INTRODUCTION:

Dementia produces decline in intellectual functioning, and onset is gradual².Dementia is common disorders among elderly and thought to be the fourth leading cause of death among adults in many nations following heart disease, cancer and stroke³.

Current estimates reveal that there are about 65.7 million cases of dementia in the world by 2030, there will be about 35 million people suffering from dementia. The overall prevalence of dementia ranges from 5 percent to 7 percent. Alzheimer’s disease is the most common dementia disorder accounting for 80 percent of all cases of dementia⁴.Dementia results in decline of reasoning, memory, and other mental abilities (the cognitive functions). This decline eventually impairs the ability to carry out everyday activities such as driving; household chores; and even personal care such as bathing, dressing, and feeding or often called activities of daily living². Dementia affects all age groups in the society and is not linked with social class, gender, ethnic group or geographical location and although dementia is more common among elderly persons, younger person also can affect⁷.

NEED FOR THE STUDY:

According to the 2011 world population prospects by the United Nations department of economic and social affairs by 2050, the number of Indians aged above 80 will increase more than 6 times from the current number of 78 lakhs to nearly 5.14 crores . Dementia is becoming more prevalent among the elderly. The prevalence of dementia projected to quadruple by the year 2047.Dementing illness are the most common disorders among elderly and thought to be the fourth leading cause of death among adults in many nations Very little is known about the prevalence of dementia and how to care the dementia patients⁵.

Dementia is the disease of the 21st century. Therefore becoming knowledgeable about the care of dementia patients, this is one of the important long-term strategies for nursing personnel. Caring for a person with dementia can have high physical and emotional costs.Since many of the studies and researcher’s own experience reveal that an inadequate knowledge among nursing students regarding care of dementia patients, the researcher wants to improve their knowledge by using a video assisted teaching module⁶.

OBJECTIVES OF THE STUDY:

q To assess the knowledge of third year nursing students regarding the care of dementia patients prior to the implementation of VATM and after implementation of VATM

q To find out the significant difference between the pre and post test knowledge scores of third year B.SC nursing students regarding care of dementia patients.

q To find out the association between Pre and post knowledge scores of third year B.SC nursing students regarding care of dementia patients with their selected demographic variables.

ASSUMPTION:

¨ B.Sc nursing students have some knowledge regarding care of dementia patient.

¨ The VATM would enhance B.SC nursing students Knowledge on care of dementia patients.

¨ Knowledge may vary from individual to individual and B.Sc nursing students to B.Sc nursing students.

HYPOTHESIS

¨ H₁: There will be significant difference between the pre and post test knowledge score of VATM regarding care of dementia patients.

¨ H₂: There will be significant association between pre and post test knowledge scores regarding care of dementia patients and their selected demographic variables at 0.05 level of significance.

DELIMITATIONS:

The study would be delimited to third year B.Sc nursing students in selected nursing colleges.

RESEARCH METHODOLOGY:

An evaluative approach and pre experimental design of one group pre-test and post-test was selected to carry out the present study. The sample consist of 50 Third year B.Sc Nursing Students who met the inclusion criteria were selected through purposive sampling technique. .The Video Assisted Teaching Module on care of dementia patient was developed and a structured closed ended knowledge questionnaire on care of dementia patient was used for the data collection. Reliability of the instrument was calculated by using Karl Pearson Correlation Coefficient formula and significance of correlation was tested using Spearman Brown prophesy formula. The ‘r’ value was 0.82 and the tool was found reliable. Pilot study was conducted in Unity College of nursing, Mangalore and it was found feasible and practicable. The main study was conducted in Shree Devi College Of Nursing at Mangalore. Data was collected from 21.9.11 to 30.9.11. Pre-test was conducted among III rd year B.Sc nursing students by using closed ended questionnaire to assess the level of knowledge regarding care of dementia patients. On 21-09-2011, the investigator collected the data from 9 am to 11 am.The investigator personally explained the need and importance of study to the students before data collection. The closed-ended questionnaire care of dementia patients was distributed to the students and 30 minutes was given to fill the answers in the presence of the investigator. Soon after pre-test the VATM was shown to the samples. Evaluation of post-test was conducted after 7 days of the pre-test. On 28.9.11 and 30.9.11 the post-test was conducted by using the same questionnaire and by the same method as pre-test.

