of living

children

Nil 6 4

7.81

Two 4 5

7 Three 10 8 2.57 3 NS

Three &more than

three 4 9

8

Previous

knowledge of

contraceptive

methods

Yes 15 16

0.003 3.84 1 NS No 9 10

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:


Page:29

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.

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

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

Philadelphia: Lippincott publishers;.


Page:30

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

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

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

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

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

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

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

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

webster.com/dictionary/family%20planning

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

8. Ministry of health 2013 family welfare. Retrieved from

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

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

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

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

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


Page:31

“A STUDY TO EVALUATE THE EFFECTIVENESS OF VIDEO ASSISTED

TEACHING REGARDING MENOPAUSE IN TERMS OF KNOWLEDGE

AND ATTITUDE AMONG WORKING WOMEN IN SWAMI

VIVEKANAND SUBHARTI UNIVERSITY AT MEERUT”

ABSTRACT:

Objectives: 1. To develop & validate VAT regarding menopause for working women. 2. To

assess and evaluate the knowledge and attitude of working women before and after

administration of VAT regarding menopause. 3. To findout the relationship between post test

knowledge and attitude of working women regarding menopause. 4. To determine the

association between posttest knowledge and attitude of working women regarding menopause

with their selected demographic variables. Research design: Pre-experimental design. Material:

Non- Probability purposive sampling Sample: working women at swami Vivekananad Subharti

University. Result: The calculated paired ‘t’ value was 17.74 greater then table value 2.01 at

0.05 level of significance which shows that there was a significant improvement in the

knowledge regarding menopause. The calculated paired ‘t’ value was 9.99 greater then table

value 2.01 at 0.05 level of significance which indicates that working women have favourable

attitude towards menopause. Conclusion: The result of the study reveals that VAT was found to

be effective in increasing the knowledge and developing favourable attitude of the working

women.

Keywords: Evaluate, Effectiveness, Knowledge, Attitude, Menopause, Video assisted teaching,

Working women.

Ms. Neha Tomer,

M.Sc. Nursing, Obstetrics & Gynecology Nursing,

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


GUIDE

Ex Capt. Geeta Parwanda,




Page:32

INTRODUCTION

“Menopause is a perfectly natural process. As family members and friends recognize that

this is a normal process and learn about the normal symptoms, they will then treat the women

like she’s normal and natural rather than crazy women.”

-Pamela Boggs

Women are the vital set up and heart of the family. When women have been tired, family

junction would be altered. Women are facing lot more problems through their life. One of most

common problem they are facing is menopausal symptoms due to hormonal changes during their

middle adulthood. The menopausal problems of women always make them so tired. So they need

treatment and health education regarding menopausal care and prevention of problems.

When a women’s hormone balance begins to shift, she may have menstrual cycles with

no ovulation called anovulatory cycles. She may begin to have menopausal symptoms.

Menopause is that stage in women’s life when both physiological and emotional changes in their

bodies are precipitated by hormonal deficiencies as a result of age. Menopause, estrogen levels

drop because the ovaries ability to produce enough estrogen has weakened.

VG Padubidri SN Daftary (2008), Menopause is the permanent cessation of menstruation

resulting in the loss of ovarian follicle development. It is considered to occur when 12 menstrual

cycles are missed. Menopausal transition, or perimenopause, is the period between the onset of

irregular menstrual cycles and the last menstrual period. This period is marked by fluctuations in

reproductive hormones as menstrual irregularities, prolonged and heavy menstruation intermixed

with episodes of amenorrhea, decreased fertility, vasomotor symptoms and insomnia. India has

large population, which has already crossed the 1 billion mark with 71 million people over 60

years of age and the no of menopausal women about 43 million.

MATERIALS & METHODS

Research Approach: Evaluative analytical approach

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

http://emedicine.medscape.com/article/264088-overview




Page:33

Population: working women ( daily wagers working as labourer) in Swami Vivekanand Subharti

University

Sample Size: 50

Setting: Swami Vivekanand Subharti University

Variables

Independent Variable: In this research study, independent variable is Video Assisted Teaching

Programme regarding menopause.

Dependant 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 working women regarding menopause.

Inclusion Criteria

(a)Women who are in the age group of 35 – 55 years. (b)Women who are willing to

participate the study.

Exclusion criteria

(a)Women who are not working in at Swami Vivekanand Subharti University. (b)Women

who are not available at the time of data collection. (c)Women who cannot understand Hindi.

TOOLS & METHODS OF DATA COLLECTION

Based on the conceptual frame work and objectives of the study the tools used to collect the data

are structured knowledge interview schedule to assess the knowledge and modified standardized

Bowle’s attitude scale to assess attitude regarding menopause. A written consent obtained prior

to subjects’ recruitment in the study. Subjects were made comfortable and oriented to the study.

Pretest was taken on day one followed by VAT & on 7th day posttest was taken.

Analysis

The present study was designed to assess the effectiveness of Video Assisted Teaching among

working women. Analysis and interpretation of data are based on the objectives of study.


The distribution of study subjects according to their demographic variables reveals that most of

the participants 16(32%) in age group 49-51yrs, 15(30%) in 43-45yrs, 12 (24%) in 46-48yrs and


Page:34

7(14%) in 52-55yrs under the study. Educational status of working women was 50 (100%) non

formal education. Regarding marital status 50(100%) of working women were married.

Regarding religion 50 (100%) of working women belongs to Hindu religion. Most of the

working women were non vegetarian 33 (66%), and 17(34%) vegetarian. Monthly income of the

working women were 3000- 5000/- 22(44%), 5001-7000/- 15(30%) and 7001 and above

13(26%). As per menopausal status most of the working women were not in menopause i.e.

31(62%) and who have got menopause were 19(38%). As per source of information, 27(54%)

accepted family member as a source of information, 19(38%) accepted health care personnel as a

source of information and 04(08%) accepted TV/Radio/ Electronic media as source of

information.

According to knowledge of working women before and after administration of VAT

The mean pre-test knowledge score of working women was (14.54) with median (14.0) and

standard deviation of (2.69) against maximum scores of 30. The mean post-test knowledge score

of working women was (21.44) with median (21.0) and standard deviation of (3.69) against

maximum scores of 30. The mean difference between pre-test knowledge and post-test

knowledge of the Working women was 6.90. The paired ‘t’ value 17.74 for df (49) was found to

be statistically significant at 0.05 level.

Thus there was striking difference between the mean pre-test and post-test knowledge scores of

the working women which explains that the VAT on menopause was effective in enhancing the

knowledge of working women regarding menopause.

According to attitude of working women before and after administration of VAT

The mean pre-test attitude score of working women was (61.38) with median (62.00) and

standard deviation of (5.90) against maximum scores of 100. The mean post-test attitude score of

adolescents was (72.86) with median (73.00) and standard deviation of (7.32) against maximum

scores of 100. The mean difference between pre-test attitude and post-test attitude of the

Working women was 11.48. The paired ‘t’ value 9.99 for df (49) was found to be statistically

significant at 0.05 level. Thus there was striking difference between the mean pre-test and post-

test attitude scores of the working women which explains that the VAT on menopause was

effective in developing the favourable attitude of the working women regarding menopause.

Result reveals that the coefficient of correlation between post-test knowledge scores and post-test

attitude scores is .177 which was less than the table value (.294), it shows that there is not

significant relationship exists between mean post-test knowledge and mean post-test attitude of

the working women, which is a true relationship not by chance, hence the null hypothesis H03

was failed to rejected and research hypothesis H3 was rejected.

According to association between post-test knowledge and attitude with selected demographic

variables


Page:35

There was association of post-test knowledge and attitude scores with monthly income and

menopausal status which was found to be statistically significant at 0.05 level of significance.

This showed that there was impact of these selected demographic variables on knowledge and

attitude of working women regarding menopause.

Whereas association of post-test knowledge and attitude scores with age, education status,

marital status, religion, dietary pattern and source of information were not found to be significant

at 0.05 level of significance. This showed that these demographic variables had no impact on

knowledge and attitude of working women regarding menopause and these were independent of

each other.

Frequency and Percentage Distribution of Demographic Characteristics of the

Working Women

Sl. No. Sample Characteristics n = 50

Frequency %

1. Age

a)

b)

c)

d)

43-45 years

46-48 years

49-51 years

52-55 years

15

12

16

7

30.0

24.0

32.0

14.0

2. Education

a)

b)

No formal education

Primary Education

50

0

100.0

0.0

3. Marital Status

a)

b)

c)

d)

Married

Unmarried

Divorced/Separated

Widows

50

0

0

0

100.0

0.0

0.0

0.0

4. Religion


Page:36

a)

b)

c)

d)

Hindu

Sikh

Muslim

Christian

50

0

0

0

100.0

0

0

0

5. Dietary pattern

a)

b)

Vegetarian

Non vegetarian

17

33

34.0

66.0

6. Monthly Income

a)

b)

c)

Rs. 3,000 – 5,000

Rs. 5,001 – 7,000

Rs. 7,001 and above

22

15

13

44.0

30.0

26.0

7. Are you in menopause

a)

b)

Yes

No

19

31

38.0

62.0

8. Source of Information

a)

b)

c)

TV/Radio/ Electronic media

Health care personnel

Family members or Friends

4

19

27

8.0

38.0

54.0


Page:37

Mean, Mean difference, Standard deviation difference, Standard error of mean

difference, paired ‘t’ value of pre-test and post-test knowledge scores of working women

n =50

KNOWLEDGE

TEST

MEAN MD SDD SE MD Paired

‘t’ value

Post-test

Pre-test

21.44

14.54 6.90 2.74 0.38 17.743*

Mean, Mean difference, Standard deviation difference, Standard error of mean

difference, paired ‘t’ value of pre-test and post-test attitude scores of the working women

n =50

ATTITUDE

TEST

MEAN MD SDD SE MD Paired ‘t’

value

Post-test

Pre-test

72.86

61.38

11.48 8.11 1.14 9.99*

DISCUSSION

The Video assisted teaching programme regarding menopause among working women was

developed and given to eleven experts from nursing, obstetrics and gynaecology and naturopathy

field for validation and their suggestions were incorporated. Video assisted teaching programme

regarding menopause is independent variable in the present study which is developed to assess

the effectiveness on knowledge and attitude towards menopause.


Page:38

The findings of the study revealed a significant knowledge score after administration of

video assisted teaching programme.

The mean post-test knowledge score was 21.44, standard deviation was 3.69. The mean

post-test attitude score was 72. 86, standard deviation was 7.32. There is the mean difference of

6.90 between pre-test and post-test of knowledge scores and mean difference of 11.48 between

pre-test and post-test of attitude scores. This indicated that the video assisted teaching

programme regarding menopause was effective in increasing the knowledge and developing

favourable attitude of working women.

