INTRODUCTION:

“First you take a drink, then the drink takes a drink, then the drink takes you.”

Francis Scott Key Fitzgerald.

The word alcoholism and alcoholic were first used by Dr. Magnus Huss, a Swedish physician. Egyptian Osiris and Roman Bacchus were patrons of high power related to alcohol. The Bible sanctioned the social use of wine but it also records divine commands to abstain. There was a cultural attitude leaning more towards abstinence but permissive ritualistic sanctity of alcohol emerged in the later social structure. The utilitarian nature of alcoholism for pleasure and pain emerged during the twentieth century.

Late in the nineteenth century the temperance movement by lay people and the Church fought against alcoholism with a moralistic approach and started treating patients on spiritual grounds with confessions and conversions.¹

In drunken driving, the main cause of accidents is that they don’t care about themselves and others. They have done it many times before and never had a problem, so they are willing to take a risk. Another cause of drunk driving is the difficulty in knowing your level of impairment after consuming a given quantity of alcohol. Alcohol slows down a person’s reflex and impairs their reasoning while deluding the drunken driver into believing they are competent to drive and their motor skills unaffected. Some of them reasons for drunken drink due to job stress, relaxation, family disharmony, pleasure, lack of control over alcohol, peer pressure.²

NEED FOR THE STUDY:

According to the statistical data collected by World Health Organization (WHO), somewhere around 76 million people across the world suffer from some or the other disorder which can be traced to alcohol abuse. With an estimated 100,000 deaths attributed to alcohol consumption every year, the scenario is not quite pleasant in the United States either. More importantly, this figure doesn't just include deaths as a result of some alcohol-related disorders (such as cirrhosis of the liver and cancer), but also includes indirect causes related to alcohol such as driving accidents, homicides.³

The health-related consequences created by alcoholism are very much disturbing to both individuals and the society. Alcohol is the third most common cause of death in developed countries. Worldwide alcohol causes 2.5 million deaths (3.8 % of total) and 69.4 million (4.5 % of total) of disability-adjusted life years. Unintentional injuries alone account for about one-third of the 2.5 million deaths, while neuro-psychiatric conditions account for close to 40% of the 69.4 million disability-adjusted life years. Thus alcoholism has become one of the most important social issues all over the world.⁴

India has one of the highest road accident rates in the world. There has been a steady rise in the casualties in road accidents in the country and their proportions in total deaths due to all accident have also increased considerably in the past. In India, nearly 80,000 get killed and 340,000 are injured every year in about 300,000 accidents on road network of just 22,00,000 km. There is an accident every minute and death every 8 min. significant variations also arise between different states of India .⁵

Heavy drinking at the workplace may potentially lower productivity. Sickness absence associated with harmful use of alcohol and alcohol dependence entails a substantial cost to employees and social security systems. There is ample evidence that people with alcohol dependence and problem drinkers have higher rates of sickness absence than other employees.⁶

This practice of alcohol consumption is not only found widespread but also considered common by the auto-rickshaw drivers. On communicating, many of these drivers were found to be ignorant about the ill effects of Alcohol. So the investigator found that conducting a study and imparting knowledge on the ill effects of alcoholism is necessary.

STATEMENT OF PROBLEM:

A study to assess the effectiveness of structured teaching programme on knowledge regarding ill effects of alcoholism among auto-rickshaw drivers of Belgaum city. Karnataka.

OBJECTIVES:

The objectives of the study are:

1. To assess the knowledge regarding ill effects of alcoholism among auto-rickshaw drivers.

2. To evaluate the effectiveness of structured teaching programme on knowledge regarding ill effect of alcoholism among auto-rickshaw drivers.

3. To find out an association between pre-test knowledge scores with selected demographic variables.

Operational Definition:

1. Assess: It means statistical measurement based on knowledge scores of auto-rickshaw drivers on ill effects of alcoholism through close ended questionnaire.

2. Effectiveness: It means the improved knowledge scores after the administration of structured teaching programme regarding ill effects of alcoholism.

