A Study to assess The Effectiveness of Structured Teaching programme on Knowledge regarding prevention of stroke among Hypertensive patients in selected Hospitals of Mehsana District.
Ms. Urmila Patidar1, Ms. Hanisha Patel1, Mr. Dipak patidar2
1Nursing tutor, Ratna Prabha Nursing College, Vadnagar, Mehsana
2Lecturer Ratna Prabha Nursing College, Vadnagar, Mehsana
*Corresponding Author Email: urmiladpk0@gmail.com
ABSTRACT:
INTRODUCTION:-Meeting the need for knowledge relating to the nature of stroke and risk factors for stroke is still a substantial challenge in the world. Lack of knowledge about stroke in general and specific knowledge of the risk factors, signs, and symptoms of stroke results in the late presentation of patients at the hospital. Gujarat has the highest burden of hypertension with 159,150 cases reported as on March 2015 out of a total number of 715, 382, working out to about 22 percent and hypertension was the most common risk with the affection of middle cerebral artery territory.1 The aim of this study was to assess the effectiveness of structure teaching program on knowledge regarding prevention of stroke among Hypertensive patient. OBJECTIVE: To assess the level of knowledge regarding prevention of stroke among hypertensive patients. To assess the effectiveness of Structured Teaching Programme on knowledge regarding prevention of stroke among hypertensive patients. To find out the association of the knowledge with their selected demographic variables. DESIGN: A quantitative approach using pre-experimental one group pre-test –post- test design. PARTICIPANTS: 60 hypertensive patients were selected using Non- Probability Convenient sampling technique in Mehsana. INTERVENTION: structure teaching programme was given to the hypertensive patient. TOOL: self- structure knowledge questionnaire will prepare and used to assess the knowledge regarding prevention of stroke. RESULT: In this study overall the highest percentage in the demographic data including the age group 40% (41-45), gender 63.33% (female), occupation 50% (unemployed), religion 93.34% (Hindu),dietary practices 93.34% (vegetarian),History of alcoholism 86.67% (NO), History of smoking 56.67% (NO) Duration of illness 40% (1-5 year) Number of hospital visit 58.33%% (1-10), previous knowledge regarding prevention of stroke 56.67% (NO) First source of knowledge 53.84 %(Mass media).Post test knowledge mean score (19.33 + 3.69) was higher than the pre test knowledge mean score (10.80 + 4.02). The calculated “T” value (14.62) was greater than the table value (1.98) at 0.05 level of significance. The pre test and post test mean % is 43.20% and 78.93% and different is 35.73%. So knowledge is increase after the intervention. This indicates that the structure teaching programme is effective in increasing the knowledge regarding prevention of stroke. Chi-square test to associate the level of knowledge with selected demographic variable. CONCLUSION: The finding of the study revealed that structure teaching programme is effective in increasing the knowledge regarding prevention of stroke.
KEYWORDS: Assess, Effectiveness, Structure Teaching Programme, Knowledge, Stroke, Hypertension, Patients.
INTRODUCTION:
The sudden death of some brain cells due to lack of oxygen when the blood flow to the brain is impaired by blockage or rupture of an artery to the brain. A CVA is also referred to as a stroke. The most common symptom is weakness or paralysis of one side of the body with partial or complete loss of voluntary movement or sensation in a leg or arm. There can be speech problems and weak face muscles, causing drooling. Numbness or tingling is very common. A stroke involving the base of the brain can affect balance, vision, and swallowing, breathing and even be taken immediately to a medical facility for diagnosis and treatment. Stroke is the No. 5 cause of death and a leading cause of disability in the United States.3
The incidence of stroke and stroke mortalities has gradually declined in many industrialized countries in recent years as a result of increased recognition and treatment of the risk factors. Modifiable risk factors can be reduced or eliminated through lifestyle changes. Hypertension is the most important modifiable risk factor for both ischemic and hemorrhagic stroke. Adequate blood pressure control is associated with a 38% reduction in stroke incidence. Cardiovascular disease and atrial fibrillation are also associated with an increased risk of stroke. Diabetes mellitus increases the risk of stroke and morbidity and mortality after stroke unconsciousness.4
NEED OF THE STUDY:
The prevalence of stroke is major disease in India. A study was conducted to focus on stroke in 2015. Developing countries like India are facing a double burden of communicable and non-communicable diseases. Stroke is one of the leading causes of death and disability in India. The estimated adjusted prevalence rate of stroke range, 84-262/100,000 in rural and 334-424/100,000 in urban areas. The incidence rate is 119-145/100,000 based on the recent population based studies. There is also a wide variation in case fatality rates with the highest being 42% in Kolkata.5
The prevalence of stroke in India was estimated as 203 per 100,000 populations above 20 years, amounting to a total of about 1 million cases. The male to female ratio was 1.7. Around 12% of all stroke occurred in population below 40 years. The estimation of stroke mortality was seriously limited by the method of classification of the cause of death in the country. The best estimate derived was 102,000 deaths; which represented1.2 % of total deaths in the country.6
STATEMENT OF THE PROBLEM:
OBJECTIVE:
