Effectiveness of Structured Teaching Programme on Recent Advances in Robotic Rehabilitation among Final year BSc Nursing Students in South India, India

Mrs. Aradhana Maniyappan

Lecturer, Department of Medical –Surgical Nursing, St: Thomas College of Nursing. Kattanam, Alappuzha district, Kerala, India

*Corresponding Author Email: aradhanashibu@gmail.com

ABSTRACT:

The research project under took was “Effectiveness of structured teaching programme on recent advances in robotic rehabilitation among final year BSc nursing students at south india, India.” A quantitative research design was adopted for this study. The study was conducted among 50 final year BSc nursing students at selected nursing colleges of, Alappuzha district, kerala, India. In order to assess the knowledge of advances in robotic rehabilitation, the study sample was selected by non- probability convenient sampling. Objectives of the study 1. Assess the knowledge level among students regarding the recent advances in robotic rehabilitation. 2. Find the effectiveness of structured teaching programme among the student 3. Find out the association of the knowledge level of the college students with the selected demographic variable. The tool used for data collection consisted of demographic profoma and structured questionnaire, basic introduction of the study was given to the subjects. The analysis of the data was based on the objectives of the study using quantitative and inferential statistics. Methodology: This study was based on one group pre- test –post -test research design which belongs to pre experimental design, was selected to assess the knowledge regarding the advances in robotic rehabilitation among final BSc nursing students in selected colleges at Alappuzha district. Result: Mean, Standard deviation, t’ value of pre-test and post-test on knowledge regarding the advances in robotic rehabilitation when t=26.447, significant at .001 level shows that the mean post test score (18.6800) is greater than mean pre-test score (6.8600). The t value is greater than the table value t (49) = 1.677, that is the structured teaching programme was effective because there is greater mean difference between the pre test value and post test. Hence the null hypothesis was rejected and the research hypothesis was accepted. Conclusion: The findings of the present study showed that structured teaching programme was effective to increasing the knowledge regarding the advances in robotic rehabilitation among final year BSc nursing students.

KEYWORDS: Effectivness, advances; Recent, Robotic rehabilitation; final year BSc nursing students; structured teaching.

INTRODUCTION:

You are just a machine, A Limitation of life

Can a robot, can write a symphony?

Can a robot turns a canvas in to masterpiece?

Robotics is a division of technology that comprises and involves the design, operation and applications with computer systems, electronics and software programming for their information and signal processing, control and measurement feedback. Technologies in robotics deal with automated and programmed machines that may replace a human’s functions in many situations such as hazardous manufacturing processes, healthcare, military or simply doing human tasks. Looking back at the history, this technology has been often seen to mimic human behaviours and frequently used to perform tasks in a typical manner (Fong et al., 2003)¹⁹. The recent trend in robotics is to design and develop an intelligent generation of robots that are competent and capable of moving, acting, helping and interacting in human-centred environments and participating in daily activities serving various practical purposes. There are many types of robotics such as industrial robots, medical robots, agricultural robot, military robots, etc.

Rehabilitation Robotics Recent advances in robotic technology and clinical neuroscience have greatly expanded the development of machines for improving function and mobility in individuals with disabilities. The machines include devices such as powered braces or artificial limbs, and brain-computer interfaces for connecting patients to computers via electrical signals. The devices can be used during therapy to retrain motor abilities or during every day activities to assist individuals with disabilities.

Disability from neurologic conditions can greatly increase health-care costs [1]. Such costs stem from inpatient care, medication cost, long-term care, and rehabilitation. Rehabilitation is critical to reduce future morbidity from immobility, depression, loss of autonomy and reduced functional independence [2], and inadequate provision of rehabilitation services, can further increase disability, leading to a vicious cycle of increasing costs [3]. Motor impairment, in particular, restricts mobility and function contributing significantly to disability and escalating costs [4] both due to the cost of long-term therapy services and that of caregiving, which are human resource intensive. While motor impairment after stroke is one of the most common reasons for rehabilitation, impairments resulting from cerebral palsy, multiple sclerosis, spinal cord injury, and Parkinson’s disease require similar interventions to improve motor function [5]. One billion people, or 15% of the world's population, experience some form of disability, and disability prevalence is higher for developing countries. One-fifth of the estimated global total, or between 110 million and 190 million people, experience significant disabilities.

STATUS OF DISABLED PERSONS IN STATES:

As per Census 2011, · At all India level, disabled persons constituted 2.21% of the total population. The highest percentage of disabled children (5-19 years) presently attending educational institution has been reported from Goa & Kerala (73%) in India.^31,32,33Comparing to the disabilities in the world there is not enough physiotherapist are there to provide treatment to the patients there comes the need for the robots to make it effectively and efficiently.