This study was supported by Jipsy Sara Ninan (2015) study on effectiveness of video assisted

teaching programme on knowledge and health beliefs regarding osteoporosis among women in

selected hospitals, Chennai. The result reveals that the mean post-test knowledge score in study

group was 17.96 health beliefs score 21.83 were higher than mean pre-test knowledge score in

study group was 6.23 and health beliefs score was 11.83, hence Video Assisted Teaching was

found to be effective in improving the knowledge of women by 9.61% and health beliefs by

10%.

There was no correlation coefficient between knowledge and attitude with‘ r’ value of 0. .177

which was statistically signification at P < 0.05. The findings of present study was supported by

Ensieh Noroozi, (2013), study on Knowledge and attitude toward menopause phenomenon

among women aged 40–45 years. The results showed that the average knowledge score of

subjects was 63.57 ± 10.79, and their average attitude score was 61.21 ± 12.73. In this study, 8%

of the subjects had poor knowledge, 68% had moderate knowledge and 38.5% had good

knowledge. Meanwhile, 81.5% of the women had a positive attitude toward menopause. The

correlation test showed that knowledge and attitude are meaningfully related to economic status

and education level. But, the relationship between knowledge and attitudes of women under

study was not significant.

There was significant association between post-test knowledge score and selected demographic

variables such as monthly income X2 =

6.676 at P = 5.99 and menopausal status X2 =

7.402 at

P=

5.99.

There was significant association between post-test attitude score and selected demographic

variables such as monthly income X2 =

12.629 at P = 5.99 and menopausal status X2 =

6.585 at

P=

5.99.

This present study was supported by Vasundhara (2011) study to determine the knowledge and

attitude of selected groups of women in Andra Pradesh towards menopause and its relationship

with selected variables. Descriptive correlational survey was used for the study. Result revealed

that women lacked knowledge about menopause and negative attitudes in certain areas of

menopause. The knowledge of the women was influenced by their education occupation and

http://www.ncbi.nlm.nih.gov/pubmed/?term=Noroozi%20E%5Bauth%5D


Page:39

income. Income and occupation had influenced the attitudes of the women where as education

had on effect on attitude formation.

LIMITATIONS

The study was conducted on a small sample of working women i.e. 50 which limits the

generalization of the study.

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 video assisted teaching for the improvement

of knowledge regarding menopause.

CONCLUSION

The result of the study reveals that knowledge deficit and less favourable attitude existed

regarding menopause among working women. The VAT was found to be effective in increasing

the knowledge and developing favourable attitude of the working women.

REFERRENCES

1. BT Basavanthappa, “Nursing Research” 2nd edition (2007), Jaypee Publication – New

Delhi, pp 189.

2. BT Basavanthappa, “Nursing Theories” 1st edition (2007), Jaypee Publication – New

Delhi, pp 147-168.

3. D C Dutta, textbook o gynaecology, 5th

edition, 2008, published by new central book

agency (P) LTD, page no. 55-62.

4. A.J. Daley, H.J. Stokes-Lampard, C. MacArthur, (2009) “Exercise to reduce vasomotor

and other menopausal symptoms”, Retrieved : January 8, 2009; Accepted: February 5,

2009; Published Online: March 02, 2009.

5. Akanksha Singh and Shishir Kumar Pradhan (2014), “Menopausal symptoms of

postmenopausal women in a rural community of Delhi, India: A cross-sectional study”, J


Page:40

Midlife Health. Retrieved on 2014 Apr-Jun; volume 5(2): page no. 62–67;, doi:

10.4103/0976-7800.133989; PMCID: PMC4071646.

6. Aust N Z J Obstet Gynaecol. 2009, Retrieved Feb 2009, Published online 2013 May 30.

7. Beth Skwarecki (2014), “Exercise Helps Menopause Symptoms and Quality of Life”,

Maturitas. Retrieved on- December 29, 2015; volume- 80: page no. 69-74.

8. B Graman Staery, 2012, “Menopause and mood disorders”, Retrieved April 12.

9. Beverley Ayers, Mark Forsha, Myra S. Hunter, 2010, “The impact of attitudes towards

the menopause on women's symptom experience”, Received: October 29, 2010;

Accepted: October 30, 2010; Published Online: November 19, 2010.

10. Gayathry Nayak, Asha Kamath, Pratap N. Kumar, and Anjali Rao (2014), “Effect of yoga

therapy on physical and psychological quality of life of perimenopausal women in

selected coastal areas of Karnataka, India”, J Midlife Health. 2014 Oct-Dec; 5(4): 180–

185. ; doi: 10.4103/0976-7800.145161; PMCID: PMC4264281

http://dx.doi.org/10.4103%2F0976-7800.133989


Page:41

“A STUDY TO EVALUATE THE EFFECTIVENESS OF SKILL COMPETENCY

PROGRAMME REGARDING COMMON OBSTETRIC COMPLICATIONS AMONG

STAFF NURSES IN SELECTED HOSPITALS AT MEERUT. “

ABSTRACT:

Objectives: 1. To develop & validate skill competency programme regarding common obstetric

complications for staff nurses. 2. To assess & evaluate the knowledge & skill of staff nurses

before & after administration of skill competency programme regarding common obstetric

complications. 3. To find out the relationship between post test knowledge & skill of staff nurses

regarding common obstetric complication. RESEARCH METHODOLOGY: The research approach

was evaluative with one group pre-test post-test design. The sample consisted of 30 staff nurses.

Non probability purposive sampling method was used. The instrument for the data collection was

structured knowledge questionnaire and observational checklist. Result: The result of major

findings indicated that staff nurses had inadequate knowledge and ineffective skill. Skill

competency programme was found to be a very effective. The mean post-test level of knowledge

is significantly higher than the mean pre-test knowledge score that is 12.17% and 16.80% post-

test with paired “t” =7.598.at P=<0.05 Significant. The mean post-test level of population

comprised of staff nurses skill score is significantly higher than the mean pre-test skill score that

is 14.3% and 20.3% Post-test with paired “ t”8.16 at P= <.0.05 significance Conclusion: Thus

the skill competency programme was found to be effective in enhancing the knowledge & skill

of staff nurses regarding common obstetric complications based on the study finding the

recommendation for future research were also made.

Keywords: Common Obstetric Complications, Skill Competency Programme, Evaluative,

Effectiveness, Staff nurses, Hospital.

Mrs. Pooja Soni

MSC Nursing Student, Dept. Of OBG Nursing, Panna Dhai Maa Subharti College of Nursing,

Meerut.


GUIDE




Page:42

INTRODUCTION

Pregnancy is not a disease but a normal physiological process, it is associated with certain risks

to health and survival both for the woman and for the infant she bears.( world health

organization) These risks are present in every society and in every setting. In developed

countries they have been largely overcome because every pregnant woman has to take special

care during pregnancy and childbirth. The death of a woman during pregnancy and childbirth is

not only a health issue but also a matter of social injustice.

According World Health

Organization, it is estimated that 150 million pregnancies occur annually.

Worldwide, every minute of every day, one-woman dies of pregnancy related

complications. Nearly 6,00,000 women die each year, of these 99% of death occurs in

developing countries.

Every single woman who dies, 30 women develop life long illness and injuries related to

pregnancy and childbirth.

15% of the woman develops life-threatening complications.

Most maternal deaths in India are caused by complications such as haemorrhage (29%), anemia

(19%), sepsis (16%), obstructed labour (10%), unsafe abortion (9%) and (8%) hypertensive

disorders of pregnancy. Maternal mortality is disease of poverty, affecting woman and their

children, restricted by national borders and of little interest to anyone else.

Every year more than 1,00,000 women Die in india due to cause related to pregnancy.

Maternal death is a tragedy for individual women, for families and for their communities. In

developed countries, the maternal mortality ratio is around 27 per 100,000 live births and in the

developing countries the ratio is 20 times higher. It varies between 480 and 1000 per 100,000

live births depending on the region. Majority 80% of these deaths are preventable by nursing

care

METHODOLOGY

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


Population: The population of present study comprise of all staff nurses who are qualified in

Diploma & Degree Nursing and working in selected hospitals.


Page:43

Sample Size: 30 Registered staff nurses working in maternity wards at subharti Hospital Meerut

Setting: The study will be conducting in selected hospitals at Meerut.

Variables

* Independent variable – skill competency programme on common obstetric complications.

. * Dependent variable – knowledge and skill of staff nurses

Inclusion Criteria: 1.. Staff nurses who had been registered from state nursing council. 2.

Staff nurses who are willing to participate in the study. 3. Staff nurses who can read & write

English , Hindi

Exclusion Criteria: 1. Staff nurses who are having managerial responsibility such as nursing

superintendent, ward in charge. 2. Staff nurses who are not available at the time of data

collection.

MATERIAL

The lesson plan on common obstetric complication was prepared based on the review of

literature and expert opinion. The content was made clear and comprehensive. The prepared

lesson plan was given for the content validity to the expert. Based on the suggestions and

opinions of the experts , the final lesson plan with A.V Aids was prepared Guidelines was made

for skill competency programme and procedure was discussed with the staff nurses for getting

frank responses. For the content validity of tools and lesson plan of skill competency programme

a criteria rating scale was prepared. It consist of items with three responses for rating against

each criterion like fully met the criteria, partially met the criteria, and mostly meet the criteria

and with the remark column for each criterion. The tools and lesson plans with request letters,

criteria rating scale was submitted to the nine experts from the field of nursing, education and

community medicine for validation, there was 100% agreement on the tools and lesson plans.

There were few corrections which were made and was incorporated.

After the tryout on 10 staff nurses .reliability co-efficient was calculated Structured Knowledge

questionnaire by using KR-20 & formula for skill inter-rater reliability method.



Page:44

For conducting main study formal administrative permission was obtained from the

OBSTETRICAL & GYENOCOLOGY DEPARTMENT IN SUBHARTI HOSPITAL for

selected staff nurses. Data was collected from 26 /2/16 to 5 /3/16

Self introduction was given to the staff nurses of hospital at Meerut.

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

Non probability purposive sampling was used to select the samples.

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

On day one pre test done by using structured questionnaire and observation checklist

On day second Skill competency programme was completed by the help of A.V aids

and demonstration.

