INTRODUCTION:

A miracle to believe – whole creations of universe has evolved from a small atom, like that from the basic unit of life, the cell from which the life evolved, these are the stem cells or the master cells. The umbilical cord is a rich source of stem cells that can be derived from cord blood and cord tissue and can treat more than 80 diseases now and still increasing or under research¹.

In India, only nine transplants are done per10 million population. Cord blood can be used to treat oncologic, genetic, hematologic and immunodeficiency disorders⁴. Umbilical Cord Blood (UCB) is the blood remaining in the umbilical cord and placenta, following birth of the baby.

The amount of blood in the umbilical cord is about 75 ml, and also it is used for getting umbilical cord tissue for the procuring mesenchymal cells which can transform into many different kinds of cells including organ, muscle, bone and cartilage cells. Cord blood banking includes the collection, processing and storage of umbilical cord blood for any future needs that are related to the family or others. There are two types of cord blood banks which are for every individual. Today there are over 40 cord blood banks worldwide, both public and private.

a) Public banks- collect donated cord blood for research or for use by anyone who may need it and no charge is associated with this service.

b) Private banks- store cord blood for personal use by the family. There is fee associated with this service².

The stem cells derived from the cord blood are called hematopoietic stem cells. The first umbilical cord blood transplantation [UCBT] was performed in 1988 in patient with Fanconi’s anemia¹. The incidence of transplantation is still increasing steadily. Hence, the umbilical cord of your baby is a treasure of life saving stem cells for life.

STATEMENT OF THE PROBLEM:

A study to assess the knowledge among student nurses regarding umbilical cord stem cell banking in selected nursing colleges of Kerala in a view to develop self instruction module.

OBJECTIVES:

The objectives of the study were,

· To assess the knowledge level about umbilical cord stem cell banking among student nurses.

· To compare the knowledge level of student nurses from selected colleges.

· To associate the knowledge score of cord blood banking and selected demographic variables.

Hypothesis:

H1: There will be a significant difference between the knowledge of students in different colleges.

H2: There will be a significant association between pre test knowledge scores of student regarding umbilical cord stem cell banking with their selected demographic variables.

Research approach:

A quantitative research approach was adopted.

Research design:

Non experimental descriptive research design.

Variables:

Demographic variables include age, socio- economic background, religion, type of family, source of information

Setting:

The study was conducted in selected nursing colleges in Kerala. Three nursing colleges affiliated to same university from same district were selected. Each college had an intake of 50 students per year.

Population:

Student nurses of selected Nursing Colleges in Kerala.

Sample:

100 student nurses of selected Nursing College in Kerala.

Sampling technique:

Purposive sampling technique was used. After obtaining permission from authorities of selected nursing colleges 100 samples were taken according to the availability and on the basis of inclusion and exclusion criteria to assess the knowledge about umbilical cord stem cell banking.

Description of the data collection instrument:

A self-prepared tool was adopted for assessing the knowledge level after validating and checking reliability with correlation coefficient of r = 0.78.

The tools consist of

Section –A: consist of age, socio economic background, religion, type of family, source of information.

Section –B: It consists of a self-preparedstructured questionnaire with 40 questions and of four options to assess knowledge of student nurses regarding umbilical cord stem cell banking. Correct answer gives 1 mark and a total score of 40. The samples were categorized into excellent, good, moderate and poor.

Pilot study:

Pilot study was conducted among 20 student nurses from one of the Nursing College other than which was selected for the main study.

Data collection process:

A Formal written administrative permission was obtained from the authorities of selected nursing colleges to conduct the study. The samples were selected based on inclusion and exclusion criteria. Knowledge level was assessed about umbilical cord stem cell banking using the self prepared questionnaire. The time allotted for answering the questions was 20 minutes. After assessing the knowledge level self instruction module was prepared and provided to them later.

RESULTS:

The collected data was tabulated and analyzed using descriptive and inferential statistics. Frequency and percentage was used to analysis the descriptive data and the knowledge score.

Assessment of demographic variables of the study.

Table -1 Frequency and percentage distribution of student nurses according to their demographic variables.(N=100)

Si. No

Demographic variable

Frequency

Percentage (%)

Age in year

≤21 years

≥22years

75%

25%

Socio economic background

High class

Middle class

Low class

93%

Religion

Christian

Hindu

Muslim

79%

19%

Type of family

Joint family

Nuclear family

96%

Source of information

Internet

Class

Journals

Internet, classes

Journals, classes

Internet, classes, journals

others

81%

The table 1 shows the result of the demographic data most of the samples (75%) belongs to the age group of 21 years or less, from middle class family (93%) and were Christians (79%). While considering type of family they were from nuclear family (96%) and majority (81%) gained information from classes.

Assessment of knowledge among student nurses

Figure – 1: percentage distribution of student nurses based on knowledge regarding umbilical cord stem cell banking in various settings.

