Assess the Effectiveness of PPT on Nurses attitude regarding significance of antioxidants in AVMC Hospital, Puducherry

Samundeeswari Mourougan¹, Gothainayagi A.², Prof. G. Muthamilselvi³

¹Lecturer, Dept. of Pediatrics, Vinayaka Missions College of Nursing, Kiumampakkam, Puducherry.

²Lecturer, Dept. of Nutrition, Vinayaka Missions College of Nursing, Kiumampakkam, Puducherry

³Principal, Dept. of OBG, Vinayaka Missions College of Nursing, Kiumampakkam, Puducherry.

*Corresponding Author Email: samu_mourougan@yahoo.co.in, gothaikish@gmail.com, vmcon_principal@yahoo.in

ABSTRACT:

Antioxidants are scavengers of free radicals. Free radicals are easily generated by exposure to environment and normal physiological reactions. Free radicals may causes cellular damage that may leads to many diseases such as Alzheimer’s disease, cataract, aging, diabetic complications. Antioxidants had proven to reduce the risk of these many dreadful diseases. Nurses plays a major role in the health care delivery system, if nurses are having favorable attitude on significance of antioxidants they can educate the patient about foods rich in antioxidants. So, investigators assessed the attitude about significance of antioxidants among nurses and it was found that 70% of nurses had favorable attitude during their pretest. The attitude score was 26.88±12.84. After the power point presentation the score was 36.17±3.07. Investigators found that all nurses had favorable and most favorable attitude towards the significance of antioxidants and none of the nurses had unfavorable and most unfavorable attitude towards significance of antioxidants so the PowerPoint presentation (PPT) was effective

KEY WORDS: Antioxidants, Effectiveness, Attitude, Association, Power Point Presentation (PPT).

INTRODUCTION:

Antioxidants are substances that protect cell from the damage caused by unstable molecules known as free radicals (Nirmala Mary.J. et. al.,2012). A free radical is any atom that there is at least one unpaired electron in the outermost shell. (Gutteridge and Mitchell, 1999). These uncoupled electrons are very reactive with adjacent molecules present inside the cells such as lipids, proteins, and carbohydrates can cause cellular damage (Kuhn, 2003). Free radicals can also be produced by many cells as a protective mechanism. Neutrophils produce free radicals to attack and destroy pathogens, while the liver uses free radicals for detoxification (Lunec et al., 2002).

However, the presence of free radicals within the body can also have a significant role in the development and progression of many diseases like heart disease, congestive heart failure, hypertension, cerebrovascular accidents, and diabetic complications (Chen et al., 2002).

Antioxidants are substances capable of counteracting the damaging effects of free radicals in body tissues. Antioxidants are divided into two classes based on mechanism of action: (1) chain-breaking antioxidants, such as Vitamin E and C and β-carotene, ‘‘break the chain’’ of free radical formation by donating an electron to stabilize an existing free radical; and (2) preventive antioxidants are enzymes that scavenge initiating free radicals before they start an oxidation chain. (Kuhn, 2003; Goodyear-Bruch and Pierce, 2002)

Antioxidants are found both endogenous and exogenous in origin, that function interactively and synergistically to neutralize free radicals. These compounds include 1) Nutrient derived antioxidants - Vitamin C, Vitamin E, Carotenoids, and other low molecular weight compounds such as glutathione and lipoic acid. 2) Antioxidant enzymes -superoxide dismutase, glutathione peroxidase, and glutathione reductase, which catalyze free radical quenching reactions. 3) Metal binding proteins - such as ferritin, lactoferrin, albumin, and ceruloplasmin that sequester free iron and copper ions that are capable of catalyzing oxidative reactions (Jacob, R.A, 1995)

Dietary antioxidant nutrients such as Vitamin C, Vitamin E, Carotenoid may prevent many human disease caused by oxidative damage including aging, cataract, coronary heart diseases, cancer. The antioxidant enzymes – glutathione peroxidase, catalase, and superoxide dismutase found naturally in human body metabolize oxidative toxic intermediates and require micronutrient cofactors such as selenium, iron, copper, zinc, manganese for optimum activity. Inadequate dietary intake of these trace minerals compromise the effectiveness of these antioxidant defence mechanisms. Consumption and absorption of these nutrients had shown prevention in many degenerative diseases (Duthie, G. G., et al 1994).