On day 7 post test knowledge and skill was administered in order to evaluate the

effectiveness of the skill competency programme on common obstetric complications

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 aspaired ‘t’ 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


SECTION I The Socio-demographic variable related to age indicates that maximum (70% ) of

the staff nurses were of aged 25-30 years, 16.7 % of them who were 31-35years,3.3% of them

who were 36-40 years and 10.0% of them who is above 41-45 years. The Socio-demographic

variable related to professional education indicates that 100% of the staff nurses were

professional educated The Socio-demographic variable related to income monthly indicates that

majority of the staff nurses income (n=93.3% ) were 10,000-15,000. 6.7 % were 20,000 and

Most of the (n=70.0%) of staff nurses have not take previous attended course regarding obstetric

emergencies/complications, 30 staff nurses have taken previous course attended regarding


Page:45

emergencies/ complications, Most of the 36.7% staff nurses had 5 year experience 33.3% had 3

years experience, 20.0% had 1 year experience ,10.0 had 2 years experience.

SECTION- II This section represent the Assessment of pre-test level of Knowledge and skill

of staff nurses regarding common obstetric complications.

Area wise Knowledge Gain after skill competency programme

N=30

Assessment of Knowledge among staff nurse of pre-test scores regarding various aspects

of common obstetric complications.pre-test knowledge mean score of 12.17% post-test

knowledge score of 16.80 % They are having average knowledge on all aspects.

The staff nurses pre-test overall Knowledge on common obstetric complications. They are

having 3.30 %of Knowledge before the administration of skill competency Programme.

Assessment skill among staff nurses of pre-test scores 14.3% post-test score

20.0%regarding common obstetric complications aspects They were having initially ineffective

skill on all aspects.

SECTION-III Assessment of Post-test level of Knowledge and skill of staff nurses regarding

common obstetric complications.

KNOWLEDGE

ASSESSMENT

% OF PRE-

TEST

KNOWLED

GE

% OF POST-

TEST

KNOWLEDG

E

%OF

KNOWLEDGE GAIN

1.common obstetric

complications

57.1 84.0 26.9

2.Foetal monitoring 50.0 70.0 8.0

3. Measure blood pressure 90.0 98.0 20.0

4. Weight measure 38.0 58.0 20.0

5. Administration of drugs

in midwifery

74.0 82.0 8.0

Overall 58.4 80.6 22.2


Page:46

Assessment of Knowledge among staff nurses of post-test scores regarding various

aspects of common obstetric complications post mean score of 16.80% In Considering the

aspects of common obstetric complications. They are having adequate Knowledge on all

aspects. Table no.9 shows the staff nurses post-test overall Knowledge on common obstetric

complications. They are having 53.3 percent of Knowledge after the administration of skill

competency programme.

Assessment skill among staff nurses in terms of post-test scores regarding various aspects

of common obstetric complications. mean score of post-test skill 20.0%. They are having

effective skill on all aspects. Table no.12 shows the staff nurses post-test overall skill on

common obstetric complications. They are having 53.3% percent of skill after the administration

of skill competency programme.

SECTION IV Comparison of pre and post test Knowledge and skill scores regarding common

obstetric complications among the staff nurses.

Area wise Skill gain after Skill Competency Programme.

N=30

SKILL ASSESSMENT % OF PRE-

TEST SKILL

% OF POST-

TEST SKILL

%OF

SKILL GAIN

1.Foetal monitoring

inspection

48.0 74.0 26.0

2.Measure blood

pressure inspection

51.9 69.3 17.4

3. Measuring weight 40.0 62.0 22.0

4. Administration of

magnesium sulphate

injection

47.8 64.4 16.7

5. Administration of

iron injection

48.0 62.0 14.0

OVER ALL 47.8 66.7 18.9


Page:47

Comparison of overall Knowledge of staff nurses before & after Skill competency

ProgrammeOn an average staff nurses improved their Knowledge after Skill competency

Programme The difference between pre and post- test Knowledge score is t= 7.958 significant

and it was significant. Statistical significance was calculated by using paired ‘t’test.

SECTION –V Findings related to the correlation between post test knowledge and post skill

score of staff nurses regarding common obstetric complications represent the correlation in

knowledge and skill among the staff nurses , which is represented ‘r’ value. The calculated value

is r= .349 at the level P=.058 which shows negative correlation between knowledge and skill

which denotes by the investigator that the good knowledge shows effective skills among the

staff nurses after the skill competency programme on common obstetric complications .

DISCUSSIONS

On the basis of the objectives of the study and the revealed finding, discussion can be

framed as follows :

In relation to the second objectives, the findings of the present study shows that in pre-

test staff nurses 96.6% were having average knowledge on common obstetric complications &

3.3%were having good knowledge, where as in pre-test staff nurses were having poor skill

regarding common obstetric complications.

But in post-test 53.3% had good knowledge 46.6% of staff nurses had average knowledge

on common obstetric & post-test skill average staff nurses have 53.3% had good skill & 46.6%

had average skill re finding obstetric complication.

Their finding of knowledge is consistent with ASHLY BABY, JEEVAN(2014)where 54 had

satisfactory knowledge, 38 had poor knowledge & only 8 had good knowledge regarding

management of anemia during pregnancy.

On the basis of the objectives third of the study and the revealed finding, discussion

can be framed as follows :

In relation to the third objectiveThe present study pre-test Knowledge score was 12.17% and the

post test Knowledge score was 16.80%. The difference between pre-test and post-test


Page:48

Knowledge score was 4.6%. Staff nurses’s pre-test level of Knowledge on common obstetric

complications and 96.6% of them were having average Knowledge. After administration of Skill

competency programme the post-test level of Knowledge on common obstetric complications

showed that 53.3% of the staff nurses were having good Knowledge and 46.6% of them were

having average Knowledge. This result is due to the effectiveness of Skill competency

Programme on common obstetric complication.

In the pre-test skill score was 14.3% & the post-test skill score was 20.0% The difference

between pre-test and post-test skill was 57% The level of skill in pre-test shown that 100% of

staff nurses were having average skill and none of them were having good skill towards common

obstetric complications. After Skill competency programme, none of them were having poor skill

and 46.6% staff nurses shown effective skill and 53.3% shows good skill towards common

obstetric complications.

The finding of third objective are supported by Sarika chaturvedi(19 may 2014)

competence of birth attendants at providing emergency obstetric care under

india’sJananisurakshayojana(JSY).

Jananisurakshayojana (JSY) conditional cash transfer program for institutional delivery

To Access emergency obstetric care by competent staff can reduce maternal mortality. India has

launched the JananiSurakshaYojana (JSY) conditional cash transfer program to promote

institutional births. During implementation of the JSY, India witnessed a steep increase in the

proportion of institutional deliveries-from 40% in 2004 to 73% in 2012.

Jananisurakshayojanawasimplemented in three districts of Madhya Pradesh (MP)

province training was arrange for assessing obstetric complications, hemorrhage and eclampsia,

there were 233 birth attendant nurses participated at 73 JSY facilities. Their competence at (a)

initial assessment, (b) diagnosis, and (c) making decisions on appropriate first-line care for these

complications was recorded.

The obstetric care competence score was obtained which showed 75% of participants

scored below 35% of the maximum score. The overall score, although poor, was marginally

higher in respondents with Skilled Birth Attendant (SBA) training, those with general nursing

and midwifery qualifications, those at higher facility levels, and those conducting >30 deliveries


Page:49

a month. In all, 14% of respondents were competent at assessment, 58% were competent at

making a correct clinical diagnosis, and 20% were competent at providing first-line care.

LIMITATIONS

This study was confined to 30 staff nurses which limit the generalization of the findings

The research design lacks a control group hence the result of the study must be

generalized with caution

The sample selection was non- randomize Purposive sampling technique which limits

generalization of the findings.

CONCLUSION

The staff nurses initially had low level of knowledge & poor skill toward common

obstetric complications.

The maximum deficit was found in area of prevention of common obstetric

complications.

The minimum deficit was found in area of meaning of common obstetric complication.

The skill competency programme was found more effective in increasing the knowledge

after administration of skill competency programme regarding common obstetric

complication.

The skill competency were found more effective in developing the good skill toward

common obstetric complications.

REFERRENCES

BOOKS;-

1. Benett R, Linda K Brown. Myles Text book for Midwives. 12th ed. Edinburgh: Churchil

Living Stone; 1993.

2. DC DUTTA, textbook for gynaecology, 5th

edition , 2008 , published by new central book

agency (p) LTD,

3. Dutta D.C, Text book of obstetrics. 7th edition edited by hiralalkonar.

4. International Confederation of Midwives. Essential competencies for basic midwifery

practice. 2013. Available


Page:50

5. Fullerton JT, Thompson JB, Johnson P. Competency-based education: the essential basis of

preservice education for the professional midwifery workforce. Midwifery. 2013;29:1129–

36. [PubMed]

JOURNALS:-

1. Anandalakshmy PN, Buckshee K. Maternal Mortality in a referral hospital of northern India -

A sixteen year review. The Journal of Family Welfare: September 1997; 43 (3): 1-4.

2. Cressman, AM; Natekar, A; Kim, E; Koren, G; Bozzo, P (July 2014). "Cocaine abuse during

pregnancy.". Journal of obstetrics and gynaecologyCanada : JOGC = Journal d'obstetrique et

gynecologie du Canada : JOGC 36 (7): 628–31.

3. Fenne D, Essien E, Golji N, Sabitu K, Alti-Mu’azu M, Musa A et al., Improving the quality of

obstetric care at the teaching hospital. International Journal of Gynecology and Obstetrics.1997

Nov;59suppl 2:s 37-46.

4. French. JI et. al. Gestational bleeding bacterial vaginosis and common reproductive tract

infection: risk for preterm birth. Journal of Obstetrics and Gynaecology: 1999; 93 (5): 715-2

INTERNET WEBSITES–

1. http://www.google.com

2.http://www.jcdr.in/article_abstract.asp?issn=0973709x&year=2012&month=May&volume=6

&issue=4&page=597-601&id=2107.

3. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3139259

5. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC

http://www.ncbi.nlm.nih.gov/pubmed/23906879


Page:51

“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.


GUIDE

Ex. Capt. Geeta Parwanda,




Page:52

INTRODUCTION:

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

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

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

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

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

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

healthcare to diagnose and manage COPD in a scientific manner.

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

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

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

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

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

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

progressively lead to death.

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

leading

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

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

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

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

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

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

about the severity and risk of the disease they loss their

50% of the lung functions.

METHODOLOGY

Research design: pre- experimental design

Research Approach: Evaluative research approach

Population: COPD patients

Sample Size: 30


Page:53

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.


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

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

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

Analysis

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

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


Page:54


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

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

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

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

were female.

