A Study to Assess the Knowledge regarding Breathing Exercises among Post Covid-19 patients in Kerala with a view to Develop an Instructional Module
SharanKurian1, Sibi Achankunju1, Silpa Biju1, Sneha Marcel1, Sneha Priya E1, Jyothilakshmi J2
1Student, IVth Year BSc Nursing, Bishop Benziger College of Nursing, Kollam, Kerala, India.
2Assistant Professor, Department of Community Health Nursing,
Bishop Benziger College of Nursing, Kollam, Kerala, India.
*Corresponding Author Email: snehapriyasneha99@gmail.com
ABSTRACT:
The research work undertook was "A study to assess the knowledge regarding breathing exercises among post COVID-19 patients in Kerala with a view to develop an Instructional module”. The objective of the study was to: to assess the knowledge regarding breathing exercises among post COVID-19 patients in Kerala, to find out the association between knowledge regarding breathing exercises among post COVID-19 patients and selected demographic variables such as age in year, sex, type of family, area of residence, educational status, occupation, and source of information. A quantitative approach was used in the study. Convenient sampling technique was used. Sample consisted of 60 post COVID-19 patients in Kerala who are discharged from government or private hospitals in stable condition. The samples were selected based on inclusion and exclusion criteria. A total of 60 samples were selected based on convenient sampling technique and the knowledge among post COVID 19 patients is assessed by providing self-structured questionnaire through Google forms. The structured questionnaire was given to them for completion. The time given to complete the questionnaire was 30 minutes. The tool was found to be reliable. The study result shows that 30% of sample had poor knowledge, 58% had adequate knowledge, 7% had good knowledge and 5% had excellent knowledge regarding breathing exercises among post COVID-19 patients in Kerala and there was significant association between age in years, sex, type of family and source of information at 0.05 level of significance. Based on the findings the investigators have drawn implication which were of vital concerns in the field of nursing practice, nursing administration and nursing education for future development.
KEYWORDS: Assess, knowledge, breathing exercises, post COVID-19 patients.
INTRODUCTION:
The coronavirus that causes COVID-19 attacks the lungs and respiratory system, sometimes resulting in significant damage to the respiratory system. COVID-19 often leads to pneumonia and even acute respiratory distress syndrome, a severe lung injury.1
Recovering lung function is possible but can require therapy and exercises for months after the infection is treated.
Breathing exercise can strengthen the lungs and may be beneficial for reducing the impact of COVID-19 before, during and after its attack. COVID-19 affects the entire respiratory tract, further obstructing air flow. It can trigger asthma attack and cause acute respiratory distress syndrome. Deep breathing exercises that clear the lungs and strengthen the lung function may be especially beneficial for post COVID-19 patients.2 During recovery, breathing exercises work to strengthen the diaphragm a major respiratory muscle that located under the lungs. It can also help in improving lung capacity, bringing much needed oxygen into the blood stream. A systematic review and meta-analysis of 19 randomized controlled studies found that breathing technique reduce shortness of breath. Breathing exercises also improved lung ventilation, which is the ability of the lungs to expel carbon dioxide and unpleasant air.3
The two common symptoms that post-COVID-19 clients may report shortness of breath and fatigue. In some individuals Coughing and chest pain may also be present. Clients with difficulties may have a low exercise capacity preventing them from participating in vigorous and or longer-term cardiorespiratory exercises. Therefore there is a need for conducting the study regarding knowledge of breathing exercises among post COVID-19 patients.4
STATEMENT OF THE PROBLEM:
A study to assess the knowledge regarding breathing exercises among post COVID-19 patients in Kerala with a view to develop an instructional module.
OBJECTIVES:
· To assess the knowledge regarding breathing exercise among post COVID-19 patients in Kerala.
· To find out the association between pretest knowledge regarding breathing exercise among post COVID -19 patients and selected demographic variables.
· To develop an instructional module regarding breathing exercise among post COVID - 19 patients.
