Mr.
Ananthabadmanaban, B. Ashok
Lecturer, Department of Community Nursing, Angel College of Nursing, Khammam
Corresponding Author Email: anandabadmanaban@gmail.com
ABSTRACT:
Background: Globally
around 1.5 million symptomatic Hepatitis ‘A’ cases occur each year with likely
tens of millions of infections. Hepatitis A virus (HAV) is responsible
for considerable morbidity and economic losses to under developing countries
like India. Objectives: To assess the effectiveness of structured teaching programme of knowledge on prevention of Hepatitis A among
the adults. Design: A one group pre test
and post test Pre experimental design was adopted for the study. Setting: Thandalam village at Kanchipuram
District. Participants: 100 adults with fulfilling the inclusion criteria were
selected by convenient sampling. Methods: A pre test was conducted by using knowledge
questionnaire related to hepatitis A. Immediately after pre test structured
teaching programme was given to the adults about
prevention of hepatitis A for 7 days and
8th day post test was conducted to
assess the effectiveness of structured
teaching programme. Collected data was analysed by using descriptive and inferential statistics.
Results: In pre test, 67 (67%) had inadequate knowledge and 33 (33%) had
moderately adequate knowledge whereas in post test, 82(82%) adults had adequate
knowledge and 18(18%) had moderately adequate knowledge. By comparing pre test
and post test knowledge score, structured teaching programme
improved their knowledge on prevention of Hepatitis ‘A’ with statistical
significance P<0.05. There was a statistically no significant association
found between the post test scores of the sample with their demographic
variables. Conclusion: The findings imply the need for educating adults on
effective management of prevention of hepatitis A. An Education should be
extended to the urban slum adults also.
KEYWORDS: Effectiveness,
Structured teaching programe, Prevention of hepatitis
A, Adults.
INTRODUCTION:
The incidence of hepatitis A
is closely related to socio-economic conditions, and sero-epidemiological
studies show that prevalence of anti-hepatitis A
antibodies varies from 15% to close to 100% in different parts of the world. An
estimated 1.5 million clinical cases of hepatitis A occur worldwide each year.
The disease is endemic in many low-income countries where food and water
hygiene may be of a low standard, (WHO, 2010)1
Hepatitis A virus (HAV) infection in early childhood is mostly
asymptomatic or mildly symptomatic. In the absence of specific anti-viral
drugs, it requires only supportive management. The relative frequency of
symptomatic hepatitis and asymptomatic infection has been reasonably well
characterized and appears to be strikingly age dependent. With improvement in
socio-economic conditions and its consequences, early childhood exposure to the
virus has decreased. Hence, there has been a gradual shift in the age of
acquiring the infection from early childhood to adulthood in different parts of
the world.
Concomitantly, there was an
increase in symptomatic cases and in severe clinical outcomes including liver
failure. The social and economic burden of this morbidity and mortality led to
the development of several vaccines4. In 2005, encouraged by the
huge success of targeted vaccination, the US American Advisory Committee on
Immunization Practices recommended universal childhood HAV vaccination in all children
aged between 12-23 months in the United States3.
The peak age of seroprevalence is shifting from the 1st decade
of life to the 2nd and 3rd decades. This shift in age of
acquiring infection from childhood to older age groups is termed as epidemiological
shift5. In a country like India with an extensive variations and
heterogeneity in the determinants of acquiring anti-HAV antibodies, a unified
approach for vaccination would appear epidemiologically inappropriate. These
populations are likely to co-exist within same geographic areas, having diverse
economic and social classes.
This study evaluated knowledge
regarding transmission, clinical manifestations and prevention of viral
hepatitis in Puerto Rico2. We assessed the level of knowledge about
HAV (six questions), HBV (12 questions) and HCV (eight questions) among
non-institutionalized Puerto Rican adults aged 21–64 years. Demographic
characteristics and self-reported knowledge of these infections were determined
through a face-to-face interview. A mean knowledge score was computed by
summing correct responses to each scale. Mean knowledge scores according to
demographics were compared using ANOVA or the Kruskal–Wallis
test. Mean knowledge scores for HAV, HBV and HCV infections were 2.6 ± 1.5, 6.1
± 2.4, and 3.6 ± 1.1, respectively. For HAV and HBV infections, the mean
knowledge score significantly (P < 0.05) increased with age, level
of counseling received and number of sources of information. However, for HCV
infection the mean knowledge score significantly increased with decreasing age,
increased educational level and increased annual family income. Health
education must be focused on transmission and prevention methods, including the
availability of a vaccine for HAV and HBV.
STATEMENT OF THE PROBLEM:
Assess the effectiveness of structured
teaching programme on prevention of hepatitis ‘A’
among adults in Thandalam village at Kanchipuram
District.
