A Study to Assess the Effectiveness of Planned Teaching Programme on Knowledge regarding Dental Caries among School Students in Rural Areas of Anichakuppam, Puducherry

 

Mrs. Merlin Raja Kumari. S¹, Dr. Rebecca Samson², Ms. Sountharya³,

Ms. Sivasangari³, Ms. Suriyaprabha³, Ms. Susindra Devi³, Ms. Seventhi³, Ms. Shilpa Wilson³, Dr. Ravichandran³

¹Assistant Professor, College of Nursing, Pondicherry Institute of Medical Sciences, Puducherry, Pin – 605014, India

²Research Guide, Dean, and HOD- Dept. of. CHN, College of Nursing, PIMS, Puducherry, India

³Lecturer, Biostatistician, PIMS, Puducherry, India.

 

ABSTRACT:

Dental caries is considered to be major public health problem globally due to its prevalence and significant social impact. The WHO reports 60 -90% of school children worldwide have dental caries. For children in particular, poor oral health can have negative impacts on quality of life and academic performance at school. Objectives: To assess the existing knowledge of school students regarding dental caries. To determine the effectiveness of planned teaching programme on knowledge regarding dental caries among the school students. To find the association between the pre/post test knowledge scores with selected demographic variables. Setting: Selected schools in rural areas of Anichakuppam, Tamilnadu, India. Methods: Data was collected over a period of one week in February 2017. The researcher obtained formal permission from the Head Masters of selected schools of rural areas of Anichakuppam at Tamilnadu. The evaluative approach was used to conduct the study using one group pre test and post test research design. Purposive sampling technique was used to select the samples. The sample size was 46. Informed consent was obtained from the study participants. The data was collected using structured interview questionnaire. A planned teaching programme was conducted after assessing the knowledge by pre test. On 7^th day post test was done. The data gathered were analyzed employing descriptive and inferential statistics. Results: The present study assessed the knowledge of school students regarding dental caries found 39(84.8%) students had inadequate knowledge, 7(15.2%) students had moderately adequate knowledge in pre test and in the post test 13 (28.3%) had moderately adequate knowledge and 33 (71.7%) students had adequate knowledge on dental caries. It showed that there was a significant improvement in knowledge of school students after a planned teaching programme. Thus the investigator concluded that conducting planned teaching programme was found to be an effective, appropriate and feasible mode to develop knowledge of school students about dental caries.

 

 

 

INTRODUCTION:

Oral health is multifaceted and includes the ability to speak, smile, taste, touch, chew, swallow and convey a range of emotions through facial expressions with confidence and without pain, discomfort and disease of the craniofacial complex.⁽¹⁾. The oral health of children 12 years old is the object of several epidemiological studies conducted around the world. According to the World Health Organization, the importance given to this age group is due to the fact that it is this age that children leave primary school. Thus the age of 12 was determined as the age of global monitoring of caries for international comparisons and monitoring of disease trends.⁽²⁾

 

Children are the future of every country and all societies strive to ensure their health in all aspects. Our country is home to nearly 500 million young people among whom children less than 15 years are around 370 million. Since India’s independence continuous efforts have been made to improve the status of children.⁽³⁾ Dental caries is one of the most common conditions affecting the general health of children. Healthy teeth and the need for oral health care are important for any section of society. Dental caries remains the most prevalent chronic disease in both children and adults. The effects of dental caries on growth and physical, social/emotional and cognitive development have implications on success and productivity throughout life span.⁽⁴⁾

 

Dental caries is a global disease with few populations exempt from its effects. In developing countries, development increases so does dental caries and children are at the forefront of the disease disadvantage^.(5). Although dental caries prevalence in developed countries has declined over the past decades, the goals of reducing dental caries are still unmet for a significant proportion of the World’s population⁽⁶⁾ In children from less developed countries, the prevalence of caries in deciduous teeth was found to be traditionally high in comparison to that of the children of same ages in developed countries and it is either similar or frequently higher⁽⁷⁾

 

Prevention of dental caries aims to keep the primary and permanent dentition free from disease and to reduce the risk of the child experiencing pain or sepsis or acquiring treatment induced dental anxiety if dental caries does occur. As every child is at risk of developing caries, preventive intervention is required for children⁽⁸⁾.

 

Hence the study was conducted to assess the effectiveness of planned teaching programme to the school students regarding dental caries.

 

OBJECTIVES:

1. To assess the existing knowledge of school students regarding dental caries.

2. To determine the effectiveness of planned teaching programme on knowledge for school students regarding dental caries.

3. To find the association between the pre/post test knowledge scores with selected demographic variables.

 

MATERIAL AND METHODS:

·       Research Approach: Evaluative research approach.

