INTRODUCTION:

Today’s children are tomorrow’s citizen. The development of a country can be determined by estimating the health status of children in that country. Children are the major consumers of health care. Children always need special care to survive. Good health of children is given prime importance in all countries.¹

An accident is defined as “An unexpected unplanned occurrence which may involve injury”. Also accident is that “Occurrence of a sequence of events which usually produces unintended injury, death or damage to property”.²

Unintentional injuries are a leading cause of death among children and young adults. Over 8, 75,000 children less than or equal to 18 years of age die annually in the world as a result of injuries, mostly in low and middle income countries where injuries account for 13% of the total burden of morbidity among children less than or equal to 15 years of age according to a report from the United Nations children’s fund. From 2006 through 2010, the rate of death among children and youth ages 1 through 24 was 44 per 100,000 (492 deaths). Injury-related deaths were the leading causes of death (46.3% unintentional and 26% intentional).³

First Aid to the sick and the wounded has been practiced since ancient times. The famous German Surgeon general Esmarch (1823- 1908) is considered to have conceived the idea of ‘First Aid’. The term ‘First Aid’ was adopted officially in England for the first time in 1879 by the St. John Ambulance Association.⁴

An experimental study was conducted by Shobhamasih et al (2014) on knowledge and practice of primary school teachers on First Aid. In this study, the knowledge and practices post-test score of primary school teachers were significantly higher compare to pre-test knowledge and practice score about First Aid management of selected minor injuries. Similar studies from other parts of world also shows that teachers agreed that epistaxis, dental injuries and minor abrasion due to sports or playing is common in primary school children.⁵

NEED FOR THE STUDY:

Most of us don’t think about the value of First Aid until we need it. Many of its basic skills can be mastered without attending a formal training course. Medical emergencies are bound to happen, the best thing we can do is to be prepared and know about how to give First Aid.⁶

Globally about 16,000 people die of injuries every day and about 58 million people die every year. This corresponds to an annual mortality rate of 97.9 per 1, 00,000 population. Mortality due to injury is only the tip of ice berg as millions of people require hospital treatment for several days. According to WHO report 2010, injury accounts for 14% of total burden of diseases. In comparison to other diseases and health conditions, injury morbidity, mortality and disability account for disproportionate death among children and young adults. This leads to a major burden on health sector and social welfare services and its socio economic consequences for the cause as well as loss of productivity.⁷

As perWorld Health Organization (WHO) nearly 9,50,000 children die in the world due to injury every year. The National Crime Records Bureau reveals that nearly 15-20% of injury death occur among children. For every death nearly 30-40 children are hospitalized. It also reports that in 2009 about 22,766 deaths due to injuries among children occurred also 8.2% deaths and 20-25% hospitalization occur among children.⁸

According to the Registrar General of India the total accidental death in 2010was 2, 20,094 and the death rate was 23.62%.The data show 43% increase in total death and 19% increase in rate of death over 10 years. In Andhra Pradesh30,000 accidental deaths were reported in 2009 and the state’s percentage share to the country’s total accidental death and the rate were 6.5% and 36.5% respectively. In accidental deaths Andhra Pradesh has 14^th position in the country. In Karnataka about 1133 children up to the age of 14 is dying every year and it comprises of 5.5%of the total accidental death. In Bangalore about 99 reported accidental child death occurring every year and it is 3.9% of the total accidental deaths in the city. In 2007 All India accidental death rate was 30% whereas in Andhra Pradesh it is 39%.Unnatural accident rate in India was 36.3% whereas in Karnataka it is 43.2%.The unnatural accidents include road and rail accidents, poisoning, drowning, fire, falls, electrocution etc.⁸

One year data from Hyderabad shows that 209 children below the age of 18 years died and 5,505 children brought to the hospital with injury. Majority of the children belonged to average socio economic house hold and were studying in schools. Nearly one fourth of the total death in children was due to road traffic accidents. These were followed by burns with 17% and falls with 13%.Drowning and poisoning accounts for 6% and 5% respectively. It is estimated that Hyderabad witnesses an average of nearly 10,000 hospitalizations every year. Road traffic accidents were the leading cause of injury (40%).Falls are the second cause with 19% of injuries. Animal bites, Poisoning, Burns and Assault accounts for 11%, 10%, 9%, and 6% respectively.The number of injuries was the highest among the age group of 5-25 years (48%) and it was observed that about 9% of the injuries occur at school.⁸

Studies reveal that the first place to receive First Aid was nearby hospital in 92% of cases. Triage was commonly absent. Only 26% were brought to hospital within one hour and 13% reached hospital within three hours. Nearly half of the children brought to hospitals had moderate (45%) and severe (17%) injuries.50% of moderately injured children were discharged with disabilities.⁹

