A Quasi experimental study to assess the effectiveness of information education communication programme on knowledge regarding first aid management of accidents among people residing in selected villages of Panipat

Preeti Hooda¹, Navreet Kaur Saini²*

¹M.Sc. Nursing, Ved Nursing College, Prem Institute of Medical Sciences, Panipat.

²Assistant Professor, Ved Nursing College, Prem Institute of Medical Sciences, Panipat.

*Corresponding Author Email: saini.reet2@gmail.com

ABSTRACT:

Background: First aid is the assistance given to any person suffering a sudden illness or injury. It is an immediate help given to a victim with injury or sudden illness, by a bystander until appropriate medical help arrives. It is care provided to preserve life and prevent the condition from worsening. Material and methods: This was a quasi-experimental study with time series research design. Sixty subjects comprising of people residing in Baroli and Israna villages of Panipat were conveniently enrolled in experimental and control group each. Information, education and communication using information booklet, lecture and discussion on first aid management of accidents was delivered to the subjects in experimental group. Pretested and validated self-structured questionnaire was used to assess knowledge. Result: There was significance gain in post-test I knowledge score from 11.10 to 24.08 (p=<0.05) and in post-test II knowledge score from 11.10 to 23.63 (p=<0.05) among experimental group. No significant gain in knowledge was found in post-test I and post-test II in control group. Conclusion: The study findings revealed that information education communication programme given to subjects regarding first aid management of accidents helped to enhance the knowledge of subjects.

KEYWORDS: Information education communication, knowledge, first aid, management, accidents, village.

INTRODUCTION:

First aid is an immediate help given to a victim until appropriate medical help arrives, care provided to preserve life and prevent the condition from worsening.¹ Approximately 1.35 million people are expected to die as a result of road traffic crashes each year globally. Also, road traffic injuries are one of the leading cause of death for children and young adults aged 5-29 years.² In India, road traffic accidents increased to nearly 1.49 lakh in 2018. Uttar Pradesh registered the maximum increase in fatalities due to road traffic accidents.³

Burn is an injury of the skin that can damage the tissues and organs caused by contact with heat, chemical solutions, radiation, hot objects, radioactivity, electricity etc.⁴ Burn is a global public health problem, accounting for an estimated 1,80,000 deaths annually. The majority of these occur in low- and middle-income countries and almost two thirds occur in the African and South-East Asia regions. In India, over 10,00,000 people are moderately or severely burnt every year.⁵

A bite is a wound inflicted by a dog and medical issues to be addressed with the dog bites are the skin damage, injury to tissue like muscle, nerve and bone. Approximately 4.5 million dog bites occur every year, majority of them are minor and require no medical attention. However, from 2001 to 2016, the CDC estimates that there were 5,473,893 patients treated in emergency departments for injuries resulting from dog bites and there was a 139 percent increase in hospitalizations due to dog bites.⁶ According to the World Health Organization (WHO), India represents 36 per cent of deaths due to rabies occurring worldwide. Approximately 1.75 million dog bites happen in India every year.⁷ Snake bites are puncture wounds caused by the snake. According to the World Health Organization, about 1,00,000 people die from venomous snake bites every year. Rural areas account for most of these fatalities in developing nations due to lack of access to antivenoms.⁸

A poison is any substance that is harmful to the body when ingested, inhaled, injected or absorbed through the skin.⁹ Poisoning is a significant global public health problem ranking 45th in total deaths worldwide. According to WHO data, an estimated 1,93,460 people died worldwide from unintentional poisoning. Low- and middle-income countries contributed 84% deaths among these.¹⁰ In India, 50,000 people die every year from toxic exposure. According to the National Poisons Information Centre, New Delhi, pesticides are the commonest cause of poisoning in developing countries which includes organophosphates, carbamates, chlorinated hydrocarbons, pyrethroids and aluminium or zinc phosphide.¹¹ The present study was conducted to assess and compare the pre-test and post-test knowledge regarding first aid management of accidents among experimental group and control group. The hypothesis, H1: There will be significant difference between mean post-test knowledge regarding first aid management of accidents after administering information education communication programme among experimental group and control group, was framed.

