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A STUDY TO ASSESS THE KNOWLEDGE AND PRACTICE OF PRIMARY SCHOOL TEACHERS REGARDING PREVENTIVE MEASURES
OF ASTHMA AMONG PRIMARY SCHOOL CHILDREN WITH
A VIEW TO DEVELOP SELF INSTRUCTIONAL
MODULE IN SELECTED SCHOOLS AT TUMKUR.
PROFORMA FOR REGISTRATION OF SUBJECTS
FOR DESSERTATION
MISS. KAVITHA.V.K.
CHILD HEALTH NURSING
MADHUGIRI SRI RAGHAVENDRA COLLEGE OF NURSING
MADHUGIRI – 572132 TUMKUR DISTRICT
1. / NAME OF THE CANDIDATEAND ADDRESS / MISS. KAVITHA.V.K.
M.Sc., Nursing 1st Year
Madhugiri Sri.Raghavendra College of Nursing , Shankar Matt Road, Raghavendra Colony,
Madhugiri- 572132, Tumkur district.
2. / NAME OF THE INSTITUTION / Madhugiri Sri.Raghavendra College Of Nursing .
3. / COURSE OF STUDY AND
SUBJECTS / M.Sc., NURSING 1st Year
Child Health Nursing
4. / DATE OF ADMISSION TO
COURSE / 10-06-2009.
5. / TITLE OF THE TOPIC / A study to assess the knowledge and practice of primary school teachers regarding preventive measures of asthma among primary school children with a view to develop self instructional module in selected schools at Tumkur.
RAJIV GANDHI UNIVERSITY OF HEALTH SCINCES
BANGALORE, KARNATAKA
PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION
6. BRIEF RESUME OF INTENDED WORK:
INTRODUCTION:
“The study of disease is really the study of man and his environment, prevention is better than cure”
- K.Park
Asthma is the most common chronic disease of child hood, the primary cause of school absences and the third leading cause of hospitalization in children. Although the onset of asthma may occur at any age 80% to 90% of children have their first symptoms before 4 – 8 years of age.1 Asthma is chronic inflammatory disorder of the lower airway due to temporary narrowing of the bronchi by bronchospasm manifested as dyspnea, wheezing and excessive cought.2 Increase prevalence of childhood asthma in India and the encouragement of self management practice mean that many children experience asthma symptoms and use of asthma medication whilst at school.
Child spend most of the day time at school. Physical education activities may put school children with asthma at risk, since attack are likely to occur full time nurse thus placing the responsibility for daily asthma management of students with asthma by non medical staff and thears.3 In later part of the 20th century and certainly in these early years of 21st century, we spend the vast majority of time in an indoor world. Modern house much better insulated but also less well ventilated. Central heating, air conditioning, carpets and curtains have their own contribution towards the quality of indoor environment. Improved capabilities to measure indoors allergens have led to numerous publications on the allergen load in homes, place of employment, public transportations and schools.4
The most chronic and recurrent pulmonary disease of the pediatric age group, asthma is responsible for a considerable loss of school days, a large number of visits to the pediatrician, and frequent hospitalization Childhood asthma likely to have an impact on social and emotional aspects of lives of the children and their families. Acute exacerbation of asthma is potentially life-threatening complication. Prevention and early identification of the condition plays an important role.4
It important for teachers and staff to be aware of the preventive measures of asthma in the school environment.3 Among a child out of ten is asthmatic. School absenteeism is frequent due to an insufficient control of asthma.5 Some studies revealed that the teachers had limited knowledge about preventive measures of asthma in children and recommended that instructions about asthma should be given to all primary school teachers during their teacher training course. Proper education and knowledge of school teachers about the disease is essential which will help in preventing the disease in school setting.3
6.1. NEED FOR STUDY:
Teachers spend most of their day time in the class room, there may be a little opportunity for communication with the school doctors or nurse when they visit the school. There is clearly a need for more meetings to be facilitated between teachers and the health professionals.3 Asthma is prevalent in school age children and contributes to school absenteeism and limitations of activity. Although the students indicates that school based programmes have the potential to improve out comes, competing priorities in the educational effective strategies.5
Child spend a great deal of time in school and can be exposed to situations that increase their risk for an asthma exacerbation or a reaction to food. As such the clinician can play a significant role in educating children, their families and school personnel about principles that he can be applied not only to manage reaction when they occur but also to prevent them. This theme issue will provide information on indoor allergens commonly present in school and day care settings, as well as information on how to manage and prevent children with asthma.6