An Evaluative study was conducted by Margadham(2014)on ‘Evaluation of the knowledge of high school students and teachers in Silesia on the principles of First Aid’. The objective of the study was to evaluate the level of knowledge about First Aid among secondary school students and teachers. The sample consists of 227 secondary school students (34 males and 193 females) and 79 secondary school teachers (28 males and 51 females). The result showed that 7 of students achieved an excellent result, 57 a good result and 163 represented inadequate level of knowledge. None of teachers achieved an excellent result, 11 achieved a good result and 63 represented inadequate level of knowledge.¹⁰At the time of accidents, disasters, mass casualties etc. volunteer groups like National Cadet Corps has significant role in rescue services. The knowledge regarding First Aidin Minor Injuries to the physical and adventurous training to National Cadet Corps help them to play a major role in emergency management in adverse conditions where the medical professionals find difficulty to reach.

STATEMENT OF THE PROBLEM:

Effectiveness of Video Assisted Teaching onFirst Aid for Minor Injuries among National Cadet Corp Students, at a selected High School, Secunderabad, Telangana

OBJECTIVES OF THE STUDY:

1. To develop and validate Video Assisted Teaching on First Aid for Minor Injuries among National Cadet Corp (NCC) Students in a selected High School.

2. To assess the Knowledge on First Aid for Minor Injuries among NCC Students before and after Video Assisted Teaching.

3. To Evaluate the Effectiveness of Video Assisted Teaching on First Aid for Minor Injuries among NCC Students in a selected School, in terms of gain in Knowledge.

4. To find out the association between the post-test knowledge scores on First Aid for Minor Injuries among NCC Students of selected School with their demographic variables.

Hypotheses:

H1: There will be a significant increase ofpost-test knowledge scores on First Aid for Minor Injuries among NCC Students of a selected School, at 0.05 level of significance.

H2: There will be a significant association between the demographic variables and the post-test knowledge scores on First Aid for Minor Injuries among NCC Students in a selected School.

Assumptions:

The study assumes that

• The NCC Students may have some Knowledge onFirst Aid for Minor Injuries.

• The Video Assisted Teaching may increase the Knowledge of NCC Students on First Aid for Minor Injuries.

Delimitations:

The study is delimited to

· 50 NCC students who were studying in a selected School, Secunderabad.

· Who were available at the time of data collection.

· Who were willing to participate in the Study.

Conceptual Framework:

Conceptual framework adopted for the present study was based on Modified Ludwig VonBertalanffy’s General System Theory (1968).

REVIEW OF LITERATURE:

In order to accomplish the goal of the present study, the reviews have been organized under the following headings.

· Studies related to Minor Injuries.

· Studies related to First Aid.

· Studies on Effectiveness of educational interventions related to First Aid for Minor Injuries.

MATERIAL AND METHODS:

RESEARCH METHODOLOGY:

This study used an quantitative research approach, Quasi Experimental one group pre-test post -test design. On day one, a pre-test was given in the form of Structured Knowledge Questionnaire on demographic variables and Structured Knowledge Questionnaire on First Aid for Minor Injuries followed by administration of Video Assisted Teaching on First Aid for Minor Injuries and post-test was given to assess the gain in Knowledge by the same Structured Knowledge Questionnaire.The data collection was done from 17^thFebto 23^rd Feb, 2015. According to the criteria formulated by the researcher, 50 NCC Students were selected using simple random sampling technique, by lottery method from St. Mary’s High School, Secunderabad, Telangana.

Research Variables:

Independent Variable:

Independent variable in the present study is Video Assisted Teaching on First Aid for Minor Injuries for NCC Students in a selected School.

Dependent Variable:

Dependent variable in the present study is the Knowledge of NCC Students regarding First Aid for Minor Injuries.

Development and Description of the Tool:

Based on the extensive review of literature, discussion with the experts, investigators and with professional experience of the investigator structured tool and Video on First Aid for Minor Injuries was prepared.

Section A: Demographic data of the sample:

It consisted of ten questions dealing with the demographic variables such as Age, Gender, Religion, Education of mother, Education of father, occupation of mother, occupation of father, Monthly income, previous knowledge, Source of knowledge.