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

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

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

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

employee.

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

were unmarried.

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

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

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

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

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

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

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

friends.

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

(20%) were Eggetarian.

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

were had family history of COPD.

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

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

having illness of 4-5yrs.


Page:55

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

FREQUEN

(f)

PERCENTAGE

(%)

1.

AGE IN YEARS

45-49 1 3.3

50-54 7 23.3


Page:56

55-60 22 73.4

2. GENDER

Female 5 16.6

Male 25 83.4

3. Education

No formal education 17 56.6

Primary 9 30

Secondary 1 3.3


4. OCCUPATION

Unemployed 11 36

Business 2 6.6

Govt. Employee 1 3.3

Private employee 3 10

Others ( Retired,

Pensioner, Coolie)

13 43.3

5. MARITAL STATUS:

Married 28 93.44

Unmarried 2 6.66

6. TYPES OF FAMILY

Nuclear family 4 13.4

Joint family 26 86.6

7. INCOME MONTHLY

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


Page:57

Rs 5001-8,000/- 13 43.3

Rs 8,001 Above 11 36.6

8. PERSONAL HISTORY

Alcohol 1 3.33

Smoker 14 46.66

Non alcoholic/ non smoker 15 50

9. SOURCE OF

INFORMATION ABOUT

COPD.

By T V / Radio 1 3.4

By health personnel 26 86.6

By family members or

friends

3 10

10. DIETARY PATTERN

Vegetarian 8 26.6

Non- Vegetarian 16 53.4

Eggetarian 6 20

11. FAMILY HISTORY OF

COPD

Yes 3 10

No 27 90

12. DURATION OF

ILLNESS

Less than 2years 10 33.3

2-3 years 6 20


Page:58

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

3-4 years 8 26.6

4-5 years 6 20

Attitude

test

Mean Standard

deviation

(S.D.)

Mean

Differen

ce

SDM SEM

D

Paired ‘t’

value

Pretest 47.51 3.766 12.59 3.1

0.57

21.39

Post test 60.10 3.703


Page:59

Scores Mean SD ‘r’ value ‘P’ value

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.


Page:60

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

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.


Page:61

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

2002.JAMA. 2005;294(10):1255–1259.

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

Physician. 2008;78(1):87–92.

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

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

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

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

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

2005;54(250):625-628.

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

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

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

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


Page:62

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).

Ms. Kusum

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

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


GUIDE

Mrs. Arul Malar

HOD Medical surgical Nursing




Page:63

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

management, patients with cancer.

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


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


Page:64

Exclusion Criteria:

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.


Page:65

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.

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%) .


Page:66

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.

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. Gender


Page:67

a)

b)

Female

Male

21

29

42%

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%

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%


Page:68

10.

a)

b)

c)

d)

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

(Physician/Nurse or any other

4

0

0

46

8%

0%

0%

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.

Knowledge scores

regarding home care

management among

cancer patients

Mean SD Mean

Differ

e-

Ence

SDD SEMD Paired ‘t’ value

Pre test 15.32 4.45 2.88 5.57 0.78 3.654

Post test 18.2 2.94


Page:69

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

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:

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


Page:70

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

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.


Page:71

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

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

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

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

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

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

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

IARC 2003

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

edition(2008), published by

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


Page:72

“A STUDY TO EVALUATE THE EFFECTIVENESS OF VIDEO ASSISTED

TEACHING ON KNOWLEDGE AND ATTITUDE REGARDING ORGAN DONATION

AMONG SELECTED DEGREE COLLEGE STUDENTS AT SUBHARTI UNIVERSITY

MEERUT”

OBJECTIVES: 1.To develop and validate the video assisted teaching regarding organ

donation among degree college students. 2. To assess and evaluate the knowledge and attitude of

the degree college students regarding organ donation before and after the administration of video

assisted teaching. 3. To determine the relationship between post test knowledge and attitude of

degree college students regarding organ donation. 4. To find out the association of post test

knowledge and attitude scores of Degree College students with their selected demographic

variables METHODOLOGY:.The research design was pre experimental one group pre test post

test design.A structured knowledge questionnaire and attitude scale were developed and utilized

for data collection. RESULTS: The results of the study indicated that in pretest the mean

knowledge score was 13.8 with standard deviation 3.8 and in post test mean knowledge score

was 28.3 with the standard deviation of 4.9. This indicates that video assisted teaching is

effective in improving the knowledge of the students regarding organ donation. The paired‘t’ test

value was 18.16 which was statistically significant at P <0.00. In pretest the mean attitude score

was 73. 39 and in post test the mean attitude mean score was 13.42. The paired ‘t’ test value 1.59

which was statistically not significant at P <0.05. This indicates that video assisted teaching is

brought some improvement in attitude of the students regarding organ donation. The mean post

Mrs. Sanju Solanki

M.Sc Nursing, Dept. of Community Health Nursing,


GUIDE

Mr. Naveena JH

Asst. Professor, Community Health Nursing



Page:73

test knowledge score is 28.3. Mean post test attitude score is 77.78. The r value for post test

knowledge and attitude shows 0.41 at p=<0.05 level of significance. Hence there is a correlation

between post test knowledge and post test attitude scores of degree college students on organ

donation. There was no significant association between any of the above selected demographic

variables with the post test level of knowledge. There was a significant association between

selected demographic variable such as age (2 =6.636) at P = <0.05, Religion (

2 =14.645) at P

= <0.05 and post test level of attitude of degree college students

INTERPRETATION & CONCLUSION: Thus, the Videos assisted teaching programme was

found to be effective in enhancing the knowledge and attitude of Degree college students

regarding organ donation.

KEY WORDS: Evaluate, Effectiveness, Knowledge, Attitude Video Assisted Teaching, Organ

Donation, Degree College Students


Page:74

INTRODUCTION

“Don’t Take Your Organs To Heaven For God Known’s They Are Needed Here, You Have

The Power To Donate Life”

For many doctors, nurses, and the general public the term life support calls up the image of

a ventilator. However, there are many types of life support one of them being organ transplants.

As with any other type of life support, organ transplantation comes with its share of problems.

Forty years ago, many people died because doctors could not successfully complete a transplant

and prevent rejection of the new organ. The knowledge of anti-rejection drugs was limited, and

the surgery involved was extremely difficult. Today, science has made improvement in the field

of transplantation to the point that most transplant operations are considered low risk.

WHO (2014) Organ donation is the donation of biological tissue or an organ of

the human body, from a living or dead person to a living recipient in need of

a transplantation. Transplantable organs and tissues are removed in a surgical

procedure following a determination, based on the donor's medical and social history, of which

are suitable for transplantation. Organ donation is the process of surgically removing an organ or

tissue from one person (the organ donor) and placing it into another person (the recipient).

Transplantation is necessary because the recipient’s organ has failed or has been damaged by

disease or injury.

WHO (2014) Organ transplantation is one of the great advances in modern medicine.

The main factor limiting organ donation is the availability of suitable donors and organs.

Currently, most transplants follow multiple organ retrieval from heart beating brain-dead organ

donors. However, brain death is often associated with marked physiological instability, which, if

not managed, can lead to deterioration in organ function before retrieval. In some cases, this

prevents successful donation. This strategy of active donor management requires an alteration of

philosophy and therapy on the part of the intensive care unit clinicians and has significant

resource implications if it is to be delivered reliably and safely.


Page:75

U.S. National library of medicine (2012) Organ donation takes healthy organs and

tissues from one person for transplantation into another. Experts say that the organs from one

donor can save or help as many as 50 people. Organs can donated by people include.

Internal organs: Kidneys, heart, liver, pancreas, intestines, lungs

Skin

Bone and bone marrow

Cornea

Most organ and tissue donations occur after the donor has died. But some organs and tissues

can be donated while the donor is alive. People of all ages and background can be organ donors. If

the person is under age 18, His/her parent or guardian must give permission to become a donor. If

the person is 18 or older He/ She can show to be a donor by signing a donor card.

Institute of medicine of national academies (2006) Organ transplantation has grown

increasingly safe and effective; the demand for transplants has grown far faster than the supply of

available organs. In 1954, with the first successful organ transplantation in humans, transplanted

organs have given hundreds of thousands of people the chance for longer, more productive lives. In

2005 alone, slightly over 28,000 solid organs (kidney, liver, lung, heart, pancreas, and intestine)

were transplanted in the United States, up from approximately 12,600 organ transplants in 1988. As

organ transplantation has grown increasingly safe and effective, the demand for transplants has

grown far faster than the supply of available organs. Since 1988, the number of people on the U.S.

waiting list has increased more than five-fold, from 16,000 to its current total of more than 90,000.

Each year approximately 40,000 people are added to the transplant waiting list.

Organ shortage (2012) Organ transplantation is the best available established technique for

the treatment of end stage failure of most essential organs (liver, heart and lungs). Corneal

transplantation is similarly well established and tissue transplantation, particularly of bone but also

of skin, tendons, etc., is growing very rapidly. Over 1 million people world-wide have benefited

from successful organ transplantation. A number of transplant patients have survived well over 25

years and five years survival rates for most organ transplant programmes are around 70%. With

http://www.nlm.nih.gov/medlineplus/organtransplantation.html


Page:76

modern techniques of organ preservation and advances in immune-suppression, a significant

proportion of patients can now expect to achieve long-term survival with a high quality of life.

Pınar Dogan, Dilek Toprak, Nihal Sunal (2012) conducted a study on Knowledge,

attitude and behaviors of university students on organ transplantation, in Turkey. A stratified

random sample of 955 students were asked for six sociodemographic, seven personal information,

nine behavior and twenty attitude questions using a Likert-type scale survey form. Results revealed

that Totally 955 students participated the study and 85.6% reported that the most significant barrier

against organ transplantation was inadequate organ donation. While 363 students (38.0%) didn't

decide to donate any organs although they had positive views on organ donation, 209 students

reported that they would donate all of their organs and the organ chosen as likely to be donated the

most was kidney. When the reasons for negative views on organ donation were examined, the

primary reasons were found to be "presence of religious barriers" and "discouragement". Also, 719

(75.3%) students had no knowledge about where the organs were donated. This study Concludes

that University students have insufficient information about organ donation. Informing them about

the details of the organ donation will have an effect on increasing the donationrates.

