Effectiveness of Structured Teaching Programme Regarding Risk Factors and Prevention of Renal Failure Among Adults in Selected Hospitals at Bangalore, Karnataka.

Swapna Mary A¹, Dr. Maheswari Jaikumar²

¹Associate Professor, Medical Surgical Department, Sarvodaya College of Nursing, No. 11/2,A.D.Halli, MagadiMain Road, Bangalore – 560079

²Principal Meenakshi College of Nursing, Chikkarayapuram, Near Mangadu, Chennai – 600069

*Corresponding Author Email: swapnamarya@gmail.com

ABSTRACT:

Background: Chronic kidney disease is a global threat to health in general and for developing countries in particular, because therapy is expensive and lifelong. In India 90% of patients cannot afford the cost. Over one million people worldwide are alive on dialysis or with a functioning graft.Incidents of CKD have doubled in the last 15 years. Objective: To assess the existing knowledge regarding risk factors and prevention of renal failure among adults attending OPD. To determine the effectiveness of structured teaching programme regarding risk factors and prevention of renal failure among adults attending OPD. To find out the association between posttest knowledge regarding risk factors and prevention of renal failure with their selected demographic variable. Materials and Methods: The research design selected for the study was pre experimental one group pretest and posttest design. Sixty adults were selected through convenient sampling techniques. The study was conducted at Sarvodaya Hospitals at Bangalore. The instrument used for the study was self-structured knowledge questionnaire. Result: The result showed that there was a significant difference between pretest and posttest knowledge score and also revealed that there was significant association between knowledge and type of family.

Implications: The result of the study has shown various implications on nursing practice, nursing education, nursing administration and nursing research. Conclusion: Thus from this study one can conclude that STP could be an effective strategy to improve the knowledge of adult regarding risk factors and prevention of renal failure.

KEYWORDS: Effectiveness, structured teaching programme, risk factors, prevention, renal failure, adults.

INTRODUCTION:

Kidney diseases are silent killers which largely affect the quality of life. Chronic kidney disease, also known as chronic renal disease, is the progressive loss in renal function over a period of months or years. Chronic kidney disease is a widespread medical condition that is progressive in nature^1,2.

Risk factors for developing CKD differ between races and countries. It would be interesting to know the incidence of CKD and its causes in India, which is a densely populated country with low income, different food, cultural traditions and lifestyle habits. Patients with ESRD have to pay for dialysis and transplantation themselves. The currently reported incidence of CRF in India is based on explorated data from the US³.

In a population based study from Bhopal in Central India, have reported the average and age adjusted incidence rate of ERSD as 151 and 232 per million populations. In a community based study in Northern India, the prevalence of ESRD was reported to be 7852 per million populations. In India, there is a rise in the burden of chronic diseases like hypertension and diabetics. India has the largest number of diabetics in the world with a prevalence of 3.8% rural and 11.8% in urban adults. The prevalence of hypertension has been reported to range 40% in urban adults and 12.17% in rural adults, it is estimated that 25- 40% of these clients are likely to develop CKD with a significant percentage requiring renal replacement therapy^3,4.

OBJECTIVES OF THE STUDY:

1. To assess the existing knowledge regarding risk factors and prevention of renal failure among adults in selected Hospitals, Bangalore.

2. To determine the effectiveness of structured teaching programme regarding risk factors and prevention of renal failure among adults in selected Hospitals, Bangalore.

3. To determine the association between posttest knowledge regarding risk factors and prevention of renal failure among adults with their selected demographic variables.

Null Hypotheses:

Ho₁: There will be significant difference between the pre and posttest knowledge score regarding risk factors and prevention of renal failure among adults.

Ho₂: There will be significant association between the posttest knowledge scores and selected demographic variables of the subjects.

MATERIALS AND METHODS:

An evaluative research approach was adopted for this study. The research design selected was pre experimental – one group pretest and posttest design. The study was conducted in Sarvodaya Hospital, Bangalore, Karnataka. Sixty adults in the age group of 18-35 years were selected by using convenient sampling technique. Data collection was done after obtaining permission from the management and written consent from the subjects. Self-structured knowledge questionnaire was used to collect data on demographic data such as age, educational qualification, marital status, etc. and on knowledge regarding renal failure using 30 multiple choice questions. The reliability of the knowledge tool was assessed by split half technique and the reliability obtained was r^I = 0.97. The prepared tool was validated by different experts. The collected data was analyzed and organizedaccording to the objectives of the study using descriptive and inferential statistics.