Section B: Structured Knowledge Questionnaire:

It consisted of 34multiple choice questions to assess the knowledge of NCC Students onFirst Aid for Minor Injuries.Each question had four options in that one was the right answer and the rest of three were wrong. The score for right answer was allotted “one” for the wrong answer “zero”.The minimum score was ‘0’ the maximum score was ‘1’ total score was 34

The level of knowledge was categorized based on the scores obtained by the samples in terms of percentage as:

· Inadequate knowledge < 33.3%

· Moderate knowledge 33.3% - 66.6%

· Adequate knowledge > 66.6

Content Validity of Tool:

In order to establish content validity of the tool, it was submitted to seven experts from the field of Child Health Nursing, Pediatrics and Statistics. The Tool was sent to them with a request to go through the tool and to give their valuable suggestions and expert opinions and to do the necessary modifications where ever necessary.Then, the Tool was modified as per the expert’s suggestions and opinions like addition of questionnaire like use of bandages, degree of burns and finally the tool was constructed.

Reliability of the Tool:

The tool was tried out on five NCC Students of Holy Family High School, Secunderabad and assessed the effectiveness of Video Assisted Teaching onFirst Aid for Minor Injuries. The time taken by the sample to complete the tool was about 25 minutes. The reliability of the tool was tested by Split half method using Spearman Brown formula. The “r” value obtained was 0.76which indicated that the tool was reliable.

Development of Video Assisted Teaching:

The content of Video Assisted Teaching on First Aid for Minor Injuries was gathered from extensive review of literature, First Aid text books, discussion with guides and experts in the field of Pediatrics,Child Health Nursing and researchers professional experience, content was organized under the following headings Introduction, Aims of First Aid, Minor Injuries, First Aid Kit, wound, hemorrhage, epistaxis, Burns, Fractures, Stings, Head Injury, Dental Injury, Eye Injury, Conclusion.

Validation of Video Assisted Teaching:

The VAT was submitted to seven experts from the field of ChildHealth Nursing, and Pediatrics for validation along with the tool. The experts were requested to validate in the following aspects like

· Adequacy of content

· Content organization

· Language used

· Presentation format

Plan for Data Analysis:

Both Descriptive and Inferential statistics were used to analyze the obtained data in order to achieve the results based on objectives of the study.

Ethical considerations:

Formal permission was obtained from the Administrative authority of Holy Family High School. Informed consent was obtained from the subjects orally and written form after explaining about purpose of the study and maintaining confidentiality of the collected data. No ethical issues were raised during the study.

FINDINGS:

Main findings are discussed under the following headings

Section- I Description of demographic variables of NCC Students:

The maximum percent (52%) of NCC Students was in the age group of 14- 15 years. Majority of NCC Students (66%) were boys. Most of the NCC Students were from Hindu background. Both the parents of the NCC Students (48%) were equally qualified. Majority of the mothers of NCC Students (60%)were qualified when compared to fathers. Majority of NCC Students of family income (32%) were between 10,000- 15,000 per month.Majority of NCC Students (94%) had basic information about First Aid for Minor Injuries before this study.Majority (40%)of the NCC students had information through book.

The table1depicts that there is an increase in the post-test score when compared to the pre-test score. In the pre-test score, 84% of the NCC Students had moderately adequate knowledge and 16%of the NCC Students had inadequate knowledge, none of the NCC Students had adequate knowledge. Majority (52%) of the NCC students had adequate knowledge, 48% of them had moderate knowledge, none of the NCC students had inadequate knowledge. This increase in post- test knowledge scores indicates that the VAT on First Aid for Minor Injuries was effective in increasing the knowledge of NCC Students.

Table 2 depicts the mean pre-test knowledge score of NCC Students on First Aid for Minor Injuries is 13.68 with a standard deviation of 3.34. The mean pre-test scores are lower than the mean post-test scores 22.08 with standard deviation 3.69. This indicates that there is increase in post- test knowledge scores. The increase of post- test knowledge score is due to effectiveness of teaching through VAT.

The difference between pre-test and post-test level of knowledge was found through paired ‘t’ test. It revealed that calculated value 15.76 was higher than tabulated ‘t’value 2.02. It shows that VAT was found to be effective at 0.05 level as there was significant increase in the level of knowledge on post-test. Hence research hypothesis (H₁) was accepted.

Section IV Association between levels of knowledge of NCC Students with their demographic variables.

Findings reveal that the association between knowledge and religion (X²= 4.86, df= 2), Education of mother (X²= 5.32, df= 3), Education of father (X²= 14.8, df= 3), occupation of mother (X²= 5.11, df= 3), were significantly associated at P< 0.05 level. However variables such as age (X²= 0.173, df= 2), gender (X²= 2.56, df= 1), occupation of father (X²= 1.98, df= 3), monthly income (X²= 2.84, df= 3), were not found to be significant. It was evident from the result that NCC students were influenced by religion, education of mother, education of father, occupation of mother.