NEED FOR THE STUDY:

Statistics had shown that about 81 million Americans have been diagnosed with some form of cardiovascular disease. Every year, there are 650,000 deaths attributed to this disease, 27 percent of all deaths. There are over 1.3 million new cases of cancer every year, and over 500,000 deaths. Arthritis, gout, lupus or fibromyalgia afflict over 46 million adults, two-thirds of them under the age of 65. By the year 2030, the numbers for arthritis sufferers alone are projected to climb up to 67 million Americans over the age of 18, reflecting 40 percent increase over current numbers. Almost 24 million people in America — 7.8 percent of the population — have diabetes. Over 5 million people in the United States currently have symptoms of Alzheimer's. This number is expected to increase by half a million every year as the baby-boomers become senior citizens. The leading cause of blindness in the United States, glaucoma affects 4 million Americans. Approximately 120,000 of these people have become blind from this disease. 10 percent of people between the ages of 66 and 74 have macular degeneration, 30 percent of the population from 75-85 years old. By counter acting these entire dreadful diseases Antioxidants plays a major role in preventing the risk of all these diseases (Dr. Lester Parker 2013).

Oxidative damage plays a huge role in many modern-day diseases, such as muscle and tissue degeneration, heart disease, diabetes, cancer, as well as many other health problems. People are exposed to free radicals as a normal bi-product of regular bodily processes, like breaking down glucose for energy, taking toxic medicines, as well as through exposure to pollutants. In addition, over-exposure to the sun (sunburn) and smoking can also increase body’s need to oxidize and create free-radicals. Antioxidants stop this cellular chain reaction of oxidation by neutralizing the free radicals (Dr. Edward F.2008).

The largest and most advanced analysis of the antioxidant content of common foods to date shows that disease-fighting antioxidants found in fruits and vegetables, such as beans, artichokes, and even the much-maligned Russet potato. Researchers found that small red beans contain more disease-fighting antioxidants than both wild and cultivated blueberries, which have been heralded in recent years for their high antioxidant content. In fact, three of the top five antioxidant-rich foods studied were beans. The study also shows that nuts and spices, such as ground cloves, cinnamon, and oregano, are rich in antioxidants, although they are generally consumed in much smaller amounts than fruits and vegetables (BrunildaNazario, MD 2004).

Vitamin C, Vitamin E and Beta carotene are among the most widely studied dietary antioxidants. Many plant derived substances collectively termed phytonutrients or phytochemicals are becoming increasingly known for their antioxidants activity (Dr. Mark Percival1998).

As a boon to health many studies about antioxidants like antioxidant supplementation in many degenerative diseases, identification of antioxidant compound and its activity in foods are done. Though numerous studies were done on antioxidants, still the knowledge and attitude about the antioxidants is unknown. This present study investigates about the attitude regarding significance of antioxidants among nurses and to enhance the knowledge and attitude about the significance of antioxidants through power point presentation. So that nurses can educate the patients regarding food rich in antioxidants it will help the patient to recover from their illness very soon and prevent many diseases.

OBJECTIVES:

1) To assess the nurses attitude towards significance of antioxidants

2) To assess the effectiveness of PPT on nurses attitude towards significance of antioxidants

3) To associate the nurses attitude towards significance of antioxidants with selected demographic variables

HYPOTHESES:

1) There was a significant difference between pre-test and post-test attitude score of nurses regarding antioxidants

2) There was a significant association between pre-test attitude scores of nurses regarding antioxidants with demographic variables

METHODOLOGY:

Research approach and Design: Quantitative approach with pre and post-test only design

Population: Nurses working in AVMC hospital, Puducherry.

Sampling technique: simple random sampling

Sample Size: forty

Tool: 5 point Likert scale was used for assessment of attitude.

Statistical Test: Descriptive and Inferential Statistics

RESULTS:

Frequency distribution of subjects by sample characteristics (n=40)

The study result revealed that majority of the samples were belongs to the age group of 21 – 30 years where as 4 samples were in the age group of 31 – 40 yrs. Highest number of samples (23) were diploma holders and undergraduates were only 12. Most of the samples (22) monthly income were Rs. 5000 – 10,000 and they were living in joint family system. The highest number of samples (31) were belongs to Hindu religion and they were residing in rural areas.

Figure 1: Assessment of attitude among Nurses

The data revealed that during the pretest 15% of nurses had most unfavorable attitude and 13% of nurses had un favourable attitude on significance of antioxidants where as 70% of nurses had favourable attitude. During the posttest the attitude of nurses for favourable was 88% and 12% of nurses had most favourable attitude on significance of antioxidants.