1. To assess the level of knowledge regarding prevention of stroke among hypertensive patients.
2. To assess the effectiveness of Structured Teaching Programme on knowledge regarding prevention of stroke among hypertensive patients.
3. To find out the association of the knowledge with their selected demographic variables.
HYPOTHESIS:
H0-There will be no significant difference between knowledge score regarding prevention of stroke among hypertensive patients at 0.05 level of significance.
H1-There will be significant difference between the knowledge regarding prevention of stroke among hypertensive patients at 0.05 level of significance.
MATERIAL AND METHODS:
RESEARCH APPROACH:
Quantitative Pre-experimental approach was used in the present study.
RESEARCH DESIGN:
One group Pretest-Posttest research design was adopted.
RESEARCH SETTING:
The study was conducted in selected hospital of Mehsana District.
TARGET POPULATION:
The population of the study were Hypertensive patients in selected hospital of Mehsana District. Gujarat.
SAMPLE SIZE:
Total samples selected comprising of 60 hypertensive patients in selected hospital of Mehsana District. Gujarat. (N= 60)
SAMPLING TECHNIQUE:
Non- Probability Convenient sampling technique was used to select the samples.
CRITERIA FOR SELECTION OF SAMPLE:
Inclusion Criteria
· People in the age group of 25 to 45 years.
· Those who are available at the time of data collection.
· Those who are willing to participate in the study.
· Those who can read and write in Guajarati and English.
· Those who are not cooperative during the time of data collection.
· Patients who have visual or auditory impairment will be excluded from the study.
Section A-:
This section is the first section seeking information on demographic background of people i.e. Age, Gender, occupation, religion, diet, smoking, alcoholism, illness, number of hospital visit, previous knowledge regarding stroke, and source of information regarding prevention of stroke. It consists of total 11 questions.
Section B:
This section is the second part of Self-structured questionnaire which deals with objective type of items from 1-25. It tries to assess the knowledge of the patients regarding prevention of stroke at the understanding and application level as per Bloom‟s taxonomy. 25 items of multiple choice question type to assess the knowledge regarding prevention of stroke among hypertensive patients. The subject responded by choosing 1 correct option from the given four options.
The inference was drawn as below:
Good : 20-25
Average : 14-19
Poor : 0-13
Content Validity:
The prepared tool along with the objective of the study, self-structured knowledge questionnaire to assess knowledge and blueprint were submitted to experts for content validity. Twelve experts from the field of Nursing.
Reliability:
The reliability of the tool is computed by using the Split half technique method. The reliability was established by using split-half method and it was found to be r= 0.84 indicate that the tool was statistically significant and thus the tool was reliable.
RESULTS:
Demographic data were analyzed using frequency and percentage. Frequencies, percentage, mean, median, mean percentage and the standard deviation were used to determine the knowledge score. The ‘t’ value was computed to show the effectiveness of structured teaching programme and chi-square test was done to determine the association between the pretest knowledge of people with selected demographic variables.
FINDING RELATED TO DEMOGRAPHIC DATA:
Highest percentage in the demographic data including the age group 40% (41-45), gender 63.33% (female), occupation 50% (unemployed), religion 93.34% (Hindu),dietary practices 93.34% (vegetarian),history of alcoholism 86.67% (no), history of smoking 56.67% (no) duration of illness 40% (1-5 year) number of hospital visit 58.33%% (1-10), previous knowledge regarding prevention of stroke 56.67% (no) first source of knowledge 53.84 %(mass media).