Mohan Sivanand (2013) A huge gap exists between patients who need organ transplants

and potential donors. It's not that there aren't enough organs to transplant. Nearly every person

who dies naturally, or in an accident, is a potential donor. Even so, innumerable patients cannot

find a donor. Reader's Digest did an Asia-wide study of organ donations, and found that India

lags far behind other countries in this regard. As Dr Sunil Shroff of Chennai, managing trustee of

the Multi Organ Harvesting Aid Network foundation, an NGO that promotes organ donation,

says: "Healthy people are unaware of the sufferings of patients with organ failure." Organ

shortages are a global problem, but Asia lags behind much of the rest of the world. The organ

donation rate from dead bodies in India is estimated to be a minuscule 0.05 per million people

(although India has among the world's highest number of deaths from road accidents). Hong

Kong's organ donation rate is less than 5 per million, while it's 25 per million in the United

States.

METHODOLOGY

Research design: pre experimental one group pretest post test design


https://www.researchgate.net/profile/Pinar_Dogan6

https://www.researchgate.net/profile/Dilek_Toprak2

https://www.researchgate.net/researcher/2012196016_Nihal_Sunal


Page:77

Population: Degree college students who are studying in selected degree colleges of swami

vivekanand subharti university Meerut.

Sample Size: 60

Setting: Acharya Vishnu gupt Subharti institute of management & commerce, Chhatrapati

shahuji Subharti institute of technology & engineering college at Subharti University, Meerut

Variables

INDEPENDENT VARIABLES:-

Independent variables are believed to care or influence the behavior and ideas. In this study the

independent variables is video assisted teaching programme on organ donation .

DEPENDENT VARIABLES:

Dependent variables are knowledge and attitude level of degree college students studying in

subharti university at Meerut.

INCLUSION CRITERIA:-

- Degree college students of Acharya Vishnu gupt Subharti institute of management &

commerce, Chhatrapati shahuji Subharti institute of technology & engineering college

aged between 18-25 years.

- Both boys and girls who are willing to participate in the study.

- Degree college students who are available at the time of data collection.

EXCLUSION CRITERIA

- Degree college Students who are absent on the particular day of data collection.

- Degree College students who are sick during the time of study.

- Degree college students who are not willing to participate in the study.

MATERIAL

The conceptual framework adopted for the study was based on J.W Kenny’s Open system model

(1990) .The research design was pre experimental one group pre test post test design. The study

was conducted in Acharya Vishnu gupt Subharti institute of management & commerce,

Chatrapati shahuji Subharti institute of technology & engineering colleges Subharti university at


Page:78

Meerut. The independent variable was Video assisted teaching and the dependent variables were

the knowledge and attitude of degree college students regarding organ donation.A structured

knowledge questionnaire and attitude scale were developed and utilized for data collection. Data

gathered were analysed and interpreted in the light of objectives and hypothesis using descriptive

and inferential statistics.


To conduct this study a structured questionnaire was prepared for collecting data

regarding demographic variables and knowledge aspect of degree student regarding organ

donation. And a attitude scale was prepared to collect data regarding skill aspect of degree

college student about organ donation.


The results of the study indicated that in pretest the mean knowledge score was 13.8 with

standard deviation 3.8 and in post test mean knowledge score was 28.3 with the standard

deviation of 4.9. This indicates that video assisted teaching is effective in improving the

knowledge of the students regarding organ donation. The paired‘t’ test value was 18.16 which

was statistically significant at P <0.00. In pretest the mean attitude score was 73. 39 with

standard deviation 18.69 and in post test the mean attitude mean score was 13.42 with the

standard deviation of 13.42. The paired ‘t’ test value 1.59 which was statistically not significant

at P <0.05. This indicates that video assisted teaching is brought some improvement in attitude of

the students regarding organ donation.

The mean post test knowledge score is 28.3 and Standard deviation is 4.1. Mean post test

attitude score is 77.78 and Standard deviation is 13.42. The r value for post test knowledge and

attitude shows 0.41 at p=<0.05 level of significance. Hence there is a correlation between post

test knowledge and post test attitude scores of degree college students on organ donation. There

was no significant association between any of the above selected demographic variables with the

post test level of knowledge. There was a significant association between selected demographic

variable such as age (2 =6.636) at P = <0.05, Religion (

2 =14.645) at P = <0.05 and post test

level of attitude of degree college students.


Page:79

Association between Post-Test Level of Knowledge and their Demographic Variables

N=60

Demographic variables

Average

knowledge

Good

knowledge

Total

P

value

Chi square

test

N % N %

Age in

year

19-21years 25 41.66 32 53.33 57 0.13 2=

2.256

df-1

Not

Significant

22-24years 0 00 03 5 03

25-27years 0 00 0 00 0

28-30years 0 00 0 00 0

Gender

31 & above 0 0 0 .281 2=

1.164

df = 1

Not

Significant

Male 19 22 41

Female

06 13 19

Religion

Hindu

22 31 53 .642 2=0.886

Df=2

Not

Significant

Christian

Any other

3

0

3

1

6

1

Area of

residence

Rural

Urban

11

12

13

19

24

31

.866

2=

0.289


Page:80

Semi-urban 2

3

5

Df=2

Not

Significant

Type of

Family

Nuclear

family

Joint family

Extended

family

10

13

2

11

23

1

21

36

3

.464

2=

1.535

Df=2

Not

Significant

Occupatio

n of father

Un employee

Government

employee

Private

employee

Self

employee

Agriculture

3

4

3

10

5

3

10

6

8

8

6

14

9

18

13

.575

2=

2.900

Df=4

Not

Significant

Occupatio

n of

mother

Housewife

Un employee

Government

Private

employee

self employee

24

0

0

0

1

27

0

5

2

1

51

0

5

2

2

.129

2=

5.667

Df=3

Not

Significant


Page:81

Family

income per

month

Below 5000

5001to

10,000

10,000 to

15,00

150001 to

20,000

Above 20001

6

8

5

3

3

6

8

7

7

7

12

16

12

10

10

.750

2=

1.920

Df=4

Not

Significant

Type of

diet

Vegetarian

Mixed 15

10

24

11

39

21

.493 2=

0.471

Df=1

Not

Significant

Previous

knowledge

on organ

donation

Yes

No

7

18

15

20

22

38

.239

2= 1.386

Df=1Not

Significant

Source of

health

informatio

n

Family

members/

friends

11

12

23

.642

2=

0.887

Df=2

Not

Significant

Relatives &

Nabougrous

0

0

0

New/T.V/

Radio/ Other

12 18 30


Page:82

Media

Health

Professional 2 5 7

DISCUSSION

Based on the objectives of the study the findings of the pre-test Knowledge score of the Degree

college students regarding Organ donation shows that they were able to answer the questions to

some extent. In pretest 50.0% students were having average knowledge, none of the students

were having good knowledge and 50% students were having below average knowledge

regarding organ donation. Attitude score of degree college students shows in pretest 1.7 %

students were having un favourable attitude, 30 % students were having moderately favourable

attitude and 68.3% students were having highly favourable attitude regarding organ donation.

In post test 41.7 % students were having average knowledge, 58.3 % students were

having good knowledge and none of the students were having below average regarding organ

donation. Attitude score of degree college students shows in post test 1.7 % students were

having un favourable attitude, 6.7 % students were having moderately favourable attitude and

91.7 % students were having highly favourable attitude regarding organ donation.

In pretest the mean attitude score was 73. 39 with standard deviation 18.69 and in post test the

mean attitude mean score was 13.42 with the standard deviation of 13.42. This indicates that

video assisted teaching is brought some improvement in attitude of the students regarding organ

donation. The paired ‘t’ test value 1.59 which was statistically not significant at P <0.05. It

indicates that video assisted teaching was not effective to improve attitude of degree college


Page:83

students regarding organ donation which was not statistically at P <0.05. Hence Null Hypothesis

H02 was failed to rejected and research hypothesis H2 was not accepted.

The mean post test knowledge score is 28.3 and Standard deviation is 4.1. Mean post test attitude

score is 77.78 and Standard deviation is 13.42. The r value for post test knowledge and attitude

shows 0.41 at p=<0.05 level of significance. Hence there is a correlation between post test

knowledge and post test attitude scores of degree college students on organ donation.

LIMITATIONS

This study is limited to degree college students between the age group of 18-25 years.

Research design is limited to pre experimental single group pre test post test design

Sample size is limited to 60 students of selected degree colleges at Subharti university

meerut.

Data collection period is limited to 4-6 weeks

CONCLUSION

As the part of the study 60 degree college student were given the video assisted teaching

programme. The programme helps the degree college students to improve their knowledge and

attitude on organ donation. This will ultimately helps to reduce the burden of organ shortage in

the earth.

REFERRENCES

1. Alarcon R, Blanca MJ, Frutos MA. Assessment of an educational program for adolescents

about organ donation and transplantation. Transplant Proc. 2008 Nov;40(9):2877-8. doi:

10.1016/j.transproceed.2008.09.013. Available From:


2. Amber Rithalia, Catriona McDaid, Sara Suekarran, et,al. Impact of presumed consent for

organ donation on donation rates: a systematic review. BMJ. 2009; 338: a3162. Published


Page:84

online 2009 Jan 14. doi: 10.1136/bmj.a3162 Available From:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2628300/

3. Berry C, Ley EJ et.al,. In-house coordinator programs improve conversion rates for organ

donation. J Trauma. 2011 Sep;71(3):733-6. doi: 10.1097/TA.0b013e31820500e6.

Available From: http://www.ncbi.nlm.nih.gov/pubmed/21399548

4. Baughn D, Rodrigue JR, Cornell DL. Intention to register as organ donors: a survey of

adolescents. Prog Transplant. 2006 Sep;16(3):260-7. Available From:


5. Clive O Callender, MD, FACS and Patrice V Miles, National Minority Organ Tissue

Transplant Education Program (MOTTEP), Washington, DC. J Am Coll Surg.

2010 May; 210(5): 708–717. Available From:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2861044/

6. Chen JX, Zhang TM, Lim FL, Wu HC, Lei TF, Yeong PK, Xia SJ.Current knowledge

and attitudes about organ donation and transplantation among Chinese university

students. Transplant Proc(abstract). 2006 Nov ;38(9):2761-5. Available from:


7. C.L. Albright , K. Glanz, L. Wong, et,al. Knowledge and Attitudes About Deceased

Donor Organ Donation in Filipinos: A Qualitative Assessement. Transplantation

Proceedings, Volume 37, Issue 10, December 2005, Pages 4153-4158. Available from;

http://www.sciencedirect.com/science/article/pii/S0041134505011723.

8. Callender CO, Hall MB, Branch D. An assessment of the effectiveness of the Mottep model

for increasing donation rates and preventing the need for transplantation--adult findings.