3. Structured teaching programme: Lesson prepared by the investigator designed for the participants of the study, regarding ill effects of alcoholism.

4. Knowledge: In this study it refers to information regarding ill effects of alcoholism among the auto-rickshaw drivers.

5. Ill effects: Affected by an impairment of normal physical or mental health.

6. Alcoholism: In this study it refers to dependence on alcohol that seriously interferes with life adjustment.

7. Auto-rickshaw drivers: A person who has license to drive auto-rickshaw to earn his livelihood.

Hypothesis:

1. H1: There will be significant difference in the pre-test and post-test knowledge scores at 0.05 level of significance.

2. H2: There will be a statistical association between pre-test knowledge scores and selected demographic variables at 0.05 level of significance

Assumptions:

1. Auto-rickshaw drivers may not have knowledge regarding ill effects of alcoholism.

2. Auto-rickshaw drivers knowledge regarding the ill effects of alcoholism can be improved by administering a structured teaching programme.

Delimitation:

· The study is limited to only Auto-rickshaw drivers of Belgaum city.

RESEARCH METHODOLOGY:

Research approach:

In the present evaluative approach was used to assess the knowledge regarding the ill effects of alcoholism.

Research design:

Pre-experimental - one group pre-test post-test research design was adopted to carry out the present study.

Variables: The variable for the present study are:

· Independent variables:

· Structured Teaching Programme on ill effects of alcoholism.

· Dependent variables: Knowledge of auto-rickshaw drivers.

· Extraneous variables: Personal characteristics which include age, education, residence, religion, marriage, income, type of family, years of driving experience consumed alcohol and source of information regarding ill effects of alcoholism.

Population:

The population of the present study comprises Auto-rickshaw drivers of Belgaum City, Karnataka.

Sample size:

Sample size of the present study consists of 60 samples of auto-rickshaw drivers.

Sampling technique:

Non–probability Convenient sampling was used to select the samples for the study.

Sampling criteria:

Inclusion criteria:

· Auto-rickshaw drivers willing to participate in the study.

· Auto-rickshaw drivers present during the period of data collection.

· Auto-rickshaw drivers above 18 years of age.

Exclusion criteria:

· Auto-rickshaw drivers who are presently receiving treatment for alcoholism.

· Auto-rickshaw drivers who are not willing to participate in the study.

· Auto-rickshaw drivers below18 years of age.

Description of the tool:

The tool consists of:

Section I: Socio-demographic data containing 10 items.

Section II: Consists of 30 items (multiple choice questions) on ill effects of alcoholism.

Classification of knowledge score was done as shown below:

· (X+SD) = Good knowledge Score

· (X+SD) to (X-SD) = Average knowledge Score

· (X-SD) = Poor knowledge Score

A score of ‘1’ was given to all correct answers while a score of ‘0’ was given to all incorrect answers.

Plan for Data Analysis:

The plan of analysis was as follows:

· Organization of data in a master sheet

· Tabulation of the data in terms of frequencies, percentage, to describe the data. Mean, median, mode, range and standard deviation computed for asses knowledge score.

Inferential statistics were used to draw the following conclusions:

· Paired ‘t’ test to evaluate the effectiveness of structured teaching programme on knowledge regarding ill effects of alcoholism.

· Chi-square (χ2) test was used to find out an association between knowledge scores and the selected demographic variables at 0.05 level of significance.

RESULTS:

Findings related to socio demographic variables.

Table no 1:Frequency and percentage distribution of auto-rickshaw drivers according to socio demographic variables. n = 60