FINDING RELATED TO PRE AND POST KNOWLEDGE SCORE:
Table 1. Showed that out of 60 pre-test samples poor knowledge is 80 %, average 20%. And Good 0%. Post-test poor knowledge is 0%, average 30% and a good 70%.
Table 1. Frequency and percentage distribution of pre-test and post-test knowledge
|
LEVEL OF KNOWLEDGE |
PRE TEST |
POST TEST |
||
|
Frequency |
% |
Frequency |
% |
|
|
Poor |
48 |
80% |
00 |
00% |
|
Adequate |
12 |
20% |
18 |
30% |
|
Good |
00 |
00% |
42 |
70% |
Figure1. Bar diagram representing percentage wise distribution of the sample according to pre-test and post-test level of knowledge.
FINDING RELATED TO EFFECTIVENESS OF STRUCTURED TEACHING PROGRAMME:
The pre-test knowledge means the score is 10.80 and the standard deviation is 4.02. Post-test knowledge score is 19.73 and a standard deviation of 3.69. The ‘T’ test calculated value is 14.62 and table ‘T’ test table value is 1.98 which is significant at 0.05 levels. Thus it rejects the null hypothesis and accepts the research hypothesis. The pre-test and post-test mean % is 43.20% and 78.93% and different is 35.73%.so knowledge is increase after the intervention. This indicates that the structured teaching programme is effective in increasing knowledge.
Table 2. Mean, mean difference, standard deviation, and “t” test value of pre-test and post test knowledge score
|
Knowledge Scale |
Mean |
Mean Different |
SD |
" t "test |
Value |
DF |
|
Calculated “t” Value |
Table “t” Value |
|||||
|
Pre Test |
10.80 |
8.93 |
4.02 |
14.62 |
1.98 |
59 |
|
Post Test |
19.73 |
3.69 |
Table No. 3. Comparison of the mean percentage of pre-test and post-test knowledge score.
|
Type of test |
Knowledge regarding Disaster Management |
|
|
|
Mean |
mean percentage |
|
Pre-test |
10.80 |
43.20% |
|
Post-test |
19.73 |
78.93% |
|
Mean percentage difference |
8.93 |
35.73% |
|
N=100 |
|
|
Figure 2. Bar diagram showing the effectiveness of structured teaching programme on knowledge percentage
Finding related to the association between pretest knowledge score with selected demographic variables:
The association between the Pre-test level of Knowledge and socio-demographic Variable. Based on the third objectives used to chi-square test to associate the level of knowledge and selected demographic variable. The chi-square value shows that their no significance.
CONCLUSION:
The conclusions drawn from the finding of the study are as follows:
The ’t’ test is done to find the effect of structured teaching programme. It revealed that there is a highly significant gain of knowledge after the administration of intervention. The”t” value is 14.62 and research hypothesis is accepted and the null hypothesis is rejected. The pre-test and post test mean % is 43.20% and 78.93% and different is 35.73%. So knowledge is increase after the intervention. This indicates that the structured teaching programme is effective in increasing knowledge regarding prevention of stroke.
REFERENCES:
1. Waugh Anne, Grant Allison. Anatomy and Physiology in Health and Illness.9th ed. New York: Churchill Livingstone publication; 2003.149-55.
2. Pappanch J, Kirkhan F J. Cerebrovascular disease and stroke prevention Bethesda MD: U.S. National Library of Medicine;; 93(10):890–898.
3. Chaurasias B D. Human Anatomy: regional and Applied Dissection and Clinical. 5th ed. New Delhi: CBS Publishers; 2010. 245-252.
4. Dowswell.G, et al., (2015). Adjusting stroke patient’s poor position. The journal of advanced nursing. 32(2):286-291.
5. Stroke Epidemiology and Stroke Care Services in India [Internet]. Available from https://www.ncbi.nlm.nih.gov/pmc/articles /PMC3859004/
Received on 12.12.2019 Modified on 23.12.2019
Accepted on 31.12.2019 ©A&V Publications All right reserved
Asian J. Nursing Education and Research. 2020; 10(1):89-92.
DOI: 10.5958/2349-2996.2020.00020.8