RAJIVGANDHIUNIVERSITY OF HEALTH SCIENCE KARNATAKA BANGALORE

ANNEXURE – II

PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION

1. / Name of the candidate and address (in block letters) / Ms ROOPA.T. KALE
CITY COLLEGE OF NURSING
SHAKTHINAGAR
MANGALORE - 575002
2. / Name of the Institution / CITY COLLEGE OF NURSING
SHAKTHINAGAR
MANGALORE - 575002
3. / Course of Study and Subject / M. Sc NURSING
COMMUNITY HEALTH NURSING
4. / Date of Admission to the Course / 13.6.2008
5. / Title of the study
EFFECTIVENESS OF PLANNED GROUP TEACHING PROGRAMME ON EYE DONATION AMONG ADULTS IN A SELECTED RURAL COMMUNITY OF MANGALORE
6. / Brief resume of the intended work
6.1Introduction
“Let your eyes changes some one’s life”.
Vision is the most important sense because it allows to interact freely with the environment and enjoy the beauty of life. Eye is sometimes called the “mirror of soul”, it twinkles with humour, sparkles with joy, softens with worry, hardens with anger, clouds when things go wrong or one loses hope. The eye often reflects physical health; it is clear when well, dull when ill1 . The use of sight is an integral part of early life experiences. Most individuals are not consciously aware of the degree to which they depend on it for daily functioning. Once vision becomes significantly limited, it influences the activities of daily living. Even simple tasks become difficult to perform. So the eye care is very important to maintain the health of the eyes.
The problem of blindness all over world is as old as mankind itself. As estimated, every five seconds one individual goes blind in the world. To combat the problem of corneal blindness some specific activities should be carried out. Those are establishment of good eye banking services, excellent publicity for eye donation, creating awareness in the public about eye donation through health education programmes. Motivating public for eye donation through media participation, involvement of community leaders, religious leaders, health guides and paramedical workers etc.2
Eye donation is priceless gift from one human to the other.3By donating eyes we are giving vision to blind people and making their life self-dependent and joyful. The first “successful” human to human corneal transplant was done in 1903 in Czechoslovakia by Zirm to visually rehabilitate a patient who had suffered a burn. The eye banking movement, since 1944, has spread world wide. In case of death of any family member or friend we should keep in mind to call the eye bank. Eyes have to be removed within 4 to 6 hours after death so no time should be wasted to inform the eye bank.4The eye will give bright life to some one; otherwise one valuable organ will become waste so “Donate your eyes to relive after death.”5
6.2The need for the study
“Money cannot buy eyes, it is a gift only you can give”
Blindness was first highlighted in India during the 1921 census. The census indicated a blindness prevalence rate of 172/100,000 population. In 1944, the Bhore Committee estimated that there were 2 million blind individuals in the country. In1963, trachoma pilot project estimated there were 4.5 million economically blind and equal number of totally blind persons in the country. During 1971-74, ICMR undertook national level Comprehensive Blindness Survey, this projected that 9 million were economically blind and 55% were totally blind in the country. During 1986-89, the WHO, undertook a survey and reported that 12 million economically
blind and 8 million were identified as blind in one eye. According to the latest findings of eye bank association of India during 2005 there are around 10 million blind people, out of which 2 million suffer from corneal blindness with more than 60% of them being children below the age of 2 years5 this is the world’s largest burden and every year nearly 20,000 to 25,000 or more people fall victim to corneal blindness.6 The above statistics reveals drastic increase in blindness prevalence rate.
In India the first eye bank was started in Madras in 1945.According to available statistics in India 12,746 eyes were collected in 1992 and approximately 8,400 cornea transplants performed. In 1993 there were 166 eye banks in India of which approximately 27 eye banks collected more than 50 eyes per year and 6413 corneal grafting were done as reported by 104 eye banks. In India approximately 1,90,000 persons are blind in both eyes and 590,000 persons are blind in one eye. There is an inherent demand for nearly one million eyes and an estimated 20,000 persons are added to this backlog each year. As emphasised by these statistics there is great need for eye donation in India.8 Five thousand operations are being performed every year. In spite of having professional surgeons corneal transplantation cannot be carried out due to lack corneal donors. This may be due to lack of awareness in general public, improper development of infrastructure in villages, absence of motivation among the trained personnel and social and religious taboos.9