REVIEW OF LITERATURE:
1) Studies related to incidence and prevalence of post COVID-19 syndrome:
A retrospective cohort study was conducted in NHS hospitals in England, 2020 to assess the incidence and prevalence of post COVID-19 syndrome in individuals admitted to hospital with COVID-19. The objective of the study was to quantify rates of organ specific dysfunction in individuals with covid-19 after discharge from hospital compared with a matched control group from the general population. Total 47 780 individuals in hospital with covid-19 and discharged alive by 31 August 2020 were selected as the sample for the current study by using electronic health records. The study result showed that, rates of respiratory disease (P<0.001), diabetes (P<0.001), and cardiovascular disease (P<0.001) were significantly raised in patients with covid-19. Individuals discharged from hospital after covid-19 had increased rates of multiorgan dysfunction compared with the expected risk in the general population. The increase in risk was not confined to the elderly and was not uniform across ethnicities.5
2) Studies related to effectiveness of breathing exercise among post COVID-19 patients:
A prospective interventional study was conducted to assess the effectiveness of aerobic exercise training program on cardio-respiratory fitness and quality of life in patients recovered from COVID-19, 2020. Total 20 recruited patients were selected as the sample, who having below standard 6-min walk test and quality of life score at baseline. All the participants underwent five weeks (3sessions/week) of aerobic training (20–60 min/session) and breathing exercise training (10 min/session). The study result showed that, cardiorespiratory fitness, dyspnea and quality of life has been significantly improved after 5-weeks of training. An increase in exercise tolerance was observed in sub-group 1 (who did not used inpatient ventilator support) manifested by a longer 6-min walk distance 667.8 (35.32) m compared to sub-group 2 (who used inpatient ventilator support) 602.9 (46.1) m. Hence the study concluded that, rehabilitation training in COVID-19 recovered patients may benefit the recovery after COVID-19.6
3) Studies related to knowledge regarding breathing exercise among post COVID-19 patients:
A descriptive study was conducted to assess the knowledge regarding deep breathing exercises on respiratory function among asthmatic patients in Narayana medical college hospital, Nellore, Andhra Pradesh 2019. The aim of the study was to assess the knowledge regarding breathing exercise among asthmatic patients. Total 60 Asthmatic patients admitted in Narayana Medical College Hospital, Nellore were selected as the sample for the current study by using Non-probability convenience sampling technique method. A structured knowledge questionnaire method was used to collect data collection procedure. The study result showed that, regarding the level of knowledge on deep breathing exercises among asthmatic patients, 2(3.33%) had A+, 2(3.33%) had A, 6(10%) had B+, 24(40%) had B, 10(16.67%) had C, and 16(26.67%) had D grade. Regarding association, education, occupation and family income had significant association with level of knowledge at P< 0.05 level. The study concluded that majority of asthmatic patients, 24(40%), had moderate knowledge regarding deep breathing exercises.7
MATERIALS AND METHODS:
Descriptive research design was adopted for this study. The present study was conducted in Kerala. The researcher conducted the study through Google forms. The sample consisted of 60 post COVID- 19 patients in Kerala who have recovered from COVID-19 and residing in home with the inclusion criteria. Non probability convenient sampling technique was used in this study.
Tool:
The tool used for the present study is demographic proforma and structured knowledge questionnaire.
Data collection procedure:
Data collection was done through Google forms in areas of Kerala by using self-structured questionnaires based on the knowledge of breathing exercises among post COVID-19 patients who discharge from government or private hospitals in Kerala.
The data was collected for a period of 1 week from 09-06-2021 to 02-06-2021 after obtaining consent from the samples to participate in the study. The samples were selected based on inclusion and exclusion criteria. A total of 60 samples were selected based on convenient sampling technique and the knowledge among post COVID 19 patients is assessed by providing self-structured questionnaire through Google forms. The structured questionnaire was given to them for completion. The time given to complete the questionnaire was 30minutes.
Data Analysis:
The systematic organization and synthesis of research data is done by data analysis. Researchers will analyze the data by using descriptive and inferential statistics based on the objectives and assumptions of the study. Chi square test was used to find out the association between knowledge and selected demographic variable.
RESULTS:
Description of demographic variables:
This section deals with the sample characteristics under study. In present study the demographic data revealed that out of 60 samples majority, 53.3% were in the age group of 20-30 years, 26.7% were in the age group of 51-60 years, 11.7% were in the age group of 31-40, 8.3% were in the age group of 41-50 .70% of the sample were males and 30% were females. Most of the samples 73.3% were from nuclear family and 26.7% were from joint family. Regarding their area of residence, majority of 63.3% were rural and 36.7% were urban. Regarding their educational status 43.3% were under graduates 38.3% were graduate and 18.3% were post graduates. The data regarding occupation reveals that 63.3% were self-employees, 21.7% were private -employees, 15% were govt. employees. Majority of 48.3% get information from health care professionals, 20% had personal experience, 20% use health magazines and journals and 11.7% use other methods.
Description of knowledge regarding breathing exercises among post COVID -19 patients:
The present study revealed that out of 60 samples 30% sample had poor knowledge regarding breathing exercises, 58% had adequate knowledge, 7% had good knowledge and 5% had excellent knowledge.