Moreover, the Patients are being cared by the nurses who are with the patient round the clock. Nurses should have an adequate knowledge regarding the recent advances in rehabilitation so that they can work in hand in hand with other health care professionals for providing better and promising care for the patients. Besides the nursing students built the next generation with more strength and planning. Nurse being a care giver, advocate, educator, co-ordinator, researcher, facilitator have immense responsibility to care the people, society, community which in turn can serve the nation too. Hence, I feel it’s necessary to impart knowledge among the 4^th year nursing students regarding the recent advances in robotic rehabilitation.

OBJECTIVES:

· To assess the knowledge regarding the recent advances in robotic rehabilitation among final BSc nursing students

· To assess the effectiveness of structured teaching programme regarding recent advances in robotic rehabilitation among final BSc nursing students.

To find out the association between pre-test knowledge regarding the recent advances in robotic rehabilitation among selected demographic variable.

HYPOTHESIS:

H1: There will be a significant difference between pre-test and post test score of Knowledge among final year BSc nursing students.

H01: There will be no significant difference between the pre-test and post test score of knowledge among the final year BSc nursing students.

H2: There will be significant association between pre-test knowledge of final year BSc nursing students regarding recent advances in robotic rehabilitation and selected demographic variables.

H02: There will be no significant association between pre-test knowledge of final year BSc nursing students regarding recent advances in robotic rehabilitation and selected demographic variables.

MATERIAL AND METHODS:

A quantitative research approach was adopted to determine the effectiveness Figure 1: Frequency and percentage wise distribution of samples according to the structured teaching programme on knowledge regarding the recent advances in robotic rehabilitation among final BSc nursing students. One group pre-test post-test design was adopted. 50 samples were selected by convenient non probability sampling. The findings of the study have been discussed in relation to the objectives and other similar studies. The tool for data collection was structured knowledge questionnaires with demographic Performa, consisted of 20 multiple choice questions for assessing the knowledge regarding recent advances in robotic rehabilitation among final BSc nursing students in St. Thomas College of nursing in kattanam, Alappuzha district,Kerala,India. Final year BSc nursing students who were present at the time of data collection. After conducting the pre-test, the researcher gave the intervention through structured teaching programme. Post test was conducted and the study findings were assessed by using the same tool. The researcher analysed the data by using descriptive and inferential statistics based on objectives and hypothesis.

RESULTS:

Description of the sample characteristics: This section describes the frequency and percentage wise distribution of demographic variables.

Figure 1: Frequency and percentage wise distribution of samples according to Family

The data presented in figure 1 shows that most of the samples in this group belongs to Nuclear family.

Figure 2: Frequency and percentage wise distribution of samples according to Residential area.

The data presented in figure 2 shows that most of the samples in this group belongs to urban residential area.

Figure 3: Frequency and percentage wise distribution of samples according to the source of income (N=50)

The data presented in figure 3 shows that most of the samples family have source of income from the private and other occupations,

Figure 4: Frequency and percentage wise distribution of samples according to Monthly income (N=50)

The data presented in figure 4 shows that most of the samples in this group have income between Rs. 10,000 to Rs. 20,000.

Figure 5: Frequency and percentage wise distribution of samples according to Religion (N=50)

The data presented in figure 5 shows that most of the samples belongs to the religion Christian.

The data presented in figure 6 shows that most of the samples in this group is unmarried.

The data presented in figure 7 shows that most of the samples in this group poor knowledge level during pre-test and an excellent knowledge level on post-test.

Figure 6: Frequency and percentage wise distribution of samples according to Marital status(N=50)

Figure 7: Frequency and percentage wise distribution of samples according to pre-test and post-test knowledge level.

Mean. standard deviation, t value of pre-test and post-test on knowledge regarding the recent advances in robotic rehabilitation.

Score	N	Mean	Standard deviation	t-value
Pre test score	50	6.8600	2.31283	26.447
Post test score	50	18.6800	2.38567	26.447

Association of knowledge level and selected demographic variables.

Sl. No.

Variables

Frequency (n)

Percentage (%)

Chi-square

Inference

RELIGION

· Hindu

· Christian

· Muslim

· Others

24%

72%

0.397

Not Significant

FAMILY

· Joint

· Nuclear

· Others

16%

84%

0.087

Not Significant

RESIDENTIAL AREA

· Rural

· Urban

48%

52%

0.277

Not Significant

OCCUPATION

· Govt job

· Private job

· Own business

· Semi

· Others

36%

16%

36%

2.464

Not Significant

INCOME OF FAMILY

· 10,000-20.000

· 20,000-30,000

· 30,000-50,000

· Above 50,000

48%

44%

0.907

Not Significant

MARITAL STATUS

· Married

· Unmarried

94%

3.740

Not Significant

Association of knowledge level and selected demographic variables:

The association was compicited by chi square test. It was inferred that the present study showed no significant association between pre-test knowledge with selected demographic variables like religion, place of residence, occupation, income of family and marital status with knowledge (calculated value greater than tabulated value significant level at 0.001 ). Hence null hypothesis is accepted. So there was no significant association between demographic variables and knowledge at 0.001 level of significance.