S No.	Socio-demographic variables	Frequency (f)	Percentage (%)
1.	Age in years.
	a. Less than 20	6	10
	b. 20-30	25	41.6
	c. 31-40	14	23.4
	d. 41-50	6	10
	e. 51-60	7	11.6
	f. Above 60	2	3.4
2.	Residence
	a. Rural	03	5
	b. Urban	51	85
	c. Semi urban	06	10
3	Religion.
	a. Hindu.	35	58.3
	b. Muslim.	22	36.7
	c. Christian.	03	5
	d. Others.	00	00
4	Marital status
	a. Single	18	30
	b. Married	42	70
	c. Divorced	00	00
	d. Widower	00	00
5	Types of family
	a. Nuclear	13	21.7
	b. Joint	47	78.3
	c. Extended	00	00
6	Education
	a. Illiterate	04	6.7
	b. Primary School Education	26	43.3
	c. Secondary High School Education	24	40
	d. Graduation	06	10
7	Income monthly in rupees
	a. Below2500	00	00
	b. 25001-5000	38	63.3
	c. 5001-10000	22	36.7
	d. More than10000	00	00

Table no. 1 continued

S No.	Socio-demographic variables	Frequency (f)	Percentage (%)
8	Years of driving Autorickshaw
	a. 1-5yrs	10	16.7
	b. 6-10yrs	26	43.3
	c. 11-15yrs	18	30
	d. More than15yrs	06	10
9	Have you taken alcohol
	a. Yes	36	60
	b. No	24	40
10	Information about ill effects of alcoholism
	a. Yes	38	63.3
	b. No	22	36.7
	Source of information
	a. Health personal	18	30
	b. Media	07	11.6
	c. Neighbors	00	00
	d. Friends	10	16.6
	e. Parents	3	5

The data presented in Table 1 indicates that,

· Majority of the auto-rickshaw drivers 25(41.6%) belonged to the age group 20-30 years, and minority 2(3.4%) belonged to the age group of above 60 years.

· Majority of the auto-rickshaw drivers were staying in urban area 51(85%) and minority 3(5%) were living in rural area.

· Majority of the auto-rickshaw drivers 35(58.3%) were Hindus, 22(36.7%) were Muslims, while 3(5%) belonged to Christain religion, 0(0%) belonged to other category.

· Majority of the auto-rickshaw drivers 42(70%) were Married,18 (30%) were Single, while 00(0%) belonged to Divorced and Widower.

· Majority of the auto-rickshaw drivers 47(78.3%) were from Joint family and 13(21.7%) were from Nuclear family, while 00(0%) were from Extended family.

· Majority of the auto-rickshaw drivers 26(43.3%) were Primary school education, 24(40%) were Secondary high school education,6(10%) were did Graduation and minority 4(6.7%) were Illiterate.

· Majority of the auto-rickshaw drivers according to their income per month shows that 38(63.3%) of samples had 2500-5000 Rs and 22(36.7%) of samples had 5001-10000 Rs and 00(0%) had Below 2500 Rs and More than 10000 Rs.

· Majority of the auto-rickshaw drivers according to their Years of driving auto-rickshaw shows that 26(43.3%) of samples had 6-10 years, 18(30%) of sample 11-15years, remaining 10(16.7%) of sample had 1-5 years, and minority 6(10%) were more than 15 years.

· Majority of the auto-rickshaw drivers 36(60%) had taken alcohol and remaining 24(40%) of sample said No they have not taken alcohol .

· Majority of the auto-rickshaw drivers according to information about ill effects of alcoholism shows that 38(63.3%) of samples are belongs to Yes they have got the information and remaining 22(36.7%) were not got information.

· Majority of the auto-rickshaw drivers according to source of information about ill effects of alcoholism shows that 18(30%) of samples source of information was health personnel, 10(16.6%) of samples source of information friends, 7(11.6%) of sample source of information was media,3(5%) of sample source of information was parents and 00(0%) of samples source of information was neighbors.

SECTION II: Findings related to knowledge of auto-rickshaw drivers regarding ill effect of alcoholism.

Table 2: Mean, Median, Mode, Standard deviation and range of knowledge scores of auto-rickshaw drivers regarding ill effect of alcoholism. n=60

Area of Analysis	Mean	Median	Mode	Standard Deviation (SD)	Range
Pre test	10.06	10	8.8	3.2	12
Post test	21.05	21	20.09	3.4	12
Difference	10.09	11	12.1	0.2	00

Table 2: reveals that difference between pre-test score and post-test score showed that over all difference in between pre-test and post-test in Mean was 10.09, Median was 11, Mode was 12.1, Standard deviation was 0.2 and Range was 00.