The increasing number of children with asthma in the schools necessitates an examination of the preparedness of teachers in the care and management of children with asthma. Teachers are not adequately prepared to assist children with the management and prevention of asthma in the classroom. It is important that teachers should be able to recognize symptoms of an asthmatic attack or take the necessary precautions to avoid such an attack. Asthma can be life threatening; it is essential to assist those involved in monitoring and managing children with asthma, and provide timely and appropriate care. In this way, the goal of having a child with asthma, live as normal a life as possible, including all school activities, can be realized.3
There is need to train teachers and provide an agreed joint education and health policy on preventing asthma in schools. A healthy student is a student ready to learn. Teachers are important figures in the lives of young people: their beliefs about student health concerns are often solicited. However prevention of asthma in schools and the role of school teachers to adopt in this conditions has only recently been explored. There is a need to provide school teachers with education on asthma prevention.3
Thus the investigator felt the need to provide health education to primary school teachers regarding preventive measures of asthma among primary school children. Considering the educational back ground, age of teachers, knowledge and practice on preventive measures of asthma.
6.2.REVIEW OF LITERATURE;
6.2.1 A study focused on a systematic review of US state environmental legislation and regulation with regards to the prevention of asthma. A sample size of fifty states and the District of Columbia Department of community intended to prefect children against asthma were selected by observational method. The study that concluded with difference in state environmental regulation and legislation are likely to lead to difference in exposure and thus to impacts on children’s health. States rarely address children specifically in environmental regulation and legislation, though many state regulations go for to limit children’s exposures to environmental hazards.6
6.2.2. A study was conducted about school based asthma education in an urban community Berkely. A sample size of 8488 students surveyed during the first 3 years of the intervention 15.4%(n=1309) were identified as asthmatic, approximately 76% of eligible students (n=990) from 15 middle schools and 3 high schools participated in the program. The study that concluded with school-based asthma curriculum designed specifically for urban students has been shown to reduce symptoms, activity limitations and health care utilizations for intervention participants.7
6.2.3. A study was focused on asthma education for rural school nurses: resources, barriers and outcomes. A sample size of 7 rural countries in Maryland how to implement and to reinform asthma management behaviors in children with asthma and their caregivers were selected by questionnaire method. The result of this study shows that the programme increased their mean asthma knowledge scores more than nurses who did not take the programme. The study that concluded with importance of understanding the unique characteristics of rural school nurses, the resources they need, and the barriers and challenges they face in their practices.8
6.2.4. A study was conducted about asthma prevalence, management and education in New York state elementary schools. A survey of school nurses was conducted in New York state elementary schools to assess asthma and asthma management in 100 students were selected by questionnaire method. The study that concluded with schools need to adopt key components of asthma management and schools nurses should be encouraged to work with others in the school setting to address indoor air quality problems that might be affecting health.9
6.2.5. A study focused on prevalence and risk factors of asthma and wheezing in school going children in Lucknow. A sample size of 112 schools, 17 and 15 schools were randomly selected for recruitment of subjects in age group 6-7 and 13-14 years respectively were selected by questionnaire method. The study that concluded with promotion of rational use of antibiotic in first year of life, avoidance of fast food and promotion of breast feeding and intake of fruits and vegetables may reduce the risk of asthma/wheezing and should be encouraged.10
6.2.6. A study was carried out the prevalence of asthma and some respiratory symptoms in school children from rural/regions of Poland. The aim of our study was to estimate the prevalence of asthma and some respiratory symptoms and disease in school children from rural region of Poland in 2001. A sample size of 541 school children were selected by questionnaire method. The study that concluded with a substantial increase of asthma related symptoms observed in the rural region of Poland.11