A pilot study conducted to determine awareness of eye donation and corneal transplantation in an adult population. The study reported that 257 participants (50.69%) were aware of only eye donation, but 22 (4.34%) were aware that eye donation had to be done within 6 hours of death, 430 (79.50%) participants were not aware of corneal transplantation. The study concluded that more innovative strategies have to developed to increase awareness of eye donation and corneal transplants especially for illiterate and rural population.7
A prospective study was conducted to evaluate the response to request for eye donation from relatives of post mortem cases. The result showed that of the 159 donors identified, there were 119 (74.8%) men, 40 (25.2%) women and 88 (74.8%) kin were aware of the concept of eye donation, but 71 (44.7%) families had not heard of it before. Willingness for eye donation was seen in 66 (41.5%), whereas 93 (58%) families refused eye donation. The study concluded that active counselling by a motivated team can be effective even in families with no prior knowledge and low socioeconomic status to undertake eye donation from relatives of post-mortem cases.10
According to health ministry statistics, 38,596 corneas were collected during the end of March 2008, a growth of nearly 30% from the previous year. Nearly 75% of eye collection is voluntary in India and the rest is by those who get counselling and information from doctors under the hospital Cornea Retrieval Programme. Just 25% eye collection is though the hospital programme. In India There is a huge gap between the need and availability of cornea. This is due to lack of awareness in population regarding eye donation. Hence the investigator felt the need to select this study to create awareness among people regarding eye donation.3
6.2Review of literature
Review of literature is divided into two categories:
  1. Prevalence of blindness
  2. Knowledge regarding eye donation
  1. Prevalence of blindness
A cross-sectional study was conducted to estimate the prevalence and causes of blindness in children in southern Indian state Andhra Pradesh. The sample consisted of 6935 children in the age group of 7 to 15 years. The data was collected by examination and interview method. The study showed that the prevalence of childhood blindness was 0.17% (95% CI 0.09 to 0.30). Treatable refractive error caused 33.3% of the blindness followed by 16.6% due to Vitamin A deficiency and amblyopia after cataract surgery. The major causes of the remaining blindness included congenital eye anomalies (16.7%) and retinal degeneration (16.7%). The study concluded that the approximately 400 million children in India may be blind including 2,26,440 with easily treatable refractive error and these data these data suggest that priorities for action to reduce childhood blindness in India.11
A study was conducted to estimate the prevalence of blindness and its causes in rural Karnataka. The sample consisted of 1505 people aged 50years and above from 15 villages. The data collected by eye examination and visual acuity test by Snellen’s chart.The result showed that the prevalence of blindness was 6.6%(95% CI:5.3-7.8%),bilateral cataract was principal cause of blindness among 78.7% and 12.1% were operated for cataract.The study concluded that ,the study area has a high burden of cataract blindness. Cataract surgical services should be made readily accessible and available to this rural population.12
  1. Knowledge regarding eye donation
A study was conducted to determine the awareness of eye donation and willingness to pledge eyes for donation in rural population of Andhra Pradesh. The sample consisted of 7,775 subjects of all ages older than 15 years. The data was collected by interview method. The result showed that age-gender adjusted prevalence of awareness of eye donation was 30.7% (95% CI 29.5-31.9), but only 0.1% (95% CI 0.05-0.25) had pledged their eyes. The awareness of eye donation was less in subjects of 70 years old (OR 0.7: 95% CI 0.6 – 0.8) , illiterates (OR 0.2: 95% CI 0.1 – 0.2), females (OR 0.8:95% CI 0.7 -0.9), low socioeconomic status group (OR 0.4: 95% CI 0.4-0.5) and Christians (OR 0.2: 95% CI 0.1 – 0.6); 32.9% were willing to donate eyes and 50.6% needed more information to decide whether or not pledged their eyes. The study concluded that awareness of people regarding eye donation was less so there is a need to transfer the knowledge regarding eye donation.16