Table 1:Frequency and percentage distribution of samples according to their personal characteristics n=60

Serial No.	Personal Characteristics	Categories	Frequency (f)	Percentage (%)
1	Age (Years)	18-25 26-30 31-35	15 34 11	25 56.66 18.33
2	Marital status	Married Single Divorced Widow	18 42 - -	30 70 - -
4	Educational status	Primary Secondary Graduate and above Illiterate	- 12 48 -	- 20 80 -
5	Occupation	Sedentary Moderate Heavy	3 48 9	5 80 15
6	Type of family	Nuclear Joint	8 52	13.34 86.66
7	Type of diet	Vegetarian Non-Vegetarian Mixed	10 6 44	16.66 10 73.33
8	Source of health Information	Personal experience Mass media Relatives and friends Health professional	- 31 18 11	- 51.66 30 18.33

Table 2: Mean, mean difference and `t’ value of pre and posttest knowledge scores n=60

Knowledge Assessment	Mean	Standard Deviation	Paired `t' Value
Pretest	8.66	0.85	67.04
Posttest	24.56	1.62	67.04

p<0.05 for 59 df

RESULT:

The collected data were analyzed and organized according to the objectives of the study using descriptive and inferential statistics.

The results revealed that majority of the adults were between the age group of 26- 30 years. Majority (70%) was unmarried and 80% of them had completed their graduation. 73.33% consumed non-vegetarian diet, 86.66% were belonging to joint families and they (51.66%) were getting health information mainly from mass medias only.

The pretest overall knowledge scores shows that all the samples 60 (100%) had inadequate knowledge. However in posttests, majority of them 52 (86.66%) had adequate level of knowledge and none were having inadequate level of knowledge. The significant difference suggests that STP was an effective strategy in improving the knowledge of adults. Except type of family, none of the demographic variables had association with posttest knowledge scores.

DISCUSSION:

It was observed that in the present study, the mean posttest knowledge score [24.56] was apparently higher than the mean pretest knowledge score [8.66]. The paired ‘t’test value computed to find out the difference between pre and post test score was statistically significant [p<0.05].

The present study showed that there was no significant association between the posttest knowledge regarding risk factors and prevention of renal failure with age, sex, marital status, educational status, occupation, type of diet and source of health information at p<0.05 level.

IMPLICATIONS:

Nursing Practice:

Education programs conducted by the nursing personnel, both in the hospital and community areas help in preventing and controlling renal failure. The nurse plays an important role in disease prevention and health promotion education programs with effective teaching strategies, which motivate people to follow healthy practices in day to day life.

Nursing education:

The nursing curriculum should consist of knowledge related to health information using different methods of teaching. Nursing students should be made aware of their roles in health promotion and disease prevention in the present and future year which may help in achieving the goal of health for all.

Nurses at post graduate level have to develop their skill in preparing health teaching materials according to the community’s level of understanding. Improved and newer techniques have to be used for motivating public participation in renal failure preventive education by conducting workshops and seminars.

Nursing Administration:

The nurse as an administrator should plan and organize educational programs for nursing personnel and motivate them in conducting prevention programs regarding renal failure, which will be beneficial to the public. She should also encourage and depute nurses to participate in such programs conducted by any other voluntary organizations.

Nursing Research:

There is a need of extensive and intensive research in this area so that strategies for educating nurse in preventing the secondary complications associated with prevention of renal failure can be developed. The nurse researcher should conduct research on various aspects of renal failure and its prevention, which provides more scientific data and adds more scientific body of information to the nursing profession.

CONCLUSION:

The study supports the concept that structured teaching Programme for adults were an effective strategy to improve knowledge on renal failure. Because the prevalence of renal failure increases with age, a working knowledge of the risk factors and prevention of the various types of renal failure is fundamental to the care of adults.

REFERENCES:

1. Priscilla L, Karen B. Medical Surgical Nursing, 4th Edition, Elsevier, India 2008, Page no. 1250-1300.

2. Joyce M. Black, Jane Hokanson Hawks. Medical surgical nursing, 7^th edition, Singapore. Elsevier publication 2012. Page no. 1055-1058.

3. www.worldkidneyday.org

4. Suzanne C. Smeltzer, Brenda G. Bare. Textbook of medical surgical nursing, 10^th edition, Philadelphia. Lippincott publication 2004.