OBJECTIVES:
·
To
assess the level of knowledge of the adults on prevention of hepatitis ‘A’
among adults
·
To
assess the effectiveness of structured teaching programme on prevention of hepatitis ‘A’ among
adults
RESEARCH HYPOTHESIS:
·
There
is significant difference between pre and post test knowledge scores of the
adults regarding prevention of hepatitis
A
·
There
is significant association between post test scores and selected demographic
variables
THEORETICAL FRAMEWORK
Imogene King’s goal attainment theory was selected
METHODOLOGY:
Research Approach: Evaluative Approach
Design : Pre Experimental Design (One Group Pre and
Post test only design)
Setting: Thandalam village at Kanchipuram District
Population:
Adults in the age group of 20 -40 years
Sample Size:
100 adults
Sampling Technique: Convenient Sampling Technique
Method of data collection
·
Structured
Interview Schedule to assess the knowledge
·
Structured Teaching Programme on
prevention of hepatitis ‘A’ for
teaching
Data collection Procedure
·
Pretest
was conducted by using structured Interview Schedule to assess the knowledge
·
Immediately
after pretest , Structured Teaching Programme was given to the adults about the on prevention
of hepatitis ‘A’
·
After
7 days, post test was conducted by using same structured Interview Schedule to
assess the knowledge
Validity and Reliability
·
Split
–half method was used to find the reliability of the Interview Schedule
·
Test –
Retest method was used to find out the reliability of the Structured
Teaching Programme
Plan for data analysis
Descriptive Statistics:
Percentage, Mean and Standard deviation
Inferential Statistics
: Paired ‘t’ test and Chi - Square test
FINDINGS:
The table 1 depicts that the
age group 26-30 years were more number of participants. In gender most of them
were males.30% of them still open field defecation. 13% of them were previously
affected by Hepatitis A (Refer Table:1)
Table:1 Section A: Frequency and percentage of samples according
to their demographic variables
|
S.NO |
DEMOGRAPHIC VARIABLES |
FREQUENCY |
PERCENTAGE |
|
1.
|
Age
In Years a)
20-25 years b)
26-30 years c)
31-35 years d)
36-40 years |
22 38 29 11 |
22% 38% 29% 11% |
|
2.
|
Sex a) Male b) Female |
66 34 |
66% 34% |
|
3.
|
Marital
Status a) Married b)
Unmarried c)
Widowed d) Divorced/Separated |
76 17 04 03 |
76% 17% 04% 03% |
|
4.
|
Level
of Education a)
Illiterate b)
Primary education c)
Higher education d) Graduate |
27 45 22 06 |
27% 45% 22% 06% |
|
5.
|
Occupation Status a) Self
Employed b) Government c) Private Employed d) Others |
31 40 07 22 |
31% 40% 07% 22% |
|
6.
|
Type Of Family a) Nuclear family b) Joint family |
52 48 |
52% 48% |
|
7.
|
Monthly Family Income a) Less
than Rs.3000 b)
Rs.3001-Rs.5000 c) Above Rs.5001 |
69 26 05 |
69% 26% 05% |
|
8.
|
Food
Habits a) Non-
vegetarian b)
Vegetarian |
15 85 |
15% 85% |
|
9.
|
Immunization
Satatus a) Immunized b) Non
Immunized |
13 87 |
13% 87% |
|
10. |
Methods Of Disposal Of Waste a) Dumping b) Incineration c)
Manure pit |
21 27 52 |
21% 27% 52% |
|
11. |
Facility For Human Excreta Disposal Is a) public
laterine b) Sanitary laterine c) Open
field defecation |
32 38 30 |
32% 38% 30% |
|
12. |
Source of Water Supply a) Tap Water b) Well Water c) Bore Water |
47 35 18 |
47% 35% 18% |
|
13. |
Habit of Alcohol Consumption a) No b) Yes 1) Less than 2 years 2) More than 2-5 years 3) More than 5-10year 4) More than 10 years |
64 36 12 14 08 02 |
64% 36% 12% 14% 08% 02% |
|
14. |
Previous History of Hepatitis A a) No b) Yes 1) Before 1- 8 months 2) Before 8-16 months 3) Before 16-24 months &
above |
87 13 01 05 07 |
87% 13% 01% 05% 07% |
Section B: Assess the level
of knowledge of the adults on prevention of hepatitis ‘A’ among adults
The data analyses showed that
among 100 adults, 67 (67%) had inadequate knowledge and 33 (33%) had moderately
adequate knowledge in the pre test whereas in post test, 82(82%) adults had
adequate knowledge and 18(18%) had moderately adequate knowledge.
Figure : 1
Bar diagram shows the pre and post test level of knowledge scores among adults
Section C
Area -wise mean post test knowledge score of adults found significantly higher
(24.48) than their mean pre test knowledge score (13.71) as evident from ‘t’ value (99) = 21.82 p < 0.05 level. This
suggested that the Structure Teaching Programme was
effective and it increased the knowledge of adults regarding hepatitis ‘A’.
CONCLUSION:
·
Prior
to implementation of Structure Teaching Programme,
the adults had inadequate knowledge on hepatitis ‘A’; the effectiveness was
evaluated by post test scores; the mean knowledge score had improved from 13.71
to 24.48 after implementation of Structure Teaching Programme.
It shows that STP was effective.
·
Highly
significant improvement was found
between pre and post test knowledge scores
·
No
significant association was found between post test knowledge scores and
demographic variables.
REFERENCES:
1.
World
Health Organization. The global prevalence of hepatitis A virus infection and
susceptibility: A systematic review. WHO/IVB/10.01, 2010
4.
Smith
BD, Patel N, Beckett GA, Jewett A, Ward JW. Hepatitis C virus antibody
prevalence, correlates and predictors among persons born from 1945 through
1965, United States, 1999–2008 [Abstract]. American Association for the Study
of Liver Disease, November 6, 2011. San Francisco, CA 2011
5.
Guyatt GH,
Oxman AD, Kunz R, et al. GRADE guidelines: 8. Rating the quality of evidence-indirectness. J Clin Epidemiol 2011;64: 1303–10.
Received on 19.08.2014 Modified on 24.09.2013
Accepted on 27.10.2014 © A&V Publication all right reserved
Asian J. Nur. Edu. and Research 5(1): Jan.-March
2015; Page 38-41
DOI: 10.5958/2349-2996.2015.00009.9