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INTRODUCTION
He who has health, has hope, and he who has hope, has everything.
[An Arabian Proverb]
BACKGROUND OF STUDY
Hypertension is one of mankinds most common diseases affecting 15-20% of
all adults. Abnormally increased blood pressure is called hypertension. Essential (or
primary) hypertension (HTN) is a disorder of the circulatory regulation. It is currently
among the leading causes of morbidity and mortality in the world and is expected to
have even greater impact on the health of the people specially in the developing world.
Hypertension is a major cardiovascular problem world over. Its prevalence
ranges from 100 to 200 per 1000 population. Most of the cases are of primary
hypertension and many 2% could be accounted for as secondary hypertension Most of
the cases of secondary hypertension are considered to be due to some and
cardiovascular diseases. Hypertension is the most common disorder encountered in
outdoor patients. The seventh report of the Joint National Committee or prevention,
detection, evaluation and treatment of High Blood Pressure (JNC VII report) has
recommended a new classification for adult 18 years or older.
Normal 120/80 mm Hg, Pre Hypertension 120 139/90 mm Hg, Hypertension
Stage 1 140 159/90 99 mm Hg., Hypertension Stage 2 > 160/ > 100 mm Hg,
Hypertension Stage 3 > 180 / > 110 mm Hg. (JS Sandhu 2004)
Hypertension can be defined as persistent levels of blood pressure in which the
systolic pressure is above 140 mm Hg and the diastolic pressure is above 90 mm Hg. In
elderly population hypertension is above 160/90 mm Hg. (Brunner & Suddarths 1998)
Arterial hypertension is an important modifiable risk factor for cardiovascular,
cerebrovascular and renal morbidity and mortality. Accurate and reliable information
about prevalence of arterial hypertension and its risk factors is a prerequisite for
designing strategies for its control and prevention. Coronary events such as a heart
attack are still the most common result of hypertension. Increased blood pressure level
is related to increased severity of atherosclerosis, stroke, nephropathy, peripheral
vascular disease, aortic aneurysms and heart failure. If hypertension is left untreated,
1
nearly half of hypertensive clients will die of heart disease, a third will die of stroke and
the remaining 10% to 15% will die of renal failure. Hypertension is highly prevalent in
India. The Indian Heart Journal give an idea about its increasing prevalence attributable
to rapid alteration of life style in developing countries like India and Nepal. Health
Planners, physicians, community leaders and public health practitioners should
formulate region specific guidelines based on local health care priorities and economic
realities. These regional guidelines should identify reality goals, such as the thresholds
for treatment, the desirable level of blood pressure control, the affordable degree of
hypertension control, the acceptable extent of hypertension control and the possible
strategies for achieving these targets. Life style modification needs to be emphasized at
all levels and there is no threshold of acceptability and affordability as it does not
concern money but attitude, policies related to tobacco, alcohol, salt and education may
be in the domain of the state, but individuals have a greater responsibility that needs to
be constantly reminded at all levels. It is also time for the citizens to wake up and redefine priorities in life. (J. C. Mohan 2005).
The high knowledge deficit among clients with hypertension indicates a low
awareness regarding their disease. It implies that patient teaching is inadequate or
ineffective and that the self-care potential of clients is not being fully used. Health
teaching is an integral component of nursing practice.
Hence, apart from the incidental teaching, nursing personnel should conduct planned
teaching programmes for patients in order to enhance their self-care ability. Nursing
personnel working in various health care settings should be given in service education
to update their abilities in identifying learning needs of clients and in planning
conducting
and
evaluating
teaching
for
different
categories
of
patients.
1.2
the world till year 2002 was estimated to be about 972 Millions form which 634 million
patients belonged to the economically developing countries. It is also developed by a
result of anxiety, tension, dietary pattern and life style. Now a days living
2
standard is also changing. Hypertension affects vital organs like heart, lungs and
kidneys.
During the clinical experience the investigator had noticed that majority of
patient who mainly belonged to urban areas did not know much about hypertension and
its causes and prevention. They were not taking prescribed treatment, neglecting the
dos and donts of diet and did not know the importance of exercise which lead to
complications. The investigator observed that a number of hypertension patients were
hospitalized because of uncontrolled blood pressure, nephropathy and arteriosclerosis,
Hypertension complications are preventable and long and healthy life is possible
despite hypertension. Education is the process of motivating self-care so that they can
look after themselves without being dependent on trained health professionals and
thereby reducing the complications and burden on the family, and society. Hence, the
investigator felt the need to conduct this study.