Hence the research hypothesis (H₂) was accepted for association of knowledge with variables of religion, education of mother, education of father, occupation of

mother, and research hypothesis (H₂) was rejected for variables such as age, gender, occupation of father, and monthly income.

The chi-square analysis was carried out to determine the association between Knowledge scores on First Aid for Minor Injuries among NCC Students with

demographicvariables. The association between knowledge scores on First Aid for Minor Injuries among NCC Students with religion, education of mother, education of father, occupation of mother were significanly associated at p<0.05 level.

Hence the research hypotheses (H₂)was accepted for variables such as religion, education of mother, education of father, occupation of mother. However, variables such as age, gender, occupation of father, monthly income, were found to be not significant. Hence, the research hypothese (H₂₎was rejected for these variables such as age, gender, occupation of father, monthly income.

NURSING IMPLICATION:

The study implies that nurse educators have to be appropriately trained to impart well based teaching to the teachers, students so as to improve the Knowledge level in providing immediate First Aid in any emergency situation. Nurse administrators need to organize educational programs by using advanced technologies for the Nursing personnel and encourage them to conduct health programs which would be benefited to the students, teachers as well as community.

LIMITATIONS:

The study is limited to

· The sample size of present study was 50 hence generalization was not possible.

· Study results are confined to a selected school in Secunderabad, which will possibly decrease credibility of the study.

· The study did not use any control group which possibly will decrease credibility of the study.

· No attempt was made to control the extraneous variables hence the finding cannot be generalized.

· Only a single domain that is knowledge is measured in the present study. Hence, the findings cannot be generalized to other areas of domain such as attitude and practice.

· The tool used for the data collection was not standardized. It was designed by the investigator himself for the purpose of the present study based on the objectives of the study.

RECOMMENDATIONS:

On the basis of the study, certain suggestions are given for further studies.

· A similar study can be done on large population, with the intention that generalization might be possible to a larger population.

· A comparative study can be carried out between effectiveness of computer simulation and VATP.

· A Similar study can be under taken with a control group design.

· First Aid topic can be included in school curriculum.

· Similar study can be done on sports teachers to help them deal with any Minor Injuries in students.

· A study can be conducted by using exploratory design to know the effective teaching strategy on First Aid for Minor Injuries in school children.

CONCLUSION:

The findings of this study indicated the need for educating the self help group members about first aid practices. They must be motivated to adopt safety measures and practice first aid. There is a need of proper and regular educational programs to make awareness in the community about the importance of first aid practices. There is a need for health care personnel to take active part in education of the people regarding first aid.

REFERENCES:

1. UNICEF. The state of the world’s children; 2012. Available from: www. childinfo.org/.

2. Samant K. First aid manual accident and emergency.Vora Medical Publications; 1 sted. New Delhi: 2010.

3. Parker M C. Health Education for the preadolescent. Basic first aid, and Health. 2010;49(5):266-6.

4. Mohapatra R. First aid for you and me. Academic publishers;1st ed. Mumbai: 2009.

5. St. John’s ambulance association. First aid to the injured.St. John’s publications. 4thed. New York: 2013.

6. Shobhamasih,Princy john L. Management of Immediate Injuries. Nursing Journal of India. 2014; 224(1)

7. Bridhul N S. dangers of injuries and its ill effects. Health action.2012;6(4):200-5.

8. Yagan, Myanmar. Training of trainees in WHO (first aid action). World Health Organization. 2008[cited 2008 Dec 12]; 40(5):271-3.

9. Parker G Thomas. Introduction to first aid 2013 feb 28 [Cited 2012 Feb 28]. Available from http://www.healthguidance.org/1/introduction

10. Margadham S. Risk of injuries and first aid management. Nightingale Times. 2014;10(5)388-

Received on 12.02.2017 Modified on 16.05.2017

Asian J. Nur. Edu. and Research.2017; 7(4): 549-554.

DOI: 10.5958/2349-2996.2017.00107.0

Knowledge scores	Pre test		Post test
Knowledge scores	Frequency(f)	Percentage(%)	Frequency(f)	Percentage(%)
Inadequate (<33.3) Moderate33.3- 66.6%) Adequate(>66.6)	8 42 0	16 84 0	0 24 26	0 48 52
Total	50	100	50	100

Knowledge score	Mean	Standard deviation(SD)	Standard error	Paired ‘t’ value		df	Inference
				Cal Val	Tab val
Pre test	13.68	3.34	.472	15.76	2.02	49	S*
Post test	22.08	3.69	.522

Knowledge scores

Pre test

Post test