A study was conducted to assess the awareness of eye donation and willingness to pledge eyes for donation in urban population of India. The sample consisted of 2522 subjects of all ages over 15 years old. The data was collected by
interview method. The result showed that age-gender adjusted prevalence of eye donation was 73.8% (95% CI: 66.5- 81.0%) but only 1.9% (95% CI: 0.16% - 3.66%) had pledged eyes. In illiterate subjects significantly less awareness was found (95% CI: 0.1 – 0.140) subjects more than or equal to 70 years old (OR 0.3; 95% CI:: 0.2 -0.6), subjects of lower socio economic status (OR 0.4 95% CI :0.3-0.6 ), females (OR 0.6:95% CI: 0.5 – 0.8) and Muslims (OR 0.7:95% CI 0.6- 0.9). Awareness of eye donation was 44.9%. Willingness to pledge eyes for donation was significantly lower in Muslims (OR 0.18;95% CI : 0.13 – 0. 24) than in Hindus. And in subjects
 60 years old (0.3;95% CI: 0.2- 0.5). The study concluded that the information about distribution and demographic association of awareness and willingness for eye donation could help in developing strategies to increase procurement of corneas for dealing with corneal blindness.17
A cross-sectional descriptive study was conducted to describe the knowledge and attitude towards eye donation among health professionals In India. The sample consisted of 206 hospital staff members. The data was collected by questionnaire and interview method. The study showed that 25 (12.1%) participants had excellent knowledge and 59 (28.6%) had poor knowledge. Knowledge varied according to staff type. Excellent knowledge of eye donation was noted in 11 medical students (44%) and 9 post graduate doctors (36%); poor knowledge was noted in 33 nurses (56%). The study concluded that awareness among health professional towards eye donation was low14
A comparative study was conducted to assess the knowledge and attitude of final year medical students towards eye donation. The sample consisted of 49 medical and 24 non-medical students. The data was collected by a questionnaire. The result showed that more than one-third of students and controls were unaware that eyes are removed within 6 hours of death. Eight students (16.3%) and 6 controls (25%) felt that close relatives’ eyes could be donated after death; 3 students (6.1%) and 3 controls (12.5%) were undecided about donating own eyes; 19 (38.8%) students and 6 controls (25%) did not know where to go in order to pledge eyes. The controls had poorer knowledge of corneal storage. The study concluded that controls were poorly informed about various aspects of eye donation suggesting inadequate dissemination of information by the medical students and controls. Both had misconceptions regarding donation of relatives’ eyes and hesitation regarding their own.14
A cross-sectional study was conducted to determine the perception and willingness of medical students towards eye donation in Delhi. The sample consisted of 180 first year medical students. The data was collected by a semi-structured questionnaire. The result showed that majority of students (99.4%) knew that eyes can be donated after death; only 41.1% knew the ideal time of eye donation. Most of participants (87.2%) were willing to donate eyes. According to 85.5% of students mobility was the main motivational force for eye donation. Perceived reasons for not pledging eyes by the people were lack of aware (32.7%), objection by family members (27.7%), unsuitability to donate because of health problems (17.7%), and
unacceptable idea to separate the eye from the body (15.5%). The study concluded that mass media such as TV, news paper , magazines and posters were important source of information to create awareness regarding eye donation in the community.15
6.3Statement of the problem
Effectiveness of planned group teaching programme on eye donation among adults in a selected rural community of Mangalore.
6.4Objectives of the study
  1. To determine the level of knowledge of adults on eye donation before the administration of planned group teaching programme.
  2. To find the effectiveness of planned group teaching programme on eye donation to adults in terms of gain in knowledge score.
  3. To find the association between pre-test knowledge score of adults regarding eye donation with selected demographic variables.