RESULTS:

In the present study highest percentage 48% were in the age group of 20 years and only 2% were from 22year and above. However, 38% were in the age group of 19years and 12 % were in the age group 21 years. It seems that most of them were in the age group between19 -21 years. Gender wise distribution of III B.Sc nursing students shows that majority 90% of them was females when compared to males (10%). It might be done to the nature of profession. Percentage wise distribution of III year B Sc Nursing students according to their religion reveals that both Hindus and Christian at 46%. However, 8% were Muslims. The percentage distribution of third year B.Sc nursing students based on the type of family had revealed that majority of students 56% from nuclear family, 32% of students from joint family and 12% from extended family. However, this finding is in contrast with the statement given by Park. K which states that joint family system is common in India. Percentage wise distribution of the III year B.sc nursing students according to their residence shows highest percentage 52% were from semi urban areas and 14% were from urban areas. However, 34% were from rural areas. The percentage distribution of third year B.Sc nursing students on source of information had revealed that majority of respondents72% has no information, 16% of respondents obtained information from mass media and 12% of respondents obtained information from friends.

The hypothesis was tested using paired‘t’ test. The value of‘t’ was calculated to analyze the difference in knowledge of the third year B.Sc nursing students regarding care of dementia patients.

Significance of difference between pre-test and post-test knowledge scores

N=50

Areas	Mean	SD	SE	‘t’ value
Meaning and causes	11.11	1.69	0.24	46.02*
Signs and symptoms and diagnostic evaluations	13	2.65	0.37	34.69*
Care of dementia patients	9.2	2.14	0.30	30.40*
Total	10.42	2.25	0.32	32.75*

Table value =2.009 at 0.05 level * Highly significant, p<0.05

Paired ‘t’ test was calculated to assess the pre- and post-test knowledge scores of third year B.Sc nursing students regarding care of dementia patients showed a highly significant difference in all the areas. Hence, it can be interpreted that the difference in mean score values related to all the above mentioned areas were true difference and not by chance. So, the null hypothesis is rejected. It shows that the VATM was effective for all the areas.

Chi square was calculated to analyze the association between pre- test and post- test knowledge scores with demographic variables. The study had shown that, there is no association between pre- test and post- test knowledge scores with demographic variables.

The findings of the present study showed a highly significant difference (t=2.009, PO.05) between mean pre-test (40.68) and post-test (73.25) knowledge scores. The scores of the sample after the administration of the VATM were considerably high. This suggests that the improvement in knowledge scores was due to the effect of the VATM.

DISCUSSION:

Overall comparison of mean, SD and mean% of pre- and post-test knowledge scores on care of dementia patients revealed that the overall mean percentage of pre-test was 40.68% whereas, in post-test the mean percentage was 73.25% thus, depicting 32.6% overall difference in mean percentage.

Paired ‘t’ test was used to analyse the difference in the knowledge score of the third year B.Sc nursing students regarding care of dementia patients. A significant increase in the post-test score was observed in the knowledge of third year B.Sc nursing students regarding care of dementia patients. Hence the researcher hypothesis “the mean post-test knowledge of the third year B.Sc nursing students will be significantly higher than the mean pre-test knowledge scores” was accepted (t=2.009,p<0.05). It revealed that VATM was very effective in improving the knowledge level of the third year B.Sc nursing students regarding care of dementia patients.

]In order to determine the significant association of pre- and post-test knowledge score with selected variables, chi-square test was used. In pre-test the calculated chi square values of demographic variables like age, sex, religion monthly income, type of family, residence and source of information about dementia (3.42, 1.51, 1.12, 0.26, 0.68, 0.50,2.36) not significant at 0.05 level of significant. In the post-test the chi square values of demographic variables like age, sex, religion monthly income, type of family, residence and source of information about dementia were (4.30, 0.77, 1.12, 1.69, 0.073,1.19,3.87) not significant at 0.05 level.

CONCLUSION:

From the findings of the present study it can be concluded that the video-assisted teaching module regarding care of dementia patients was effective to improve the knowledge of third year B.Sc nursing students.

Prior to the implementation of VATM the mean percentage score of the third year B.Sc nursing students was 40.68% which signified poor knowledge. However, after implementation of VATM the mean percentage was 73.25% revealing good knowledge and the effectiveness was 32.6%.

IMPLICATIONS:

The findings of the present study have implications in the field of nursing education, nursing practice, nursing administration and nursing research.