·       Research Design: Quasi Experimental one group pre-test post –test research design.

·       Setting of the Study: Selected schools in rural areas of Anichakuppam, Tamilnadu.

·       Population :School students studying in rural areas of Anichakuppam,Tamilnadu.

·       Sample: Students studying in selected high schools.

·       Sample size: 46 students.

·       Sampling technique: convenience sampling technique.

 

SAMPLING CRITERIA:

Inclusion criteria:

·       Students studying from 7^th – 9^th standard.

·       Both male and female students.

·       Available during the period of study.

·       Only students who are willing to participate in the study.

 

Exclusion criteria:

Students who are mentally ill.

 

Development and Description of the Tool:

After an extensive review of literature and discussion with the experts, A structured knowledge questionnaire and a planned teaching module was prepared to assess the level of knowledge of high school students on dental caries. The questionnaire was divided into two sections. “A” and “B”.

 

Section A: It contains demographic questions on variables which include age (in years), gender, education of the parents, religion, type of family and previous exposure to dental caries.

 

Section B: It consists of 23 multiple – choice questions to assess the knowledge before and after the planned teaching programme. Questions based on dental caries and its meaning, causes, signs and symptoms, treatment, preventive measures and complications that helped to assess their knowledge.

 

Scoring Interpretation:

·       Adequate (>75% of score)

·       Moderately favorable (50-74% of score)

·       Inadequate (<49% of score)

 

Validity of the Tool:

The tool was validated by 3 experts including 1 Dentist and 2 Nursing faculty. The suggestions and minor corrections recommended by the experts were incorporated in the final preparation of demographic and knowledge questionnaire.

 

ETHICAL CONSIDERATION:

The proposed study was conducted after the approval of Institutional Review Board and the researchers got permission from the Director Principal, HOD of Community Medicine Department, Medical Officer from Anichakuppam Health Centre, and Head Master of selected high schools in rural areas of Anichakuppam. Written consent was obtained from the samples to participate in the study. Reassurance and confidentiality was maintained throughout the study.

 

PILOT STUDY:

The pilot study was conducted in February 2017 at Saminatha Vidhyalaya School at Anichakuppam, Tamilnadu. After obtaining the permission pilot study was done among 5 students. Anonymity and confidentiality were maintained while collecting information. Planned teaching was given to the students by using the planned teaching module duration of the teaching was 45 minutes. Post test was carried out after a period of one week. The investigators did not find any difficulty during the pilot study. The study was found to be feasible and practical.

 

RELIABILITY OF THE TOOL:

The tool after validation was subjected to test for its reliability. The results was established using test re test method and it was found that the tool is reliable. (r =0.7)

 

DATA COLLECTION PROCESS:

The study was carried out during the month of February 2017 with 46 school students of rural area of Anichakuppam. Samples were selected using convenience sampling technique. Self introduction was given by the investigator, the purpose of the study was explained to the subjects, assuring confidentiality of findings. Written consent was obtained from the samples to participate in the study. Pre- test was conducted by self administering questionnaire. The planned teaching was given to the students by using the planned teaching module. Duration of the teaching was 45 minutes. Post – test was conducted with the same tool after seven days. After the data obtained from the study participants it was compiled for the data analysis.

 

DATA ANALYSIS:

·       Frequency, Mean and Standard Deviation was used to describe the Socio demographic variables and level of knowledge of school students.

 

·       Wilcoxon signed rank test was used to assess the effectiveness of planned teaching programme on knowledge regarding dental caries.

·       Fishers exact test to study the association between pre- test and post-test knowledge scores and selected demographic variables of school students.

 

MAJOR FINDINGS OF THE STUDY AND DISCUSSION:

The data obtained has been analyzed and presented under the following headings

·         Section-A:

Description of Demographic variables of school students.

·         Section-B:

Description of existing knowledge of the school students regarding dental caries.

·         Section-C:

Association between pre and post test knowledge with selected socio demographic variables of school students.

 

Section-A: Description of Demographic variables of school students:

Distribution of age of school students, most of the participants were 24(52.2%) in the age group of 13 years and 12(26.1%) participants were 14 and above years. Based on gender 28(60.9%) participants were Male and 18(39.1%) were Female. Samples based on educational status most of them were 22(47.8%) 8^th standard, 13(28.3%) were 7^th standard, and 11(23.9%) were 9^th standard. Based on type of family 16(34.8%) participants belongs to joint family and 30(65.2%) participants belongs to Nuclear family. Based on religion 38(82.6%) participants were Hindu and 2(4.3%) participants were Muslim. Based on visit of dentist 18(39.1%) participants never visited and 3(6.5%) participants visited twice in a year.