Semin Nephrol. 2008 Jul;21(4):419-28. Available From:


http://www.ncbi.nlm.nih.gov/pubmed/?term=Baughn%20D%5BAuthor%5D&cauthor=true&cauthor_uid=17007163

http://www.ncbi.nlm.nih.gov/pubmed/?term=Rodrigue%20JR%5BAuthor%5D&cauthor=true&cauthor_uid=17007163

http://www.ncbi.nlm.nih.gov/pubmed/?term=Cornell%20DL%5BAuthor%5D&cauthor=true&cauthor_uid=17007163


http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=20421035

http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=20421035

http://www.sciencedirect.com/science/journal/00411345

http://www.sciencedirect.com/science/journal/00411345


Page:85

9. Dardavessis T, Xenophontos P, Haidich AB. Knowledge, attitudes and proposals of

medical students concerning transplantations in Greece. Int J Prev Med. 2011

Jul;2(3):164-9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21811659.

10. Dr. Sumana Navin, Dr. Sunil Shroff & Ms. Sujatha Niranjan. Deceased Organ

Donation in India. Mohan Foundation. 2015. Available From:

http://www.mohanfoundation.org/organ-donation-transplant-resources/organ-donation-

in-india.asp

11. Haustein SV, Sellers MT. Factors associated with (un)willingness to be an organ donor:

importance of public exposure and knowledge. Clin Transplant. 2004;18:193–200.

12. Harrison TR, Morgan SE, Di Corcia MJ. Effects of information, education, and

communication training about organ donation for gatekeepers: clerks at the Department of

Motor Vehicles and organ donor registries. Prog Transplant. 2008 Dec;18(4):301-9.

Available From: http://www.ncbi.nlm.nih.gov/pubmed/19186584

13. Institute of medicine of national academies, report brief.may 2006.

14. Mohan Sivanand, Reader’s Digest November issues exhorts citizens to give the “gift of

life” 2013 Available from; http://www.karmayog.org/publichealth/

publichealth_3204.htm.

15. Organ Donation. U.S. National library of medicine NIH National institutes of health.

2012 Available from; http://www.nlm.nih.gov/medlineplus/organdonation.html


Page:86

“A STUDY TO EVALUATE THE EFFECTIVENESS OF PLANNED

TEACHING PROGRAMME (PTP) REGARDING MICRONUTRIENT

DEFICIENCY AND ITS PREVENTION IN TERMS OF KNOWLEDGE

AMONG ADOLESCENT GIRLS IN SELECTED SENIOR SECONDARY

SCHOOLS AT MEERUT”.

ABSTRACT

OBJECTIVES: 1. To develop and validate Planned Teaching Program (PTP) regarding

micronutrient deficiency and its prevention for adolescent girls. 2. To evaluate the knowledge

regarding micronutrient deficiency and its prevention among adolescent girls in experimental

group before and after administration of planned teaching program. 3. To compare the

knowledge of adolescent girls in experimental and control group regarding micronutrient

deficiency and its prevention. 4. To find out the association between post-test knowledge of

adolescent girls with selected demographic variables in experimental group. METHODOLOGY:

The research design 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 adolescent girls. RESULTS: The 80% of adolescent girls were having good

knowledge after administration of planned teaching programme in experimental group. Post-test

knowledge score of experimental group and control group of adolescent girls were found to be

statistically significant. There was no any significant association found in the demographic

variable with the pot-test knowledge score of experimental group adolescent girls.

Ms. KHUSHBOO RANI




GUIDE

Prof. Kalpana Mandal

HOD, Community Health Nursing




Page:87

CONCLUSION: The study concluded that there was knowledge deficit in adolescent girls

regarding micronutrient deficiency and its prevention before intervention and planned teaching

programme was an effective method to improve the knowledge of adolescent girls.

KEY WORDS: Effectiveness, knowledge, micronutrient deficiency, prevention, adolescent girls,

senior secondary schools.

INTRODUCTION:

Micronutrient Deficiencies (MNDs) are of great public health and socioeconomic

importance worldwide. They affect low-income countries but are also a significant factor in

health problems in industrialized societies with impacts among wide vulnerable groups in the

population, including women, children, the middle-aged, and the elderly. They affect all

populations in Europe and more severely in the transition Countries of Eastern Europe (CEE),

the former Soviet Union, and Countries of Central Asia (CAR). They significantly contribute to

chronic diseases as the major causes of morbidity and mortality in these countries.

The World Health Organization (WHO) considers that more than 2 billion people

worldwide suffer from vitamin and mineral deficiencies, primarily iodine, iron, vitamin A and

zinc, with important health consequences. WHO publication goes on to emphasize that

micronutrient malnutrition is not, as was widely assumed, only a problem of developing

countries. WHO defines food fortification as the practice of deliberately increasing the content of

an essential micronutrient, i.e., vitamins and minerals (including trace elements) in a food, in

order to improve the nutritional quality of the food supply and provide a public health benefit

with minimal health risk.

METHODOLOGY

Research design: Quasi-experimental research (non-randomized control group design) design.


Population: The population of present study comprise of adolescent girls in senior secondary

schools.

Sample Size: 60 adolescent girls (30 of each in experimental group and control group) are

studying in selected senior secondary schools at Meerut.


Page:88

Setting: The study will be conducting in selected senior secondary schools at Meerut.

Variables

* Independent variable – planned teaching programme regarding micronutrient deficiency

and its prevention

. * Dependent variable – knowledge of adolescent girls regarding micronutrient deficiency and

its prevention

Inclusion Criteria: 1. Adolescent girls who are willing to participate in a study. 2. adolescent

girls present at a time of study. 3. adoelscent girls those are studying in IX & XI class.

Exclusion Criteria: Adolescent girls those are studying science side was excluded.

MATERIAL

The lesson plan on micronutrient deficiency and its prevention was prepared based on the

review of literature and expert opinion. The content was made clear and comprehensive. The

prepared lesson plan was given for the content validity to the expert. Based on the suggestions

and opinions of the experts, the final lesson plan with A.V Aids was prepared Guidelines was

made for planned teaching programme was discussed with the adolescent girls for getting frank

responses. For the content validity of tools and lesson plan of planned teaching programme a

criteria rating scale was prepared. It consist of items with three responses for rating against each

criterion like fully met the criteria, partially met the criteria, and mostly meet the criteria and

with the remark column for each criterion. The tools and lesson plans with request letters,

criteria rating scale was submitted to the seven experts from the field of nursing, education and

community medicine for validation, there was 100% agreement on the tools and lesson plans.

There were few corrections which were made and was incorporated.

After the tryout on 10 adolescent girl’s reliability co-efficient was calculated Structured

Knowledge questionnaire by using KR-20.


For conducting main study formal administrative permission was obtained from the SENIOR

SECONDARY SCHOOLS AT MEERUT for adolescent girls.


Page:89

EXPERIMENTAL GROUP

The researcher introduced herself and the purpose of study was explained to the group.

All the adolescent girls were explained about the nature of the study and their expected

participation.

Written consent was taken and confidentiality was assured.

To obtain free and frank response the purpose of the study was explained.

Purposive sampling technique was used for the selection of thirty adolescent girls.

On first day pre-test of knowledge of adolescent girls were taken and PTP was

administered regarding micronutrient deficiency and its prevention.

On 7th

day post-test was taken.

CONTROL GROUP

The researcher introduced herself and the purpose of study was explained to the group.

All the adolescent girls were explained about the nature of the study and their expected

participation.

Written consent was taken and confidentiality was assured.

To obtain free and frank response the purpose of the study was explained.

Purposive sampling technique was used for the selection of thirty adolescent girls.

On first day pre-test of knowledge of adolescent girls were taken micronutrient

deficiency and its prevention.

On 7th

day post-test was taken.

Analysis

The data analysis was planned so as to use both descriptive and inferential statistics. The plan of

the data analysis was as follows.


Page:90

Frequency and percentage distribution of demographic characteristics of the adolescent

girls in experimental and control group.

Mean and standard deviation of pre-test and post-test knowledge of experimental group.

Mean, mean difference, standard deviation, standard error of mean difference and ‘t’

value of pre-test post-test knowledge in experimental and control group.

Chi-square square value to be computed to be find out the association between post-test

knowledge of experimental group and selected demographic factors.


SECTION I The Socio-demographic variable related to age indicates that majority of the

adolescent girls in experimental and maximum number in control group were in the age group of

(15-16 years) i.e. 93.4% and 63.4% respectively.. The Socio-demographic variable related to the

type of family in experimental group 16 (50%) were joint family where as in control group 22

(73.3%) were nuclear family. The Socio-demographic variable related to Maximum of the

adolescent girls in experimental group had their education status of mother i.e 11 (36.6%) ,

whereas maximum of the sample in control group also had their education status of mother i.e.

13 (43.4%). The Socio-demographic variable related to the dietary pattern majority of the

adolescent girls in the experimental and control group were intermediate i.e. 28 (93.4%) and

24(80%) respectively. Most of the adolescent girls in the experimental group belong to a

monthly family income of below 5000 i.e. 16 (53.3%), whereas in control group belong to

monthly family income of 5001 to 15000 i.e.16 (53.3%). Regarding the occupational status of

father most of the adolescent girls in the experimental and control group were private employee

i.e. 20 (66.6%) and 12(40%) respectively.

SECTION- II This section represent the Assessment of the knowledge scores of adolescent

girls in experimental group

The mean pre-test knowledge score of experimental group adolescent girls was (18.86) with

median (11) and standard deviation (3.07) against the maximum score of (35). The range of

obtained score was between (0-12) indicating there was knowledge deficit exists regarding

micronutrient deficiency and its prevention.


Page:91

The mean post-test knowledge score of experimental group adolescent girls was (27.19) with

median (27) and standard deviation (1.8) against the maximum score of (35). The range of

obtained score was between (26-35) indicating there was knowledge gain exist regarding

micronutrient deficiency and its prevention after administration of planned teaching programme

on micronutrient deficiency and its prevention.

The mean difference between pre-test knowledge and post-test knowledge was (16.3). The‘t’

value of (26.29) for df (29) was found to be statistically significant at 0.05 level.

SECTION-III Finding related to compare the knowledge of adolescent girls of

experimental and control group

The mean post-test knowledge of experimental group was (27.16) and mean post-test knowledge

score of control group (19.2). The mean difference between the post-test knowledge scores of

both the group was found to be (4.08) the ‘t’ value of (6.68) for the df (58) was found to be

statistically significant at 0.05 level of significant. Thus it was inferred from the findings that

planned teaching programme regarding micronutrient deficiency and its prevention was effective

in increasing the knowledge of experimental group of adolescent girls.