Association between knowledge and demographic variables:
Association between knowledge score regarding breathing exercises and selected demographic variables such as age, sex, type of family, area of residence, educational status, occupation, source of information.
|
Sl.No |
Demographic Variables |
Knowledge |
df |
Chi-Square |
Significance |
||||
|
Poor |
Adequate |
Good |
Excellent |
|
|
|
|||
|
1. |
Age in year |
|
|
|
|
9 |
16.91 |
S |
|
|
20-30 |
7 |
20 |
3 |
2 |
|||||
|
31-40 |
4 |
2 |
1 |
0 |
|||||
|
41-50 |
2 |
2 |
0 |
1 |
|||||
|
51-60 |
5 |
11 |
0 |
0 |
|||||
|
2. |
Sex |
|
|
|
|
3
|
7.81
|
S
|
|
|
Male |
15 |
20 |
4 |
3 |
|||||
|
Female |
3 |
15 |
0 |
0 |
|||||
|
3.
|
Type of family |
|
|
|
|
3 |
7.81 |
S |
|
|
Nuclear |
12 |
23 |
1 |
1 |
|||||
|
Joint |
6 |
12 |
3 |
2 |
|||||
|
4. |
Area of residence |
|
|
|
|
3 |
7.81 |
NS |
|
|
Urban |
9 |
9 |
4 |
0 |
|||||
|
Rural |
9 |
26 |
0 |
3 |
|||||
|
5.
|
Educational status |
|
|
|
|
6 |
12.59 |
NS |
|
|
Under graduate |
9 |
17 |
0 |
1 |
|||||
|
Graduate |
6 |
12 |
3 |
2 |
|||||
|
Post graduate |
3 |
6 |
1 |
1 |
|||||
|
6.
|
Occupation |
|
|
|
|
6 |
12.59 |
NS |
|
|
Self-employee |
7 |
29 |
2 |
0 |
|||||
|
Private employee |
5 |
4 |
1 |
3 |
|||||
|
Government employee |
6 |
2 |
1 |
0 |
|||||
|
7. |
Source of information |
|
|
|
|
9
|
16.91
|
S
|
|
|
|
Personal experience |
3 |
8 |
1 |
0 |
||||
|
Health care professionals |
9 |
17 |
1 |
2 |
|||||
|
Magazines or journals |
2 |
8 |
1 |
1 |
|||||
|
Others |
4 |
2 |
1 |
0 |
|||||
The association was found out by using Chi square test. It was inferred that the present study showed significant association between knowledge and demographic variables such as age, sex and source of information (Calculated’ value was greater than table value at 0.05 level of significance) and no significant association between knowledge and demographic variables such as type of family, educational status, occupation and area of residence at 0.05 level of significance. (Calculated value was lesser than table value at 0.05 level of significance).
DISCUSSION:
The present study was conducted to evaluate the knowledge regarding breathing exercises among post COVID-19 patients in Kerala. In order to achieve the objectives of the study descriptive research was adopted. The subjects were selected by the convenient sampling technique. The sample consisted of 60 post covid-19 patients. The finding of the study has been discussed in relation to objectives and other similar studies. A prospective cohort study was conducted at Dhaka Medical College Hospital between June 01, 2020 and August 10, 2020. 355 patients were analyzed to assess the association between knowledge regarding breathing exercises and post COVID-19 patients and demographic variables. The results revealed that post COVID-19 patients have greater knowledge regarding breathing exercises and that the age, gender; education and area of residence were significantly associated with the knowledge level of 16.
CONCLUSION:
The present study was aimed to assess the knowledge regarding breathing exercises among post covid-19 patients in Kerala. A structured questionnaire on knowledge regarding breathing exercises was given to post covid-19 patients. The results showed that 5% sample had excellent knowledge, 7% had good knowledge 58% had adequate knowledge, 30% had poor knowledge regarding breathing exercises among post covid-19 patients.
The association between knowledge regarding breathing exercises among post COVID-19 patients and selected demographic variables was done by chi-square test. Only age in years, sex, educational status and source of information showed significant association with knowledge regarding breathing exercises, calculated value is greater than tabulated value at 0.05 level of significance, whereas type of family, area of residence and occupation showed no significant association with knowledge regarding breathing exercises among post COVID-19 patients.
RECOMMENDATIONS:
Based on the findings of this study, it is recommended that
· A similar kind of study can be conducted for a large group.
· A quasi experimental study can be conducted to assess the effectiveness of the video assisted teaching program on knowledge regarding breathing exercises among post COVID-19 patients.
· A study to assess the attitude and practice regarding breathing exercises among post COVID -19 patients selected community areas at Kerala.
REFERENCE:
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Received on 03.03.2022 Modified on 04.07.2022
Accepted on 02.09.2022 ©AandV Publications All right reserved
Asian J. Nursing Education and Research. 2023; 13(1):1-4.
DOI: 10.52711/2349-2996.2023.00001