Nursing practice:

¨ Health education is an important tool for health care agency. It is one of the most cost effective interventions to promote healthy living.

¨ Nurses working in the hospital as well as in the community should be equipped with knowledge on dementia and alternative modalities for reduction of these difficulties of dementia.

¨ Nurses are the key providers of preventive, curative and rehabilitative services to individual and communities.

¨ Nurses in their educative role are in a better position to mould the health related behaviour.

¨ Nurses are acting as the health promoters. They play important role in educating care givers regarding alternative therapies for reduction of difficulties of dementia and help them to lead a healthy life. Health education can be imparted in the wards, OPDs, primary health centre and schools through various methods like structured exercise programmes, lectures, pamphlets, SIM, VATM and PTP.

Nursing education:

¨ The health care delivery system at present is giving more emphasis on preventive rather than curative aspect. It is the responsibility of the individual to take care of one’s own health.

¨ The present study also gives priority for continuing education programme as it upholds and maintains the knowledge and thus making them more competent.

¨ The VATM can be used as an informational and educational mode by the teachers and nursing personnel for educating the public.

¨ Nursing students should be trained to acquire knowledge in assessing old age people with dementia and to plan out teaching programmes based on the same in the hospital and in the community setting.

¨ The holistic health care approach should be emphasized during the training of nursing students.

¨ The nursing personnel should be given in service education to update their knowledge and should also be trained to prepare and conduct educational programmes like seminar, workshop, and conference regarding this topic.

Nursing research:

¨ Nursing research represents a critically important tool for the nursing profession to acquire knowledge.

¨ The emphasis on research and clinical studies are needed to improve the quality of nursing care.

¨ The present study is only on the investigation in the area of teaching the care of dementia patients.

¨ Dementia is more common among old age people and many are unaware about the management of dementia patients. There is a great need for research in the area of care of dementia.

¨ Nurse researchers should create favourable attitude among old age people towards the management of dementia patients. This will help them to lead healthy life by reducing the difficulties of dementia.

¨ This study has highlighted the effectiveness of VATM on care of dementia patients. The findings can be utilized for conducting research on the effectiveness of VATM on various aspects of nursing.

¨ The limitations of the study are as follows

¨ The study was limited to the third year B.Sc nursing students in selected nursing colleges Mangalore.

¨ Sample size was small so the generalization of the findings is limited. Recommendations Based on findings following recommendations were put forward for the further research:

¨ A similar study can be undertaken on a larger sample so that the results can be generalised.

¨ A similar study can be undertaken using other teaching strategies.

¨ Nursing administers need to be open to novel ideas for patient benefits

¨ The study can be replicated among the GNM students, B.Sc nursing students, Post B.Sc nursing students and also can be replicate for care givers also.

¨ A comparative study can be conducted to assess the knowledge of nursing students and staff nurses.

¨ A study can be conducted to assess the knowledge of care givers regarding care of dementia patients.

¨ A follow-up study may be conducted to evaluate the effectiveness of VATM on care of dementia patients.

¨ A similar study can be undertaken on nurses to assess the skill in handling dementia patients.

¨ An experimental study with control group could be conducted to establish the effect of video assisted teaching module on care of dementia patients.

¨ A descriptive study could be conducted to determine the knowledge and attitude of nurses when caring dementia patients.

SUMMARY:

Percentage wise distribution of the III year B.sc nursing students according to their pre test knowledge shows highest percentage 96% have average knowledge and 4% have good knowledge Percentage wise distribution of the III year B.sc nursing students according to their post test knowledge shows highest percentage 72% have good knowledge and 28% have very good knowledge. Overall and area-wise comparison of mean, SD and mean% of pre- and post-test knowledge scores of the revealed that the overall mean percentage of pre-test was 40.68% whereas, in post-test the mean percentage was 73.25% thus, depicting 32.6% overall difference in mean percentage.

Paired‘t’ test was used to calculate the significant difference between pre- and post-test knowledge scores of third year B.Sc nursing students regarding care of dementia patients. It showed a highly significant difference in all the areas. Hence, it can be interpreted that the difference in mean score values related to all the above mentioned areas were true difference and not by chance. It shows that the VATM was effective for all the areas

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Received on 25.06.2012 Modified on 13.08.2012

Asian J. Nur. Edu. and Research 2(3): July-Sept. 2012; Page 113-117