3. Frequency (f) and Percentage (%) distribution of knowledge scores of auto-rickshaw drivers regarding ill effect of alcoholism. n=60

Knowledge Scores	Pre test			Post test
	Score range	f	%	Score range	f	%
Good(X+SD)	14-30	10	16.6	14-30	60	100
Average (X+SD to X-SD)	7-13	42	70	7-13	0	0
Poor(X-SD)	0-6	8	13.3	0-6	0	0

Table 3 reveals that in pre-test majority of auto-rickshaw drivers 42(70%) had average knowledge, 10(16.6%) had good knowledge and 8(13.3%) had poor knowledge. In the post-test 60 (100%) had good knowledge.

Table 4 Pre-test and post-test knowledge scores of auto-rickshaw drivers in items on ill effects of alcoholism. n=60

		Mean % of Knowledge scores of auto-rickshaw drivers.
Sl.No	Items No.	Total score	Pre-test (x)%	Post-test (y)%	Gain in Knowledge (y-x)%
1.	Ill effects of Alcoholism	1800	33.55%	70.16%	36.61%

Table 4: reveals that there was 36.61% gain in knowledge among auto-rickshaw drivers on knowledge regarding ill effects of alcoholism.

Figure 3 : Column graph representing gain in knowledge scores auto-rickshaw drivers regarding ill effects of alcoholism.

TESTING:

SECTION III: Testing of hypothesis for evaluation of effectiveness of structured teaching program for auto rickshaw drivers on knowledge regarding ill effect of alcoholism.

Table 5 : Mean difference (d), Standard error of difference (SED) and paired values of knowledge scores among auto-rickshaw drivers. n=60

Mean Difference (d)	Standard Error Difference (SED)	Paired ‘t’ test values
		Calculated	Tabulated value at 59 degrees of freedom
10.9	0.60	80.40*	1.96

*(P<0.05)

Table 5: reveals that calculated paired ‘t’ value (t=80.40) is greater than tabulated value(t= 1.96). Hence H1 is accepted. This indicates that the gain in knowledge score was statistically significant at P<0.05 level. Therefore structured teaching programme on ill effects of alcoholism is effective to improve the knowledge of the auto-rickshaw drivers.

Testing of Hypothesis

Association between the pre-test knowledge scores of auto- rickshaw drivers and demographic variables.

H2: There will be a significant association between pre-test knowledge scores and selected demographic variables at 0.05 level of significance.

Table :Association between pre-test knowledge score and selected demographic variables . n=60

Socio demographic variables

Good

Average

Poor

χ²

^{CAL. VAL}

χ²

^{TAB VAL}

Age in years.

a. Less than 20

b. 20-30

c. 31-40

d. 41-50

e. 51-60

f. Above 60

29.05*

18.30

Residence

a. Rural

b. Urban

c. Semi Urban

9.2

(NS)

9.48

Religion.

a. Hindu.

b. Muslim.

c. Christian.

d. Others.

3.84

(NS)

12.59

Marital Status

a. Single.

b. Married.

c. Divorced.

d. Widower.

11.20

(NS)

12.59

Types of family

a. Nuclear

b. Joint

c. Extended

3.20

(NS)

9.48

Education

a. Illiterate

b. Primary School Education

c. Secondary High School Education

d. Graduation

41.70*

12.59

Income monthly in rupees

a. Below 2500

b. 2501-5000

c. 5001-10000

d. More than 10000

2.98

(NS)

12.59

Years of driving autorickshaw

a. 1-5yrs

b. 6-10yrs

c. 11-15yrs

d. More than 15yrs

20.06*

12.59

Have you taken alcohol ?

a. Yes

b. No

0.49

(NS)

5.99

10.

Do you have any information about ill effects of alcoholism

b. Yes

c. No

0.82

(NS)

5.99

*=Significant association, NS=Non Significant association. df= degree of freedom.