MATERIAL AND METHODS:

This was a quasi-experimental study conducted at Baroli and Israna villages of Panipat from March 2019 to April 2019. Sample consisted of people residing in Baroli and Israna villages of Panipat and fulfil the inclusion criteria. Subjects in experimental group were enrolled from Baroli village and in control group were enrolled from Israna village. Total 120 subjects were conveniently enrolled in the study including 60 in experimental and 60 in control group. Inclusion criteria consisted of: aged 18 years and above, able to communicate in Hindi or Haryanvi and available at the time of data collection. Participants who were not willing to take part in the study were excluded. Data were collected using self-developed, validated and pretested questionnaires. Demographic profile comprised of nine items i.e. age, gender, education, occupation, type of family, marital status, monthly income, previous information regarding first aid management and from where obtained. Knowledge questionnaire consisted of 21 items which included information related to causes, risk factors, symptoms and first aid management of accidents. Items included multiple choice questions. Correct answer was scored as one, incorrect and don’t know response was scored as zero. Maximum score was 30 and minimum score was 0. Knowledge was categorised as poor knowledge (0-10), average knowledge (11-20), and good knowledge (21-30). Validity of tools were given to 7 experts, two from field of medicine and five from field of nursing. The reliability of the tools was established by test – retest method. Ethical clearance was obtained from ethical committee of study institution and permission was obtained from village heads to collect data. Informed consent was taken from the subjects and anonymity of subjects and confidentiality of information was maintained. The study was carried out for the period of four weeks. After consent, pre- test was conducted to assess the knowledge of subjects regarding first aid management of accidents by using self-structured knowledge questionnaire. For assessing the pre-test knowledge, subject data sheet and self-structured knowledge questionnaire were distributed and 20-25 minutes were given to them to complete it and instructions were given how to respond to it. After taking the pre-test, information education communication programme was administered by lecture cum discussion method using information booklet to improve knowledge. Subjects were met individually and information education communication programme was individually administered. After one week post- test was administered to assess the knowledge regarding first aid management of accidents. Information education communication programme consisted of lecture cum discussion on first aid management of accidents using information booklet. Information booklet covered introduction and definition of accidents e.g. haemorrhage, bites, road traffic accidents, poisoning, burns, causes of these accidents, signs and symptoms and first aid management of accidents. Researcher also explained how to do bandaging, how to make splints at home with wood or board. Statistical Package SPSS 20 was used to analyse the data.

RESULTS:

Demographic profile:

Majority of the subjects 42(70%) were in the age group of 21-40 years in both groups. With regard to gender, majority of the subjects, 44(73.33%) and 49(81.66%) were females in experimental and control group respectively. With regard to education, most of the subjects, 26 (43.34%) and 34 (56.66%) had studied up to senior secondary school in experimental and control group respectively. With regard to occupation, 21 (35%) subjects were doing private work in experimental group and most of subjects, 39 (65%) were unemployed in control group. With regard to family type, majority of the subjects, 43 (71.66%) were from joint family in experimental and 40 (60.67%) in control group respectively. With regard to marital status, majority of the subjects, 50 (83.34%) were married in experimental and 29 (48.33%) in control group. With regard to monthly income, 21 (35%) subjects were present in < Rs 7000 in experimental group and maximum i.e. 30 (50%) were earning between Rs 8000 – 14000 in control group. Most of the subjects, 51 (85%) had previous knowledge on first aid management in experimental and 55(91.66%) in control group respectively. With regard to source of knowledge, majority of the subjects, 22 (43.51%) had information from TV in experimental and 33 (60%) in control group respectively.

Knowledge regarding first aid management of accidents among experimental group

Figure – I: Knowledge of experimental group in pre-test, post-test I, post-test II

Figure – II: Knowledge of control group in pre-test, post-test I, post-test-II

Table – I: Mean, mean difference, standard deviation and paired ‘t’-test value of subjects in experimental group

(n = 60)
Test	Mean	Mean Difference	Standard Deviation	Paired ‘t’ test value	‘p’ value
Pre-Test	11.10	12.98	3.123	43.946 (df = 59)	0.001*
Post-Test I	24.08	12.98	2.388	43.946 (df = 59)	0.001*
Pre-Test	11.10	12.63	3.123	41.497 (df = 59)	0.001*
Post-Test II	23.63	12.63	2.123	41.497 (df = 59)	0.001*

*Significant at p <0.05

Table I shows that mean pre-test value of knowledge in experimental group was 11.10±3.123 and post-test I value was 24.08±2.388. The mean difference value was 12.98. Paired ‘t’- test value was 43.946 for the degree of freedom 59. The ‘p’ value was 0.001 which showed there was a statistically significant difference between the level of knowledge among the subjects in pre-test and post-test I. The mean pre-test value was 11.10±12.63 and post-test II value was 23.63±2.123. The mean difference value was 12.63. Paired ‘t’- test value was 41.497 for the degree of freedom 59. The ‘p’ value was 0.001 which showed there was statistically significant difference between the level of knowledge among the subjects in pre-test and post-test II.