The table 1 shows the comparison of pretest and posttest level of attitude shows that attitude pretest, mean value and standard deviation was 26.88±12.84 and in the posttest the mean value and standard deviation was 36.17±3.07. Pretest and posttest mean percentage score shown the significant difference of 9.3% for attitude on significance of Antioxidants shows the effectiveness of PPT

Table 2: Effectiveness of PPT on nurses attitude regarding antioxidants

Sl. No	Variables	Table value	Calculated value	Degrees of freedom
1.	Attitude	1.684	4.53*	39

*Significant at 0.05 level of significance.

The study findings (Table 2) revealed that calculated value 4.53, is higher than the table value 1.684 and it was found significant at 0.05 level of significance difference between pre and posttest attitude regarding significance of antioxidants among nurses, so the hypotheses was accepted.

Table 3: Association between attitude and demographic variables

Sl. No	Demographic variables	Degrees of freedom	Table value	Calculated value
1.	Age	2	5.99	1.05
2.	Educational status	2	5.99	1.17
3.	Income	6	12.59	9.81
4.	Type of family	4	9.9	0.75
5.	Religion	2	5.99	1.07
6.	Residency	2	5.99	1.27

* Significant at 0.05 level of significance.

From the Table 3 it was revealed that there is no association between pretest attitude and demographic variables.

RECOMMENDATION:

· This study can be conducted for larger number of sample for easy generalization of the topic.

· This study can be conduct with the implementation of antioxidants supplementation for chronic illness patients.

· This study can be conduct among nursing student to enhance their knowledge level for their future care

CONCLUSION:

There is a common belief that Nurses are heart of the health care delivery system. Nurses can deliver warm tender loving care to the patient, if they are highly knowledgeable they can change the attitude of the patient regarding their diet and personal care so that patient can have good health and recover from the illness very soon. The current study found that nurses had favorable attitude about significance of antioxidants so that they will import the knowledge to the patients on antioxidants found in food to overcome from illness.

REFERENCES:

1. Gutteridge JMC, Mitchell J. Redox imbalance in the critically ill. Br Med Bull 1999; 55(1):49—75.

2. Kuhn MA. Oxygen free radicals and antioxidants. Am J Nurs 2003; 103(4):58—62.

3. Lunec J, Holloway KA, Cooke MS, Faux S, Griffiths HR, Evans MD. Urinary 8-OXO-2-deoxyguanosine: redox regulation of DNA repair in vivo? Free Radic Biol Med 2002; 33(7):875—85.

4. Chen J, He J, Hamm L, Vatuman V, Whelton PK. Serum antioxidant vitamins and blood pressure in the United States population. Hypertension 2002;40:810—6

5. Goodyear-Bruch C, Pierce JD. Oxidative stress in critically ill patients. Am J Crit Care 2002; 11:543—51.

6. Jacob, R.A. The Integrated Antioxidant System. Nutr Res 1995;155:755-766.

7. Duthie, G.G., and Brown, K.M. Reducing the Risk of Cardiovascular Disease, ch 2, p. 19-38,

8. In: Functional Foods, ed. Goldberg, I. Chapman and Hall: New York 1994.

9. Mark, P. Antioxidants. Clinical Nutrition Insights. 1998. Advanced Nutrition Publications. Inc.,

10. Heath D. Scheibmeir, Katie Christensen, Sally H. Whitaker, Jay Jegaethesan, Richard Clancy, Janet D. Pierce A review of free radicals and antioxidants for critical care nurses. Intensive and Critical Care Nursing (2005) 21, 24—28

11. Ambika Boodhu and Neela Badrie. An exploratory study of public awareness and knowledge of antioxidants in Trinidad, West Indies. Journal of Food, Agriculture and Environment Vol.5 (3and4) : 2 3 - 2 8 . 2 0 0 7

12. Dr. Asim Kumar Mukhopadhyay. Antioxidants Natural and Synthetic. Amani Intenational Publisers. Kiel 2006.

13. Ivone M.C. Almeida, Joã C.M. Barreira, M. Beatriz P.P. Oliveira, Isabel C.F.R. Ferreira. Dietary antioxidant supplements: Benefits of their combined use. Food and Chemical Toxicology 49 (2011) 3232–3237

14. Srilakshmi, B. (2008). Dietetics. New Age International (P) limited, publishers.

15. Venkatraman,S and Dandekar, S. (2011). Nutrition and Biochemistry. A division of Reed Elsevier private limited.

Received on 11.01.2014 Modified on 20.04.2014

Asian J. Nur. Edu. & Research 4(2): April- June 2014; Page 216-219

Sl. No	Variables	Pre Test			Post Test			Difference in Mean %
Sl. No	Variables	Mean	S.D	Mean %	Mean	S.D	Mean %	Difference in Mean %
1	Attitude	26.88	12.84	26.8	36.17	3.07	36.1	9.3