SECTION-IV Finding related to association between post test knowledge score of

experimental group and selected demographic variables : The findings in the table 8, it is

evident that there was no significant association between knowledge of adolescent girls and age

in years, type of family, education status of mother, dietary pattern, monthly family income and

occupational status of father. So these factors are independent of each other.

Mean, Mean difference, standard deviation of difference, standard error of mean

difference and ‘t’ value of pre-test and post-test knowledge scores of adolescent girls in

experimental group.

N=30

Knowledge score of

experimental group

Mean Mean

difference

SDD SEMD


Page:92

‘t’

Pre-test 10.86

16.3

3.4

0.62

26.29* Post-test 27.16

Table – 2

Mean, Mean difference, standard deviation of difference, standard error of mean

difference and ‘t’ value of post test knowledge scores of adolescent girls in experimental

and control group.

N1 + N2 = 60

Post-test Knowledge score Mean Mean

difference

SEMD

‘t’

Control group (N2-30) 19.2

4.08

0.61

6.68 Experimental group (N1-

30)

27.16

DISCUSSIONS

On the basis of the objectives of the study and the revealed findings discussion can be

framed as follows.

In relation of the second objective the finding of the present study shows that mean pre-

test knowledge was experimental group (10.86 ) and mean post-test knowledge (27.16 ). It shows

that post-test knowledge of higher then pre-test knowledge in experimental group. These finding

were consistent with the Savita S. M (2013) finding that Thirty percent of the subjects scored


Page:93

low (< 17), 42.31 per cent scored medium (17-23) and 27.56 per cent scored high (> 23) before

the education. Assessment of the knowledge immediately after the education programme

revealed that 97.44 per cent of subjects scored high (> 23) where as 2.56 per cent scored medium

(17-23) and one month later, the knowledge level revealed that 95.51 per cent scored high (> 23)

and 4.49 per cent scored medium (17-23) reflecting that the retention of knowledge is quite

satisfactory during follow up assessment. The response improved after education intervention

that could help to combat micronutrient malnutrition.

In relation of the third objective the present study while comparing the knowledge of

adolescent girls of experimental and control group on micronutrient deficiency and its

prevention. It was found that experimental group had gained knowledge after the introduction of

planned teaching programme. These findings consistent with Barberger-Gateau P (2006),

conducted a study to assess the impact of a nutritional education intervention on knowledge and

practices among home support assistants for the elderly. Results revealed that the intervention

(experimental) group significantly improved its knowledge score (mean gain 2.5 points, p <

0.001) after the training period, whereas the score remained unchanged in the control group

(mean gain 0.5 points, p = 0.06). The impact of the nutritional education was very significant (p

< 0.0001) after adjustment for the characteristics which differed between the two groups.

In relation of the fourth objective the finding of the present study shows that there was

no association between post test knowledge of experimental group with demographic variables.

These finding were not supported with the Premalatha T, Valarmathi S, (2012) conducted a

study in Tamil Nadu India to assess the prevalence of iron deficiency anemia among adolescent

school girls in the age group of 13-17 years in Chennai and to study the associated factors. A

cross-sectional survey was executed among 400 female school students in the age group of 13-17

years in Chennai. Sociodemographic details, anthropometric measurements were obtained.

The result showed that the prevalence of anemia was found to be 78.75% among school

students. Chi-square statistics showed significant association (p<0.05) of anemia is with type of

family, socioeconomic status and diet. The study concludes that a high prevalence of anemia is

found in female students from nuclear families and whose mothers’ education is low.


Page:94

Thus the study suggested that there is a need to have survey on regular basis to assess the

knowledge of adolescent girls regarding micronutrient deficiency and its prevention.

LIMITATIONS

This study was confined to a small number of adolescent girls i.e. 60 adolescent girls (30

each in experimental and control group) which limits the generalization of the study.

The study sample was selected non-randomized purposive sampling technique which

limits the generalization of findings.

CONCLUSION

There was knowledge deficit in adolescent girls regarding micronutrient deficiency and

its prevention.

The planned teaching programme was found to be effective in increasing the knowledge

of adolescent girls in experimental group regarding micronutrient deficiency.

The post-test knowledge of experimental group of adolescent girls were significantly

higher than the control group of adolescent girls.

There was no association found between post-test knowledge and demographic variable

of adolescent girls in experimental group regarding micronutrient deficiency and its

prevention.

REFERRENCES

1. Basvanthappa BT(2007), Nursing research, 2nd edition, jaypee publishers(new Delhi)

page no 132- 140.

2. Darshan sohi, “A text book of nutrition” , 2nd edition, publisher by peevee publication,

page no 19-22.

3. K.S. Negi (2008), “ text book of statistics with latest MCQs” , 2nd edition, A.I.T.B.S.

Publishers, India, Page no 230-232.

4. Ruma singh, “Food & nutrition for nurses”, (2010 edition), Publisher by jaypee

publication, Page. No 20-25.


Page:95

5. Suresh k Sharma, “Text book of Nursing Research and statistics”, (2011 edition),

published by ELSEVIER Publication, Page no 53, 94, 405, 180.

6. Aguayo vm, paintal k, singh g. “the adolescent girls' anaemia control programme: a

decade of programming experience to break the inter-generational cycle of malnutrition

in india.” Public health nutr. 2013 sep;16(9):1667-76. Doi: 10.1017/s1368980012005587.

Epub 2013 jan 24. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23343620

7. Ajitha sharma, shalini adiga, ashok m. “knowledge, attitude and practices related to

dietary supplements and micronutrients in health sciences students” Available from :

http://www.jcdr.in/articles/pdf/4683/9329_ce(ra)_f(sh)_pf1(snak)_pfa(ak).pdf

8. Barberger-gateau p, helmer c, ouret s, gendron b. Quasi-experimental evaluation of a

nutritional educational intervention among home support assistants for the elderly.2006

jun;54(3):233-43. Available from - http://www.ncbi.nlm.nih.gov/pubmed/16902384

9. http://anemia.org/patients/feature-articles

10. http://en.wikipedia.org/wiki/health

11. http://en.wikipedia.org/wiki/disease#terminology

12. http://en.wikipedia.org/wiki/adolescence

13. http://emedicine.medscape.com

14. http://www.fao.org/docrep/x0245e/x0245e01.htm


Page:96

A STUDY TO ASSESS AND EVALUATE THE EFFECTIVENESS OF STRUCTURED

TEACHING PROGRAM REGARDING PREVENTION AND MANAGEMENT OF

OBSTETRIC NEAR-MISS EVENTS IN TERMS OF KNOWLEDGE AMONG

MIDWIVES IN SELECTED HEALTH CENTRES, AT MEERUT.

ABSTRACT:

Title: A study to assess and evaluate the effectiveness of structured teaching program regarding

prevention and management of obstetric near-miss events in terms of knowledge among

midwives in selected health centers, at Meerut. Objectives: 1. To develop and validate Structured

Teaching Program (STP). 2. To assess and evaluate the knowledge of midwives before and after

administration of STP. 3. To compare the knowledge of midwives in experimental and control

group 4. To find out the association between post-test knowledge scores of midwives with

selected socio demographic variables in experimental group. Research design: Quasi

experimental Pretest Post-test Control Group design. Material: Non- Probability Purposive

sampling Sample: The sample consisted of 60 midwives (30 in experimental and 30 in control

group) working in selected community health centers at Meerut Result: Post test knowledge

score of experimental group and control group of midwives were found to be statistically

significant as calculated value‘t’ (8.61) for df (58) {‘t’=2.0017} at 0.05 level of significance.

Conclusion: The STP was found to be effective in increasing the knowledge of midwives

regarding prevention and management of obstetric near-miss events as evidenced by the post test

knowledge scores of midwives in experimental group after administration of STP.

Keywords: effectiveness, midwives, obstetric near-miss events, community health centre.

Ms. Megha Mohan




GUIDE

Prof.(Ms).Kalpana Mandal HOD, Community Health Nursing




Page:97

INTRODUCTION

Around 529,000 maternal deaths occur every year mostly in developing countries from

peri-natal complications and childbirth. Maternal mortality refers to deaths due to complications

from pregnancy or childbirth. Almost 80% of the causes are direct causes like haemorrhage,

eclampsia, pre-eclampsia , shock, sepsis, complications of unsafe abortion, obstructed labor etc.

For every woman who dies, many more suffers from disability and disease ( AbouZahr C,

Wardlaw T(2003)). According to the WHO estimates (2014), the global maternal mortality

ratio is- 380 deaths to 210 deaths per 100,000 live births from 1990-2013. This estimate is less

than half the 5.5 per cent rate needed to achieve the three-quarters reduction in maternal

mortality targeted for 2015 in Millennium Development Goal. This shows that still more has to

be achieved.

Maternal deaths in Indian scenario also show a significant similar picture with the world

where the data shows a marked decline (1990-2013) from 560 deaths to 190 deaths per 100,000

live births. The table below shows the Maternal Mortality ratio 1990-2013, WHO, UNICEF,

The World Bank, UNFPA, The United Nation Population Division Maternal Mortality

Estimation Inter-Agency Group India:

Maternal Mortality ratio 1990-2013, WHO, UNICEF, The World Bank, UNFPA,

The United Nation Population Division Maternal Mortality Estimation Inter-Agency

Group India

Year Maternal

Mortality

Ratio(MMR)

Mater

nal

Deaths

Number of

AIDS-related

indirect

maternal

deaths

Live

births

Proportion of deaths

among women of

reproductive age that

are due to maternal

causes(PM)

Per

100,000

live

Numbers Numb

ers

Numbers Thousands Percent


Page:98

WHO,UNICEF,UNFPA,World bank estimates (2013).

Strategies like Janani Suraksha Yojna , Skilled Birth Attendant programme, and many

more had played a significant role in decreasing the maternal mortality, but the goal is yet to be

achieved. According to a recent case study (2014)conducted by Kranti S.Vora India’s maternal

health goal is to lower the maternal mortality to less than 100 per 100,000 live births but that is

still far away despite the efforts and rapid economic progress over the past two decades. The

study recommends better reporting of maternal deaths and implementation of evidence-based,

focused strategies along with effective monitoring for rapid progress in achieving the goal. This

again points towards the road to improvement towards the maternal health goals.

METHODOLOGY

Research design: Quasi Experimental pre-test post-test control group design.


Population: Midwives working in selected Community Health Centers Meerut.

Sample Size: 60

Setting: Selected Health Centers of Meerut (U.P.)