6.2.7. A study focused on school-based asthma a study in an African American elementary school for the purpose of assessing the families and school professionals how to manage the asthma in school children. A sample size of 200 school children, parents and teachers were by observational method. The study that concluded with the children reported fear of not being able to breath and the limitations of living with asthma. The teachers were concerned that they did not have a sufficient understanding of asthma to manage children’s asthma during the school day. Parents described complex lifestyles and the challenges of asthma management.12
6.2.8. A study focused on parents reported environmental exposure and environmental control measures for children with asthma. A sample size of 638 children aged 3-15 years were interviewed on enrollment in a randomized trial of asthma care improvement strategies. The study that concluded with exposure to potential environmental triggers is common, and recommended trigger avoidance measures are infrequently adopted. While specific exposure may vary with demographic and socioeconomic variables all children are at risk. New methods for educating parents to reduce such exposure should be tested.13
6.2.9. A study carried out to assessing the efficacy of a school based asthma education programme for children. This study sought to explore the effect of a school based asthma education progamme on quality of life. A sample size of 100 children with asthma who attended grades 1-5 at two selected schools were requested to participate were selected by questionnaire method. There were clinically important improvement in the school based asthma education progamme group in quality of life, specially in the symptoms subdomain. The study that concluded with the air force school based asthma educational programme appears to result in a favorable trend in quality of life for children.14
6.2.10. A study focused on asthma management and prevention current perspective. The continuing evolution of asthma treatment and prevention are reflected in updated guidelines from the National asthma Education and prevention programme and Global initiative for asthma. A sample size of 150 school children were selected by questionnaire method. Study that concluded with written action plans as part of self-management processes appear to improve physician-patient communication and disease status tracking other considerations in successful asthma management include patient education and monitoring of adherence to treatment regiments.15
6.2.11. A study focused on prevalence of allergic disease in primary school children in Edirne, Turkey. A sample size of children aged 7 to 12 in primary schools in the Municipality and 24 villages of Edirne were surveyed via a questionnaire completed by the parents. The result shows that a total of 5412 children were enrolled. The cumulative and the current prevalence of all allergic diseases were 24.6% and 9.9% respectively. The cumulative prevalence of bronchial asthma 16.4%, and the current prevalence were 5.6%. The study that concluded with the allergic disease are a major health burden for primary school children.16
6.2.12. A study focused on symptoms, severity and asthma control in 5-14 years old Lebanon school children. A sample size of 5544 children were selected by cross sectional study, applied on school children with physician diagnosed asthma, divided into two groups: those who were on controllers and those who were not. The result shown that out of 5544 children, 275 had physician diagnosed asthma. The controller’s (32.7%) group had higher mother’s education than the non-controller group (45.9%). The study that concluded with treatment of physician diagnosed asthma in 5-14 years school children was quite adopted according to the recommendations.17
STATEMENT OF THE PROBLEM
“A study to assess the knowledge and practice of primary school teachers regarding preventive measures of asthma among primary school children with
a view to develop self instructional module in selected schools at Tumkur.”
6.3 OBJECTIVES OF THE STUDY
1. To assess the knowledge of primary school teachers regarding preventive measures of asthma among primary school children.
2. To assess the practice of primary school teachers regarding preventive measures of asthma among primary school children.
3. To determine the relationship between knowledge and practice with selected demographic variables.
4. To develop an information module about preventive measures of asthma.
6.4. VARIABLES UNDER STUDY:
Educational background, Age of the teacher, location of school, place of domicle, exposure to mass media, method of teaching.
6.5. OPERATIONAL DEFINITIONS:
ASSESS In this study it is an organized systematic and continuous process of collecting data from primary school teachers regarding preventive measures of asthma.
KNOWLEDGE In this study it refers to the correct response from the respondent (primary school teachers) on preventive measures of asthma.