 

Section-B: Description of existing knowledge of the school students regarding dental caries:

Out of 46 samples, majority of the students 84.8% had Inadequate knowledge, 15.2% had moderately adequate knowledge in pre test. In post test most of the students 71.7% had adequate knowledge, and 28.3% had moderately adequate knowledge on dental caries.

 

Table 1: Frequency and Percentage distribution of pre test and post test knowledge level regarding dental caries among school students. n = 46

Level of knowledge	Pretest		Post test
	No	(%)	No.	(%)
Inadequate (<50%)	39	84.8	0	0
Moderately Adequate (51-74%)	7	15.2	13	28.3
Adequate (75-100%)	0	0	33	71.7
Total	40	100	46	100

 

 

Table 2: Association between pre test knowledge level with selected demographic variables of school students. n = 46

Demographic Variables		Level of knowledge				p-value
		In adequate		Moderately adequate
		N	%	N	%
1	Age a. 11 b. 12 c. 13 d. 14 and above	0 6 21 12	0 15.4 53.8 30.8	0 4 3 0	0 57.1 42.9 0	0.035 S
2	Gender a. Male b. Female	24 15	61.5 38.5	4 3	57.1 42.9	0.570 NS
3	Educational Status a. 7th std b. 8th std c. 9th std	8 20 11	20.5 51.3 28.2	5 2 0	71.4 28.6 0	0.021 S
4	Have you ever visited dentist. a. once in a year b. Twice in a year c. never d. No need.	7 3 15 14	17.9 07.7 38.5 35.9	3 0 3 1	42.9 0 42.9 14.2	0.468 NS

NS – Not significant (p>0.05) S- Significant (p<0.05) Fisher’s Exact test

 

The above table showed that there was statistically significant association between pre test knowledge level and selected demographic variables such as age and educational status of school students. There was no significant association between pre test knowledge level and selected demographic variables such as gender, visit of dentist.

 

IMPLICATIONS:

The findings of the study have implication in the following areas of the Nursing profession. It is explained in the following headings like Nursing practice, Nursing Education, Nursing administration and Nursing research.

 

Nursing Practice:

·       Nurses play an important role in providing adequate knowledge to the high school students about different aspects of dental caries.

·       The school health nurse should periodically organize special training programme for the school students which will help them to prevent from caries.

 

Nursing Education:

·       The nurses can organize and conduct teaching programme for school students in order to enhance their knowledge and keep them aware of dental problems, which occurs mostly in schools students. So that they themselves will be able to take care.

·       The nursing students should be made aware of their role in school health programme in present and future years which will help them to improve the dental health of school children.

 

Nursing Administration:

·       The findings of the study help Nurse administrator for decision making, policy and protocol formulation regarding dental caries in school children so that dental caries can be prevented.

 

Nursing Research:

·       Findings of the study suggests that educators and researchers should encourage nurses to read, discuss an conduct research studies. So as to enable the nurses to make data based decision rather than intuitive decisions.

 

RECOMMENDATIONS:

On the basis of study findings, the following recommendations were made for further research.

·       The study can be conducted on larger samples.

·       A comparative study can be done between rural and urban school students.

 

CONCLUSION:

The findings revealed that there was a significant improvement in knowledge of school students after a planned teaching programme. Thus the investigator concluded that conducting planned teaching programme was found to be an effective, appropriate and feasible mode to develop knowledge of school students about dental caries.

 

REFERENCES:

1.      FDI Dental Federation, 2016, http://www.ada.org/en/publication/ada-new/2016.

2.      World Health Organization, Oral Health Surveys, Basic methods. 4^th ed, Geneva, Switzerland: WHO 1997.

3.      World Health Statistics Reports 2009, Geneva, WHO,2009

4.      Sheiham, A. Dental Caries affects body weight, growth and quality of life in pre-school children, online Saudi dent.J.Nov.2012.

5.      Madhumati Chatterjee, Arup Ratan Bandyopadhyay, A study on Nutitional status and dental caries in permanent Teeth among school going girl of Bengalee population, India, Advances in Anthropology 2012. Vol.2, No.3, 112-116.

6.      Petersen PE, Bourgeois D, Ogawa H, Estupinan – Day S, Ndiaye C (2005). The global burden of oral diseases and risks to oral health. Bull World Health Orgganization 83:661-669.

7.      Russell, A. L, Leatherwood, E.C., Van Hien, L., and Van Reen, R. Dental caries and nutrition in south Vietnam. Journal of Dental Research, (1966).44,102-111.

8.      Dental caries guidance, 2010.http://www.sdcep.org.uk.

 

Received on 12.08.2019         Modified on 05.09.2019

Accepted on 17.09.2019      ©A&V Publications All right reserved