FUTURE CHALLENGES:

There are many substantial challenges for future rehabilitation robots and, among these, the most crucial lies in controller design, which should allow easy and natural movement with physical incursion and minimal ethical implications. On the basis of the studies by Rohrer et al. (2002) and Timmermans et al. (2009), in the case of stroke patients, kinematics of the actuator robot appear to be saturated and it cannot perform a movement in the full range because of the presence of sub movements of the robots. In the field of neuroprosthetics, over the next few years, mapping from electromyography patterns to muscle forces as an early step for the foreseeable future should be a main research focus (Pino et al., 2012). Interesting topics of research in the future include further studies on the mechanism of cortical control, as well as those on signal processing of peripheral or spinal nerves, especially low-level neural signal tapping into peripheral or spinal nerves (Lawrence et al., 2004).

There are several future challenges that should be considered:

(1) The needs of elderly and disabled individuals should be considered, focusing on techniques to maximize patient motivation with the fact that they evolve with time. Thus, improvements of user interface for more natural human interactions are needed such as by voice, body gestures, natural language and dialogues (Casas et al., 2008).

(2) Better context for awareness in terms of capacity of learning, reasoning, interpretation, decision making, classification of scenarios, locations and ability to recognize and differentiate individuals (Casas et al., 2008)

(3) Affective computing involves robots interpreting the emotional and cognitive aspects of human users, adapting their behaviour to the specific state of the user and the environment, and desirable sensory feedback mechanism that should be supported (Fakhreddine et al., 2008).

(4) Increasing capacities of future robots in terms of more flexibility, mobility, transportability, handling capacity, mental capacity of robots and empowerment to perform cecertain tasks on behalf of the user (Bock et al., 2012). Integration of a wide scope of diverse technologies and cooperating in such a way that they may result in better behaviour of the robot.

(5) New forms of rehabilitation robots such as bio robotics, tele rehabilitation robotics (Craig and Hermano, 2006) and nanorobotics, with challenges, should focus on intelligent implants, neural interfaces and online adaptation. New technologies of an autonomous robot should be considered for simple and easy use by a user who may have cognitive disability.

(6) In terms of ethical aspects, it is imperative that patients have full control of the level of intrusion by the robots and their privacy is protected. It is also important that on using a rehabilitation robot, due respect and assurance are given to the patient in terms of control of autonomy, cognitive ability, as well as the final responsibility (Datteri and Tamburrini, 2009). However, there is a trade-off between the user for the dignity of freedom and autonomy and for supporting and initiative by autonomous robots. For a clinical test, the patient’s personal identity must be assured and the health and other information collected must be kept confidential and protected (Datteri, 2013).

The field of rehabilitation robotics is ever expanding. New research is leading to the creation of new devices and technologies each year. As the technology develops, the area of discussion in this field increases, which makes it necessary to provide a definition and information on some terms before we continue on to the main devices.

CONCLUSION:

The present study was conducted to evaluate the effectiveness of structured teaching programme on knowledge regarding the recent advances in robotic rehabilitation among final year BSc nursing in south india,India. In order to achieve the objectives of the study, one group pre-test post-test design was adopted. The subjects were selected by non -probability convenient sampling. 50 samples were taken. The t test was found to be 26.447 significance at 0.01 level. The findings of the study have been discussed in relation to the objectives and other similar studies. Hence the research hypothesis was accepted.

ACKNOWLEDGEMENT:

I express my sincere gratefulness towards Prof.Nahomi clement (Principal of St Thomas College of nursing, Kattanam.Alappuzha district, kerala, India) and fourth year BSc nursing students for their Sincere participation and curiosity towards the topic. I express the heartfelt gratitude towards Dr. Harikumar (Research Dean of KUHS) and Dr.Jayaram U (Research co-ordinator KUHS) for their guidance and the topic. Last but not the least to God Almighty and my family especially my husband Mr. Shibu K. C and son Aashish Raj Shibu for his Boundless Inspiration.

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Received on 29.10.2019 Modified on 26.11.2019

Asian J. Nursing Education and Research. 2020; 10(1):79-83.

DOI: 10.5958/2349-2996.2020.00018.X