Niji J. Solomon (2000) conducted a study for the prevalence of selected
modifiable risk factors of hypertension among adults at Balam village, Terunelveli.
Descriptive design was used and samples of the study were 100 adults. Structured
interview schedule was used to assess the prevalence of selected modifiable risk factors.
Findings of the study revealed that the overall mean for modifiable risk factors were
57.16 with a moderate level risk of 90%. Conclusion of the study revealed that practice
of preventive steps through healthy life style can prevent a major catastrophe in future.
Joshi Clara (1997) conducted a study to assess the effectiveness of structured
teaching on self-care of pregnancy induced hypertension among pregnant women in
hospital. A structured teaching on the self- care of pregnancy in induced hypertension
mothers. The samples comprise of pregnant women with pregnancy induced
hypertension distributed.
1.3
1.4
1.
2.
3.
4.
OBJECTIVES
1.5
HYPOTHISIS
H1 There will be some knowledge regarding hypertension among hypertensive
patient.
H2 There will be significance difference between pre and post test scores.
1.6
OPERATIONAL DEFINITION
1. Knowledge - In this study it refers to the information with regard to
hypertension obtained from hypertensive patient in term of correct responses to
the items on pamplet.
2. Effectiveness Refers to improvement is post test score of knowledge among
hypertensive patients after administration of teaching programme compared to
the pre-test knowledge score.
3. Hypertensive Patients Persons of 20 to 80 years who are diagnosed as having
hypertension by a physician and he/she is on treatment for the same.
4. Structured Teaching Programme One to one individual health education with
the help of structured teaching plan given to hypertensive patients.
1.5
ASSUMPTION
There is high prevalence of hypertension among the adult population in the
Peoples Hospital at Bhopal city.
1.8
DELIMITATIONS
The study is delimited to adult patient with hypertension, living in Peoples
Hospital in Bhopal.
1.9
are scientifically based and emphasizes the selection, arrangement and clarification of
its concept.
-Polit and Hungler (1999)
Input
Consists of information material or energy that enters the system. In this study
investigator is a system with input from the environment. The input includes
hypertension background age, sex, education, occupation, income/month (in rupees),
marital status, dietary habits, and previous knowledge.
Process
After the input is absorbed by the system, it is processed in a way useful to the
system. Here it refers to the administration of pamplet to hypertensive patient. In order
to achieve the desired output, i.e. increase the knowledge of Hypertensive patient are
following process is adopted. Using a structured knowledge questionnaire knowledge of
hypertensive patient will be assessed and this will be followed by preparation and
administration of pamplet. H.T. following this knowledge will be tested again.
Output
It refers to energy, matter or information disposed of by the system as a result of
its process. In the present study, it refers to the improvement of knowledge of
Hypertension. This is assessed through a comparison between the pre-test and post-test
knowledge score of the Hypertension patient.
Feedback
It is the process that enables a system to regulate it save and provides
information about the systems output and is feedback as input. It higher knowledge
scores obtained by the hypertension patient in the post-test indicate that the structured
teaching programme was effective in increasing the knowledge of Hypertension patient.
A low score in post-test indicates that the Structured Teaching Programme was not
effective an alternative measures may be needed to improve knowledge.
1.10 SUMMARY
This chapter dealt with the introduction, background, need of the study. It
mentioned about the statement problem, objectives, operational definitions,
assumption, hypothesis and delimitation of the study and plan of writing report.
2. REVIEW OF LITERATURE
Man can learn nothing except by going from the known to unknown.
(Claude Bernard)
Review of literature is an important step in the development of a research
project. It is a complication of resources that provides the groundwork for the study.
The investigator carried out an extensive review of literature on the research
topic in order to gain deeper insight into the problem and to collect maximum relevant
information for building up the study in a scientific manner so as to achieve the desired
results.
The literature review that was undertaken for the purpose of the conducting this
study has been presented under the following headings
Section 1: Literature related to incidence of Hypertension.
Section 2: Literature related to Structured Teaching Programme on knowledge.
Section 3: Literature related to other intervention.
2.1
with border line 2hypertension. Data were collected from a multiethnic non probability
samples of 267 men and women 60-75 years of age. The final model explained 44% of
the variance in physical activity. Variable that indirectly predicted physical activity were
perceived health status, barriers to physical activity, self-efficacy for physical activity
intrinsic motivation for health and environmental influence. The significant associations
between the cognitive appraisal and motivation concepts extend previous research and
add to the understanding of the complex factors that influence regular physical activity.