Table – II: Mean, mean difference, standard deviation and paired ‘t’- test value of subjects in control group

(n = 60)
Test	Mean	Mean Difference	Standard Deviation	Paired ‘t’ test value	‘p’ value
Pre - Test	11.05	0.30	3.342	- 2.950	0.06^NS
Post –Test I	10.75	0.30	3.139	- 2.950	0.06^NS
Pre - Test	11.05	0.25	3.342	- 1.436	0.156^NS
Post–Test II	10.80	0.25	3.293	- 1.436	0.156^NS

^NS Non significant at p >0.05

Table II shows that mean pre – test value was 11.05±3.342, post-test I value was 10.75±3.139 and post-test II value was 10.80±3.293. The mean difference value was 0.30 for pre-test and post-test I and the mean difference value was 0.25 for pre-test and post-test II. Paired ‘t’- test value was - 2.950 for the degree of freedom 59. The ‘p’ value was – 0.06 which showed that there was no statistically significant difference between the level of knowledge among the subjects in pre-test and post-test I. Regarding pre-test and post-test II, paired ‘t’- test value was – 1.436 for the degree of freedom 59. The ‘p’ value was 0.156 which showed that there was no statistically significant difference between the level of knowledge among the subjects in pre-test and post-test II.

Table-III: Effectiveness of information education communication programme on knowledge regarding first aid management

(n=60)
Post – Test – I
Group	Mean	Mean Difference	Standard Deviation	Independent ‘t’ test value	‘p’ Level
Experimental Group	24.08	13.33	2.388	26.185 (df = 118)	0.001*
Control Group	10.75		3.138
Post – Test – II
Experimental Group	23.63	12.83	2.213	25.374 (df = 118)	0.001*
Control Group	10.80		3.293

Significant at p<0.05

Table III shows that with regard to experimental group, the mean post-test I value was 24.08±2.388 and mean post-test II value was 23.63±2.213. Similarly in the control group mean value of post-test I was 10.75±3.138 and post-test II was 10.80±3.293. The mean difference of post-test I value regarding knowledge was 13.33 and post-test II value was 12.83. In post-test I, independent ‘t’ test value was 26.185 for the degree of freedom 118 and post-test II value was 25.374 for the degree of freedom 118. The obtained both group ‘p’ value was 0.001 which was lesser than the level of significance 0.05. Thus, information education communication programme was effective in enhancing knowledge of experimental group regarding first aid management of accidents.

DISCUSSION:

In the present study information education communication programme was used to assess the effectiveness of teaching on subjects. Pre-test knowledge mean score ± standard deviation was 11.10±3.123. Post-test knowledge mean score ± standard deviation was 24.08±2.388. Findings were congruent to the study by Dr. Anuradha, S¹² where subject’s pre-test knowledge mean score ± was 18.27±4.54. Post-test knowledge mean score was 28.67±4.54. The results showed that knowledge level of the subjects improved after planned teaching programme. In this study, findings showed that out of 100%, 41.66% subjects had poor level of knowledge and 58.34% had average level of knowledge. No one had good level of knowledge regarding first aid management of accidents in pre-test. Findings were congruent to the study by Hema V. H¹³ where findings showed that out of 100%, 56% subjects had inadequate level of knowledge regarding first aid management. Similar results were shown study by Joseph N, Narayanan T, Bin Zakaria S, Nair AV, Belayutham L, Subramanian AM, Gopakumar KG¹⁴ where 19(13%) subjects had poor level of knowledge, however, 127(87%) had moderate level of knowledge. Similar result were shown in the study by Chitali A Gore¹⁵ where findings showed that 71 out of 150 subjects needed improvement, 35 out of 150 had inadequate knowledge. The present study had limitations such as small sample size and convenient sampling limits the generalizability of the study. Self-structured questionnaires were used for data collection. The findings of the study showed that the information education communication programme was highly effective in improving the knowledge of the subjects. Information booklet developed by researcher proved to be an effective tool in enhancing knowledge. Thus, the health care professionals can use the information education communication programme in educating the people to facilitate the first aid management of accidents.

ETHICAL CLEARANCE:

Obtained.

CONFLICT OF INTEREST:

None.

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Received on 31.07.2020 Modified on 26.08.2020

Asian J. Nursing Education and Research. 2020; 10(4):404-408.

DOI: 10.5958/2349-2996.2020.00086.5