Variables

Independent Variable: Structures Teaching Program regarding prevention and management of

obstetric near-miss.

births(lb)

2013 190[130-300] 50,000 310 25,568 6.7

2005 280[180-430] 73,000 480 26,196 9.2

2000 370[240-560] 97,000 270 26,697 12.1

1995 460[300-720] 123,00

0

60 26,689 15.5

1990 560[360-870] 148,00

0

6 26,632 19.2


Page:99

Dependant Variable: knowledge of midwives regarding prevention and management of obstetric

near-miss events .

Inclusion Criteria: Midwives working in the selected health centres

1. Who can read, write and speaks Hindi.

2. Midwives those who were available in the selected health centres during study.

Exclusion Criteria:

1. Midwives those who were not willing to participate in the study.

MATERIAL

The tool was prepared based on an extensive review of research and non-research literature, peer

group discussion, taking the expert opinion.

The tool consists of:

Part 1: Consisting of items on sample characteristics such as age in years, education, working

area, working experience, type of center, Category of health personnel, past experience with

obstetric near-miss cases, attended any skilled training programme.

Part 2: Comprises of 35 knowledge questions with a maximum score of 35. The questions are

MCQ type having only one correct answer and correct answer carries a score of one, the wrong

answer score zero.

There was Categorization of knowledge:

Score between 23-35 = good knowledge

Score between 13-22 = average knowledge

Score between 0-12 = below average knowledge


Formal administrative permission was taken from Chief Medical Officer of Community Health

Center Hastinapur, Meerut dist. Final data collection was done from 20 feb 2016 to 5th March

2016. Thirty midwives in each group were selected by the purposive sampling technique. To

obtain free and frank response, the purpose of the study was explained and the subjects were

assured about the confidentiality of their responses.


Page:100

Pre-test Knowledge of experimental group and control group midwives was assessed on the first

day. Structured teaching program was administered on prevention and management of obstetric

near-miss events on day first to the experimental group midwives. The post test was taken on

fifth day in both experimental and control group.

Analysis

The present study was designed to assess the knowledge regarding prevention and management

of obstetric near miss events. Analysis and interpretation of data are based on the objectives of

study.


According to the age group maximum of the sample in experimental group and control

group were in the age of (36 & above) years i.e. 40% and 53% respectively.

As per the professional qualification in experimental group and control group were

having Diploma in Auxilliary Nursing and Midwifery i.e. 22 (73%) and 25 (83%).

Majority of the sample in experimental group and control group were in other working

area 15(50%) and 20(67%).

Regarding working experience majority of the sample in experimental group and control

group were having more than 5 years of working experience i.e 12 (40%) and 16 (53%).

Most of the sample in the experimental group and control group were working in PHC

i.e. 16 (53%) and 14 (47%).

As per the category of health personnel majority were ANMs both in experimental group

and control group i.e. 18 (60%) and 22 (73%).

Majority of the sample in experimental group and control group have attended skilled

training program i.e. 30 (100%) and 28 (93%).

The mean post-test knowledge score (25.0) of midwives in experimental group were

significantly higher than mean pre-test knowledge score (17.0) on prevention and

management of obstetric near-miss events. (Fig.1)

87% of midwives were having good knowledge after administration of STP in

experimental group.(Fig.2)

Post test knowledge score of experimental group and control group of midwives were

found to be statistically significant as calculated value of ‘t’ (8.61) for df (58)[‘t’=2.0017]


Page:101

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

hypothesis H01 and H02 was rejected. (Table-2)

There was only one significant association found with type of centre in the demographic

variable with the post test knowledge score of experimental group midwives. Hence

research hypothesis H3 was accepted for this demographic variable association and null

hypothesis H03 was rejected.

Table-1

Frequency and percentage distribution of demographic characteristics of the midwives

Sample Characteristics

Experimental Group

(N=30)

Control Group

(N=30)

Frequency Percentage Frequency Percentage

1. Age in years:-

21-25 2 7 3 10

26-30 6 20 3 10

31-35 10 33 8 27

36 and above 12 40 16 53

2. Professional Qualification

Diploma in Auxilliary Nursing and

Midwifery 22 73 25 83

Diploma in General Nursing and

Midwifery 2 7 2 7

Diploma in Public Health Nursing 6 20 3 10

3.Working area

Labour Room 6 20 4 13

Post Natal Ward 4 13 3 10

Antenatal Ward 5 17 3 10

Other 15 50 20 67

4.Working Experience


Page:102

0-1 year 2 7 3 10

1-3 years 6 20 3 10

3-5 years 10 33 8 27

above 5 years 12 40 16 53

5.Type of Centre

Sub-centre 6 20 4 13

PHC 16 53 14 47

CHC 8 27 12 40

6.Category of Health Personnel

ANMs 18 60 22 73

LHVs 10 33 6 20

Staff Nurses 2 7 2 7

7.Attended any skilled training

programme

No 0 0 2 7

Yes 30 100 28 93

Figure.1- Cylinder graph showing the mean pre-test and post-test knowledge score of

experimental group.

Pre-Test

Post-Test

17.0 25.0

Mean Knowledge Score


Page:103

Figure 2- Bar graph showing the interpretation of knowledge score of pre-test and post-test of

experimental group midwives.

Table-2

Mean, mean difference, standard deviation of difference, standard error of mean difference

and ‘t’ value of pre-test and post-test knowledge scores of midwives in experimental group

and control group.

N=60

Post-test Knowledge Score Mean

Mean

Difference SDD SED ‘t’

Control group (N=30) 16.3

4.48 4.03 0.52 *8.61 Experimental group (N=30) 25.0

*df-58, p<0.05 level of significance,‘t’=8.61

DISCUSSION

On the basis of the objectives of the study and the revealed findings discussion can be framed as

follows:

In relation with the second objective the finding of the present study shows that mean post-test

knowledge of experimental group (25.0) was higher than the mean pre-test knowledge (17.9).

7%

90%

3%

0

13%

87%

Below Average (0-12)

Average (13-22)

Good Knowledge (23-35)

KNOWLEDGE SCORE OF PRE-TEST AND POST-TEST

Post-test Pre-test


Page:104

These findings were consistent with study of Sharon Maslovit, Gad Barkai (2007) to assess the

effectiveness of simulation based training programme among midwives and obstetric doctors in

Israeli Center for Medical Simulation, United Kingdom. One hundred and sixty five samples

have selected by random method. Questionnaire responses showed that post-test score (79.4 ±

4.3) were more than pre-test score (70 ± 5.3).

Findings of the present study shows that in pre-test there was inadequate or lack of knowledge of

midwives regarding prevention and management of obstetric near-miss events. This findings

were also supported by studies conducted by Khosla A , Dahiya V, Sangwan K, Rathore S

(2013) where the result of the study demands timely and co-ordinated management in case of

massive obstetric haemorrhage. Every nurse must have the capability to develop comprehensive

plans & interventions to tackle the situations such as obstetrical haemorrhage (ante-partum and

post trauma). Nurses should update their knowledge by getting and knowing the latest

information on disease conditions and their management.

Another supportive study by Kausar F and Morris J.L (2012) shows that once the nurses can

rule out the complications, the management would be tackled easily and it depends on proper

knowledge and training regarding “near-miss” events and their identification at an early stage.

The findings of present study were also supported by study conducted by Neil A.M (1999). The

findings of this study showed that only 48% of health care practitioners had adequate knowledge

regarding community based care in managing obstetric emergencies. Thus it was consistent with

the present study.

The findings were also consistent with the study of Kimberly Susanne Garcia (2012) to

evaluate the effect of culturally sensitive teaching on midwives knowledge on nursing

interventions to manage PPH. The findings showed that teaching improved midwives’

knowledge and skills about nursing interventions to manage PPH (pre-test M=1.385/8, post-test

M=4.846/8).

LIMITATIONS

This study was confined to a small number of midwives i.e. 60 midwives (30 each in

experimental and control group) this limits generalization of the findings.

The study sample was selected non-randomized purposive sampling technique which

limits the generalization of the findings.


Page:105

CONCLUSION

1. There was knowledge deficit in midwives regarding prevention and management of

obstetric near-miss events.

2. The structured teaching program was found to be effective in increasing the knowledge of

midwives in experimental group regarding prevention and management of obstetric near-

miss events.

3. There was a significant association between post test knowledge score of midwives with

type of centre they are currently working in.

REFERRENCES

1. AbouZahr C, Wardlaw T(2003). Maternal mortality in 2000. Estimates developed by

WHO, UNICEF and UNFPA. Geneva: WHO.

2. Anitha C Rao, PrasannaKumar Shetty: “Effectiveness of maternal and child health care

participatory training program among staff nurses, auxiliary nurse midwives and lady

health visitors. Journal of South Asian Federation Obstetrics and Gynaecology , May-

August 2012; 4(2),120-122,

3. Kalra P, Kachhwaha CP: Obstetric near miss morbidity and maternal mortality in a

Tertiary Care Centre in Western Rajasthan. Indian J Public Health. 2014 Jul-

Sep;58(3):199-201

4. Kausar F, Morris JL: Nurses in low resource settings save mothers' lives with non-

pneumatic anti-shock garment. Journal of Maternal and Child Nursing 2012 Sep; 37(5):

308-16.

5. Khosla A, Dahiya V, Sangwan K, Rathore S. Perinatal outcome in Antepartum

Haemmorhage. Jounal of Obstetrics and gynae India 1989: 9: 71-3

6. Kimberly Susanne Garcia. Mixed methods evaluation & teaching with Guatemalan

traditional midwives’ regarding nursing interventions to manage postpartum hemorrhage.

Journal of Nursing Education and Practice, 2013, Vol. 3, No. 10

7. Kranti S.Vora, et al: Maternal Health Situation in India: A Case Study - ResearchGate.

8. L. Say, J. P. Souza, and R. C. Pattinson, “Maternal near miss—towards a standard tool

for monitoring quality of maternal health care,” Best Practice and Research: Clinical

Obstetrics and Gynaecology, vol. 23, no. 3, pp. 287–296, 2009.


Page:106

9. M. H. Sousa, J. G. Cecatti, E. E. Hardy, and S. J. Serruya, “Severe maternal morbidity

(near miss) as a sentinel event of maternal death. An attempt to use routine data for

surveillance,” Reproductive Health, vol. 5, no. 1, article 6, 2008.

10. Neil A M, Study to assess the knowledge of health care practitioners regarding village

based care in Obstetric Emergencies, Journal of Obstetric and Gynaecology ; 1999.

SUBHARTI JOURNAL OF NURSING REFLECTION · 1. Gibbs' reflective cycle or Gibbs' model of reflection (1988) consist of following six distinct stages. Description Feelings Evaluation

Documents