Figure 2- Frequency distribution of student nurses based on knowledge score regarding umbilical cord stem cell banking.

Comparison of knowledge among selected settings using mean percentage.

Table -2 showing comparison of knowledge among selected settingsN=100

Settings	Setting -I	Setting -II	Setting -III
Mean value	11.6	11	13.7
Mean percentage	3.33	2.77	2.93

Association of knowledge score and demographic variables:

There were no significant association between knowledge score and selected demographic variables like age, socio-economic background, religion, type of family and source of information at 0.05 level of significance.

DISCUSSION:

The finding of the study showed that 23% of students had poor knowledge, 76% had average knowledge and only 1% had good knowledge about the umbilical cord stem cell banking. There was a study done among obstetricians to assess their levels of awareness and understanding about umbilical cord blood donation in that 80% of affiliated obstetricians feel confident discussing cord blood options with their patients, and only 49% obstetricians have insufficient knowledge of cord blood donation to effectively answer patient’s questions about donations⁹. There was a disparity with the study findings it can be because of the different category of health care professionals. Another study was conducted to assess pregnant women’s awareness of cord blood stem cells and their attitude regarding banking options. Result showed that, total of 79% of pregnant women has little awareness of stem cell banking 59%of women had heard of the therapeutic benefits of cord blood, of which 21%received information from midwives and obstetricians, 89% of respondents would opt to store CBU’s to a public bank in all five countries.¹²

In this comparison of knowledge between the settings it was found that mean percentage was 3.33, 2.77 and 2.93 between the settings respectively. These changes may be a reason related to the experience and exposure during the training period. After analysis of association between knowledge about cord blood banking and demographic variables, there was no significant associations. Also the researchers felt that these areas are the new blooming sections of the medical field more researchers and education is needed to propagate about the umbilical cord stem cells banking.

After the analysis a booklet was prepared based on the study findings in that it contains information about umbilical cord stem cell banking. Self instruction module will help the student nurses to clear the doubts of needed people by giving them a good health education regarding umbilical cord stem cell banking also help in acquiring the knowledge.

RECOMMENDATION:

· A similar study can be undertaken with a large sample to generalize the findings.

· The study can be conducted by doing pre test and post test after giving a structured teaching program.

· Similar study can be conducted in staff nurses and nurse educators.

· A similar study can be carried out to finding the knowledge of other members in the society regarding umbilical cord stem cell banking.

CONCLUSION:

Based on the study to assess the knowledge among student nurses regarding umbilical cord stem cell banking, the following conclusions were drawn.

· Only 1% of students had good knowledge, 76% had moderate knowledge and 23% had poor knowledge about umbilical cord stem cell banking.

· There was no association between demographic variables and knowledge.

· From the comparison between three settings, setting -3 had good knowledge when compare to other two settings based on the mean score and mean percentage.

REFERENCE:

1. URL: http:///www.eurocord.ed.org assessed on 07/07/2016.

2. Kaimal A. J., et al, Cost effectiveness of private umbilical cord blood banking. 2012; 114(4): pg.848-855.

3. Ballen K; et al. Current status of cord blood banking and transplantation in the Unites States and Europe. Biology of Blood and Marrow Transplantation.2010; 7(12): 635-645.

4. Malhothra Jayden, Garg Ruchika, Cord Blood Banking: Where are we? Journal of South Asian Federation of Obstetrics and Gynecology. September –December 2015; 7(3): 103-105.

5. Manorama Arogya Magazine. January 2016; pg. 14-18.

6. Statistical analysis of 4000 umbilical cord blood units preserved in Shandong cord blood bank. Pain J. 2002 June; 10(3): 257-260, available from: URL: www.ncbi.nlm.nih.gov/pubmed/9828244.

7. What are stem cells? Medical News Today. Available from: URL:http://www.medicalnewstoday.com/info/stem_cell/

8. Better stem cell therapy. Available from URL:http://www.celltherapyprogram.com

9. Mc Kernna D et al. Umbilical cord blood; current status and promise for the future. Indian J Med Res. Sep 2011; 261-269

10. Rubinstein P, Outcomes among 562 recipients of placental-blood transplants from unrelated donors, 1998 May2; 128(18):689-695; available from: URL:www.ncbi.nih.gov/pub med/9828244.

11. Cepulic et al; Acta Med Croatia; cord blood banking; June 2009; 63(3): 245-250

12. Alelenhoven et al, Med Tigdschr Geneeskol, umbilical cord blood from an unrelated donor as source for stem cell transplantation in inborn errors of metabolism. Aug 2008; 152(3): 1719-1724.

Received on 27.10.2016 Modified on 11.01.2017

Asian J. Nur. Edu. and Research.2017; 7(4): 505-508.

DOI:10.5958/2349-2996.2017.00099.4