6.5Operational definitions
  1. Effectiveness: In this study it refers to the extent to which planned group teaching programme on eye donation has achieved the desired effect as assessed by gain in knowledge score.
  2. Planned group teaching programme: In this study planned group teaching programme refers to systematically developed instructional and teaching plan that will be given to a small group comprising of 6-10 subjects to provide information regarding importance of vision, instructions for eye donation, how to become a donor, contraindications for eye donation, criteria for donating eyes,how to register for eye donation ,knowledge on eye bank etc.
  3. Adults: In this study adults refers to males and females in the age group of 20 years and above.
  4. Eye donation: Giving vision to the blind by bestowal of eyes after death by pledging it to the eye bank.
  5. Knowledge:It refers to the right responses given by thesubjects to the structured interview schedule regarding eye donation.

6.6Assumptions
  1. Adults can be motivated to assume their responsibility towards eye donation.
  2. Planned teaching program is an effective method to create awareness regarding eye donation.
  3. Adults have some awareness regarding eye donation.
  4. Willingness for eye donation can be facilitated through active health teaching by a motivated worker.

6.7Delimitations
The study is delimited to:
Adults aged 20 years and above.
Assessment of knowledge of adults regarding eye donation through a structural interview schedule.
6.8Hypotheses
All hypotheses will be tested at 0.05 level of significance.
H1:The mean post-test knowledge score of adults on eye donation will be significantly higher than the mean pre-test knowledge score.
H2:There will be significant association between pre-test knowledge score of adults regarding eye donation and selected demographic variables.
7. / Material and methods
7.1Source of data
The data will be collected from adults of the selected rural community at Mangalore.
7.1.1Research design
The research design adopted for the study will be pre-experimental, one group pre-test, post-test design.
7.1.2Setting
The study will be conducted in the selected rural community of Mangalore.
7.1.3Population
In this study population consist of adults in the age group of 20 years and above.
7.2Methods of data collection
7.2.1Sampling procedure
Convenient sampling technique will be adopted for this study.
7.2.2Sample size
The sample for the present study would be 60.
7.2.3Inclusion criteria for sampling
  • Adults in the age group 20 years and above.
  • Adults who are willing to participate in the research study.
  • The adults who can communicate in Kannada or English.

7.2.4Exclusion criteria for sampling
  • Adults with hearing impairment and visual impairment.
  • Adults who are already exposed to similar health teaching.

7.2.5Instruments intended to be used
  • Structured interview schedule.
  • Planned group teaching programme.

7.2.6Data collection method
  1. Formal permission will be obtained from District Health Officer and Medical Officer of rural primary health centre.
  2. Formal permission will be obtained from the subjects.
  3. On the first day pre-test will be conducted to assess the knowledge of adults regarding eye donation using a structured interview schedule followed by group teaching using AV aids.
  4. Post test will be conducted on the eighth day using the same structured interview schedule.

7.2.7Data analysis plan
  1. Data will be analysed in terms of descriptive (mean, percentage, SD and mean percentage) and inferential statistics (t-test and chi-square test).
  2. Data will be presented using tables and diagrams.
7.3Does the study require any investigations or interventions to be conducted on patients, or other animals? If so please describe briefly.
Yes, the planned group teaching programme needs to be given by the investigator.
7.4Has ethical clearance been obtained from your institution in case of 7.3?
Yes, consent will be obtained from the adults of the selected rural community of Mangalore.
8.References
  1. Kasturi SR. Community health nursing. 3rded. Chennai: K. V. Mathew Publication; 2000.
  2. Pande A. Essentials of eye banking 1stedition.New Delhi: Satishkumar Jain publication;2003
  3. The Hindu. Eye Donation – a perspective. available from: URL:
  4. Rotary eye bank - Eye donation. Available from: URL:htt://cc.msnscache.com/cache.aspx?
  5. Study finds that children are most its affected by corneal blindness. Available from: URL:
  6. Nanda PK. 30 percent growth in eye donations, but not enough. Available from: URL:
  7. Priyadarshini B, Srinivasan M, Padmavathi A, Selvan S, Saradha R, Nirmalan PK. Awareness of eye donation in adult population of Southern India. A pilot study. Indian Journal of Ophthalmology 2003;51(1):101-4.
  8. Saini JS, Reddy MK, JainAK, Ravindra MS, Jhaveria S, Reghuran L. Perspectives in eye banking. Indian Journal of Ophthalmology 1996; 44(1):47-55.
  9. Eye donation. Available from: URL:
  10. Tandon R, Verma K, Vanathi M, Pandey RM, Vajpeyee R. Factors affecting eye donation from post mortem cases in a tertiary care hospital. Cornea 2004 Aug;23(6):597-601.
  11. Dandona R, Dandona L. Childhood blindness in India: a population-based perspective. British Journal Ophthalmology 2003 Mar;87(3):263-5
  12. Chandrashekar TS, Bhat HV, Pai RP, Nair SK. Prevalence of blindness and its causes among those aged 50 years and above in rural Karnataka, South India. Trop Doct.2007 Jan;37(1):18-21.
  13. Gogate B, Gogate P, Khandekar R, Bhargava A. Knowledge and attitudes towards eye donation among health professionals in India. Available from: URL:
  14. Dhaliwal U. Enhancing eye donation rates by training students to be motivators. Indian Journal of Ophthalmology 2002;50:209-12.

  1. Singh MM, Ruhi M, Pagare D, Ingle GK. Medical students’ perception on eye donation in Delhi. Indian Journal Ophthalmology 2007;55:49-52.
  2. Awareness of eye donation in the rural population of India. Indian Journal of Ophthalmology 2004;52(1):73-8
  3. Dndona R. Awareness of eye donation in an urban population in India. Available from: URL: