Registration of Subjects for Dissertation

Registration of Subjects for Dissertation

T.JOHN COLLEGE OF NURSING

GOTTIGERE

BANNERGHATTA ROAD

BANGALORE-83

SYNOPSIS

REGISTRATION OF SUBJECTS FOR DISSERTATION

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,

KARNATAKA

PREPARED BY

ABILY SARA THOMAS

I YEAR MSC NURSING,

T.JOHN COLLEGE OF NURSING

GUIDED BY,

MRS.VASANTHA S,

PROFESSOR,

PAEDIATRIC NURSING,

T JOHN COLLEGE OF NURSING

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, KARNATAKA, BANGALORE

ANNEXURE – II

PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION

NAME OF THE CANDIDATE AND ADDRESS (IN BLOCK LETTERS) / ABILY SARA THOMAS
I YEAR M. Sc. NURSING
T JOHN COLLEGE OF NURSING
GOTTIGERE,
BANNERGHATTA ROAD,
BANGALORE-83
NAME OF THE INSTITUTION / T JOHN COLLEGE OF NURSING
GOTTIGERE ,
BANNERGHATTA ROAD,
BANGALORE-83
COURSE OF STUDY AND SUBJECT / M.Sc. NURSING
PAEDIATRIC NURSING
DATE OF ADMISSION TO THE COURSE / 17/11/2011
TITLE OF THE TOPIC:A STUDY TO ASSESS THE EFFECTIVENESS OF STRUCTURED TEACHING PROGRAMME ON KNOWLEDGE REGARDING PREVENTION OF HOOKWORM INFESTATION AMONG MOTHERS OF UNDERFIVE CHILDREN IN SELECTED RURAL AREA, BANGALORE.
6
7
/ BRIEF RESUME OF THE INTENDED WORK
INTRODUCTION
“Cherishing children is the mark of a civilized society.”
-Joan Ganz Cooney.
Little children are little cherubs from heaven who lost their way and found themselves trapped in the world of ours.1
Period from conception to five years is termed as under five.2 During this period children are in a dynamic state of growth with cells multiplying fast and organ systems developing in a rapid rate.They breathe more air and consume more food and water in proportion to their body weight.3 As a result children will have substantially heavier exposure than adult to any toxicants that are present in water, food, air or soil.2
Children cannot be considered little adults when it comes toharmful environment exposure.4 Younger children explore their surroundings by touching things and placing their hands and objects into their mouth. Their immunity to illness is also less developed than older children making them more susceptible.5
Many children under five years of age in developing countries are exposed to multiple disease conditions like communicable diseases, respiratory tract infections, malaria, and worm infestations due to poor, unclean and unhealthy environment.6
Worm infestation constitutes an important health problem in children. A wide variety of worms infest humans such as pinworms, roundworms, tapeworms and hookworms. Among these hookworms is a major cause of iron deficiency anaemia in countries like India.7
Hookworm is a nematode infestation affecting the small intestine and lungs.8 Two species of hookworms commonly infect humans, Ancylostoma duodenale and Necator americanus.9 Ancylostoma duodenale is predominant in North India and Necator Americanus is in South India.10
The hookworm is a parasitic nematode that lives in the small intestine of its host which may be a mammal such as dog, cat or human.9 Hookworm eggs are found in human faeces. They enter children’s bodies through the skin commonly through barefoot and then migrate to the intestinal tract, where they attach themselves onto the intestinal villi. They suck blood from children’s intestinal wall to sustain themselves.11
Infections usually are asymptomatic. Intense pruritis can occur at the site of larval penetration, usually the soles of feet or between the toes. Symptoms of abdominal pain, anorexia, indigestion, fullness and diarrhoea occur with hookworm infestation. The major manifestation is subsequent anaemia. Chronic infection causes hypoalbuminemia and edema which may lead to heart failure.12
Hookworm infestation can be prevented by some of the hygienic practices such as proper disposal of excreta, washing children’s hand before taking food and after going to the bathroom, using clean and safe drinking water and not allowing the children to play barefoot in the soil.13
6.1 Need for the study
“Wellbeing of the society is linked to safe mother and childhood.”
-Anbumani Ramadoss.
Hookworms are estimated to infect more than 740 million people around the world, possibly upto one fifth of world’s population. The most significant risk of hookworm infestation is anaemia secondary to loss of iron into gut. The prevalence of infection is as high as 80% in lesser developed countries with moist tropical climate but is only 10-20% in areas with drier climate.14 The annual number of deaths was approximately 65,000 as a result of hookworm anaemia.10
Hookworm is a leading cause of maternal and child morbidity in the developing countries of tropics and subtropics. In susceptible children hookworms cause intellectual, cognitive and growth retardation. In developed countries, hookworm infection is rarely fatal, but anaemia can be significant in heavily infected individual.9
Hookworm infestation is widely prevalent in India. More than 200 million people are estimated to be infected in India.10 About half the population in South India and 50% of school children in tribal areas of Central India are infected with hookworm.15
Children are infected more commonly and more heavily than adults. This is because children are more likely to come in direct contact with fecally contaminated soil that contains infective larvae. Children with physiologically low iron reserves may suffer greater complications from hookworm anaemia.14 In India the overall prevalence of hookworm infestation in children is about 30% in urban and 68% in rural areas.15
A cross sectional study was conducted in selected blocks of Uttar Pradesh and Jharkhand to estimate the prevalence and risk factors associated with worm infestation in children aged 6 to 23 months. Overall 920 children were recruited and 909 faecal samples examined. Results showed that the combined prevalence of infestation with geohelminths treatable by Albendazole and other intestinal parasites non treatable by Albendazole was 50.3% (457/909) and 51.6% (469/909) respectively. Exclusive use of handpump water and use of handpump water plus field defecation increased risk of geohelminthic infection while use of well water and exclusive use of soap and water practice for handwashing after defecation was protective. The study concluded that targeted deworming of population in this age group should be considered since almost half the children are infected with intestinal geohelminths treatable by Albendazole.16
A study was conducted to determine the prevalence of intestinal helminthic infection in a rural population near Vellore in South India. A sample of 78 members of 15 families from a village was studied. Stool samples from all subjects were examined on alternative days for one month. Results showed that the overall prevalence rate of various parasitic infections was 97.4%. Hookworm infestation were the commonest helminthic infections seen in 48/78 (61.5%). The study concluded that the extremely high prevalence rates may be a function of unprotected water supply and the defecation practices of the villagers.17
Since mothers play a vital role in developing healthy life style among children it is very important to empower them with knowledge and practices about prevention of hookworm infestation. Here the investigator feels that there is a need for preparing a Structured Teaching Programme to increase the knowledge of mothers in selected rural area.
6.2 Review of literature
Review of literature refers to an extensive, exhaustive and systematic examination of publications relevant to the project.18 A literature review early in the report provides readers with a back ground for current knowledge on a topic and illuminates the significance of the new study.19
The literature can be reviewed under following headings:
1. Literature related to prevalence of hookworm infestation.
2. Literature related to prevention of hookworm infestation.
3. Literature related to knowledge of mothers of underfive children regarding hookworm infestation.
1.Literature related to prevalence of hookworm infestation.
A cross-sectional study was carried out in Kwara state, Nigeria to compare the prevalence and intensity of intestinal helminth among 304 pupils from rural and urban communities. Semi-structured questionnaires were administered to the pupils and each of them had stool sample collected. Results showed that the prevalenceof helminthic infection in rural and urban pupils was 17.6% and 18.5% respectively. Hookworm showed heavy intensity of infestation among pupils from rural area as evident by high mean egg load of the parasite in the stool. The study concluded that all school pupils in Nigeria are at risk of helminthiasis.20
A study was carried out in two secondary schools in a sub urban area of Vomin Jos to determine the prevalence of hookworm infection among 463 students. Stool and finger prick blood samples were collected. Out of the 463 samples collected 15 (3.2%) were positive for hookworm with peak infection in age group13-15 years (3.9%) followed by age group 16-18 years (3.8%) then age group 10-12 years (2.6%). The hematocrit values reduced with infection. More females (6.5%) than males (1.9%) were infected.21
A cross-sectional study was conducted in 14 primary schools of Central Thailand to determine the prevalence of intestinal parasitic infections. 1037 children with age ranging from 3-12 years were examined for intestinal parasites by formalin-ether concentration technique. The result showed that overall prevalence was 4.24% Hookworm was about 0.19%. The study concluded that close monitoring and control of parasitic infections is needed.22
A study was conducted to determine the prevalence and intensity of soil transmitted helminth among 300 residents of Era-Awori village, South West Nigeria. The result showed an overall prevalence of 83.3% of helminths. Of these hookworms was found 45%. Children (1-10) years showed higher positive rates than adults. The study concluded that soil transmitted helminths are important public health problems hence action is imperative against deficiencies in sanitary facilities, improper disposal of human faeces, insufficient supplies of portable water, poor personal hygiene and substandard housing.23
2. Literature related to prevention of hookworm infestation
A study was conducted to report the reduction of hookworm infection among 697 primary school children living in riverside communities of Della state, Nigeria. Stool samples from randomly selected primary school pupils were obtained before and after treatment with a single 200 mg dose of Albendazole. Results showed that 77% prevalence of hookworm infestation before deworming the children with Albendazole was reduced to 34% post treatment. The study concluded that mass deworming stands as a feasible intervention in the control and prevention of hookworm infestation in riverine communities.24
A study was conducted in Pasir Laba Medical Centre, Singapore among 69 subjects of age 18-20 years with vague abdominal pain of more than 3 days duration. Lack of response to antacid therapy was also a criterion of selection. Results showed that 46.4% were found to have hookworms. 88% of them also recovered from symptoms after hookworm therapy. This study concluded that hookworm infection is an important cause of abdominal discomfort in young Singaporean adult males.25
An experimental study was conducted to examine the effect of a school based deworming programme on primary education outcomes in 75 primary schools in rural western Kenya. The intervention consists of medical treatment for hookworm,roundworm and whipworm that infect 92% of school aged children. The results showed a significant positive impact on school participation among lower standard pupils after one year of treatment. The study concluded that benefits of school based deworming programme may exceed the costs by more than ten times.26
3. Literature related to the knowledge of mothers of underfive children regarding hookworm infestation.
A descriptive study was conducted in selected rural community, Bangalore to assess the knowledge and practices of mothers regarding worm infestation. 100 mothers of school children were selected by simple random sampling technique. Results showed that majority of mothers had adequate knowledge (65%) and moderate practices (72%) regarding worm infestation. The study concluded that there is a need to improve the knowledge and practices with regard to prevention of worm infestation.27
A comparative study was undertaken to compare the knowledge level of urban and rural mothers on prevention of worm infestation. Sample size was 50 and convenient sampling technique was used in this study. The result showed that urban mothers have more knowledge than rural mothers. The study concluded that creating awareness among rural mothers on prevention of worm infestation is important.28
A cross-sectional study was conducted in Shesha Kekele, Southern Ethiopia to assess the maternal awareness regarding intestinal parasitic infections among 130 mothers of underfive children.Interview technique was used. Results showed that mothers had a fairly good knowledge of the mode of transmission of intestinal parasitic infection. The study concluded that improvement of sanitation and health education is required.29
6.3 Statement of the problem
A study to assess the effectiveness of structured teaching programme on knowledge regarding prevention of hookworm infestation among mothers of underfive children in selected rural area, Bangalore.
6.4 Objectives of the study
  1. To assess the knowledge regarding prevention of hookworm infestation among mothers of underfive children.
  2. To administer the structured teaching programme regarding prevention of hookworm infestation.
  3. To evaluate the effectiveness of structured teaching programme on knowledge regarding prevention of hookworm infestation.
  4. To associate the post test level of knowledge with selected demographic variables.
6.5 Operational Definitions
  1. Assess: It refers to the estimation of knowledge of mothers of underfive children regarding prevention of hookworm infestation.
  2. Effectiveness: It refers to the desired changes that can be brought through teaching programme.
  3. Structured teaching programme: It refers to systematically organized and designed instructions and teaching aids which are designed to increase the knowledge regarding prevention of hookworm infestation.
  4. Knowledge: It refers to the process of acquiring information regarding prevention of hookworm infestation.
  5. Prevention: It refers to precautionary measures taken to avoid the occurrence of hookworm infestation in under five children.
  6. Hookworm infestation: It refers to worm infestation affecting the small intestine and lungs.
  7. Mothers: Refers to woman who had given birth to one or more children.
  8. Under five children: Refers to children below five years of age.
6.6 Assumptions
  1. Mothers will have decreased knowledge regarding prevention of hookworm infestation.
  2. Structured teaching programme will improve the knowledge level of mothers.
  3. Mothers will be willing to participate in the study actively.
6.7 Delimitations
  1. Study is limited to mothers of under five children in selected rural area, Bangalore.
  2. Data collection method is limited with the tool prepared by the investigator.
  3. Study period is limited to 4-6 weeks.
  4. Sample size is limited to 60 mothers.
Conceptual Framework
Open system model.
6.8 Hypothesis
H1:There will be significant difference between mean pre test and post test knowledge regarding prevention of hookworm infestation among mothers of under five children.
H2:There will be significant association between the post test knowledge with selected demographic variables.
6.9 Variables
Independent Variables: Structured teaching programme on knowledge regarding prevention of hookworm infestation among mothers of under five children.
Dependent Variables: Knowledge onprevention of hookworm infestation.
Materials and Methods
7.1Source of data:Data will be collected from mothers of under five children in selected rural area, Bangalore.
7.1.1Research Design
The research design used in this study is pre experimental study with one group pre-test post-test design.
7.1.2 Setting: The study will be conducted at selected rural area, Bangalore.
7.1.3 Population: The population of the study comprises of mothers of under five children in selected rural area, Bangalore.
7.2 Method of Data collection: Data will be collected by using closed ended questions.
7.2.1 Sampling procedure:Non probability convenient sampling.
7.2.2 Sample size:In this study sample will be 60 mothers of under five children in selected rural area Bangalore.
7.2.3 Inclusion Criteria for sampling:
  1. .Mothers of under five children.
  2. Mothers who can understand and speak English or Kannada.
  3. Mothers who are present at the time of data collection.
  4. Mothers who are willing to participate.
7.2.4 Exclusion Criteria for sampling:
  1. Mothers who are not interested to participate.
  2. Mothers who are not having under five children
  3. Mothers who are not available at the time of study.
7.2.5 Instrument intended to be used:
Structured questionnaire consist of two parts:
Part A:consists of socio demographic variables and
Part B:consists of multiple choice questions regarding the knowledge on prevention of worm infestation.
7.2.6 Data collection method: Data collection by using closed ended questions.
7.2.7 Plan for data analysis:
The data collected under the study will be analyzed through descriptive and inferential statistics.
Descriptive statistics: Frequency and percentage will be used to describe the demographic characteristics of mothers of under five children.Mean, standard deviation and range will be used to assess the knowledge on prevention of hookworm infestation among mothers of under five children.
Inferential statistics: Paired “t” test will be used to test to compare the pre test and post test knowledge on prevention of hookworm infestation.
Chi square test will be used to find out the association between the post test and selected demographic variables.
Ethical consideration
7.3 Does the study require any investigations or interventions to be conducted on patients or other humans or animals? If so, please describe briefly.
Yes, structured teaching programme will be administered to the subjects.
7.4 Has ethical clearance been obtained from your institution in case of 7.3?
Yes, permission has obtained from the concerned authorities and subjects.
Bibliography
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10)Park K.Textbook of Preventive and Social Medicine.19th edition. Jabalpur. Banarsidas Bhanot Publishers;2007.
11)Adele Pilliteri. Child Health Nursing.Care of the child and family. Philadelphia. Lippincott publications; 1999.
12)Waldo E Nelson, Richard E Behrman, Robert M Kliegman. Nelson Essentials of Pediatrics.5th edition Philadelphia. Saunders publications; 2005.
13)Manoj Yadav. A textbook of Child Health Nursing. Jalandhar. S.Vikas & Co publishers; 2011.
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16)Awasthi S, Verma T, Kotecha PV, Venkatesh V, Joshi V, Roy S. Prevalence and risk factors associated with worm infestation in preschool children (6-23 months) in selected blocks of Uttar Pradesh and Jharkhand, India. Indian journal of medical science. 2008 Dec;62(12):484-91.
17)Kang G, Mathew MS, Prasanna Rajan, Daniel JD, Mathan MM, Mathan VI, Muliyil JP. Prevalence of intestinal parasites in rural Southern Indians. Tropical medicine and international health.2003 Jun 18;3(1):70-75.
18)Basavanthappa BT. Nursing research. 2nd edition. New Delhi. Jaypee publishers; 2007
19)Polit FD, Beck TC. Nursing research principles and methods. 7th edition.Philadelphia. Wolters Kluwer publication; 2003.
20)Adefemi SA, Musa OI. Intestinal helminth infestation among pupils in rural & urban communities of Kwara State, Nigeria. African journal of clinical and experimental microbiology. 2006 Sep; 7(3):208-11.
21)Odebunni JF, Adefioye OA, Adeyeba OA. Hookworm infection among school children in Vom Plateau State, Nigeria. American-Eurasian journal of scientific research. 2007; 2(1):39-42.
22)Wilai Saksirisampant, Jarruratt Prownebon, Maedhi Kulkhamthorn, Sutin Yenthakam, Surasak Janpla, et.al. The prevalence of intestinal parasitic infections among school children in the Central Region of Thailand. Journal of medical association of Thailand. 2006; 89(11) :1928-33.
23)Comfort Adejoke Ibidapo, Omolade Okwa. The prevalence & intensity of soil transmitted helminths in a rural community,Lagos Suburb, South West Nigeria. International journal of agriculture and biology. 2008 ; 10(1) :89-92.
24)Oyewole F, Ariyo F, Oyebo WA, Sanyaolu, Fawega T, et.al. Hookworm reduction with Albendazole among school children in riverine communities of Nigeria. Journal of rural and tropical public health. 2007; 6(1): 6-10.
25)Tan SH, Chew SJ, Chin KW. Hookworm infestation as a cause of chronic abdominal pain in young Singapore males. Singapore medical journal. 1986 Aug; 27(4):333-35.
26)Edward Miguel, Michael Kremer. The educational impact of deworming in Kenya. Econometrica. 2004 Jan; 72(1):159-217.
27)Swarajyam Y. A study to assess the knowledge and practices of mothers regarding worm infestation among school age children inorder to develop health education pamphlet in a selected rural community, Bangalore. Asian journal of nursing education and research. 2011 Jan; 1(1):29-36.
28)Vasumathi K. Comparative study on assessment of knowledge on prevention of worm infestation among urban and rural mothers in selected community areas, Coimbatore. Asian journal of nursing education and research. 2011 Jan;1(1):9-13.
29)Liza A, Kebreten Manaye, Mengistu Legesse, Muluget Belay. Maternal awareness about intestinal parasitic infections in Sheshe Kekele, Southern Ethiopia. International journal of health research 2010; 24(3):185-90.
8. / SIGNATURE OF THE CANDIDATE
9. / REMARKS OF THE GUIDE
10. / NAME AND DESIGNATION OF (IN BLOCK LETTERS)
10.1GUIDE / MRS.vasantha.s,
head of the department.
paediatric NURSING.
10.2SIGNATURE
10.3CO-GUIDE (IF ANY) / MS.UMA MAHESWRI,
LECTURER,
PAEDIATRIC NURSING.
10.4SIGNATURE
11. / 11.1HEAD OF THE DEPARTMENT / MRS.VASANTHA.S
11.2SIGNATURE
12. / 12.1REMARKS OF THE CHAIRMAN AND PRINCIPAL
12.2SIGNATURE

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