Soya K, Kumar Geetha V.P. (2003) conducted a quasi-experimental study to
assess the self-care activities of pregnancy induced hypertension and maternal outcome.
Based on sample criteria 70 primigravida with pregnancy induced hypertension (PIH)
were selected by non-probability purposive sampling, 30 A pre-test post-test on
equivalent Data was After selection pre-test was done using structured interview
schedule.
The bio-physiological markers such as blood pressure, weight gain, proteinuria
and oedema of all the clients were also assessed at the time of selection. They were
advised to contact the investigator during each of their subsequent antenatal visit up to
delivery. On the same day of selection the experimental group were exposed to
structured teaching programme; after the pre-test in one session of 45 minutes either
individual or in group. A hand out was provided to them for further reference. The post
test on both experimental and control group were done after two weeks, using the same
structured interview schedule. All the clients were monitored during each follow up
record.
The findings concluded that before structured teaching programme the
knowledge of primi gravida women with pregnancy induced hypertension was less. The
structured teaching programme on selected self-care activity (SSCA) considerably
enhanced the knowledge of primi gravida with pregnancy induced hypertension. The
structured teaching programme helped the primi gravida women with pregnancy
induced hypertension to practice selected self-care activity. The practice of selected
self-care activity by primi gravid women with pregnancy induced hypertension helped
to attain favourable self-care. There was an association between PIH and variables such
as age and occupation i.e. PIH was prevalent more among the age group 21 to 25 years
and most of the women pregnancy induced hypertension had no occupation. There was
no relationship with pregnancy induced hypertension and variables such as religion
educational status and family history of pregnancy induced hypertension.
Henriksson KM (2002) conducted a prospective longitudinal study to explore
the development of hypertension in a cohort of young middle-aged men. Using a
hospital setting in Sweden, data were collected from a birth cohort study of men
surveyed over 6 years. The sample included a total of 628 men born in 1953 to 1954, all
of whom were surveyed at 37, 40 and 43 years of age at the same time of the year. The
result indicated that at 37 years of age, 243 men (39%) had reference or normal blood
pressure, 167 (26%) had high normal blood pressure and 218 (35%) were hypertensive.
The individuals with high normal blood pressure at baseline were statistically
10
hypertension. Four different programmes have been implemented into the German
health care system. Over 80% of the physicians rated the training courses as Very
good or good and rated the teaching material and very good or good. Data
collection
effectiveness of these programmes at the treatment level. The results also demonstrate
the practicability an effectiveness of the implementation of programmes as an integral
part of disease management in routine health care for patients with diabetes mellitus or
hypertension.
Zernike (1998) conducted a study for evaluating the effectiveness of two
teaching strategies for patients diagnosed with hypertension. Experimental research
design was adopted. Samples were drawn from 30 hypertensive patients. A pre-test was
performed shortly after admission to hospital are collect information.
Comparison of the pre and post-tests of the group revealed a significant increase in
knowledge level at the time of discharge from hospital.
Joshi Clara (1997) conducted a study to assess the effectiveness of structured
teaching on self-care of pregnancy induced hypertension among primi para mother
antennal clinic.
hypertension mothers. The samples comprise of 30 primi para mothers with pregnancy
induced hypertension distributed. Findings and of study revealed that the incidence of
pregnancy induced hypertension was high among young primipara below 20 years and
gravida mothers. The age factors and family size exhibited its relationship with
knowledge gain. The pregnancy induced hypertension primipara mothers who received
teaching gained highly significant knowledge. The structured teaching on self-care
pregnancy induced hypertension primi para mothers was effective in increasing the
knowledge and in prevention of complications.
Gruesser M. (1997) conducted a study to assess the effect of structured patient
education for out patients with hypertension in general practice. A one group pre-test,
post-test approach was used. The project was carried out in co-operation with the
German hypertension league and designed to evaluate the practicability and efficacy of
the implementation in routine primary health care. A total of 466 patients were trained.
Data was collected from 272 patients. Data collected 22 weeks after the intervention
demonstrated the efficacy of the programme at treatment level : reduction of body
12
weight (2 kg, p < 0.001) and blood pressure (from systolic 158 <18 to 148 < 17 mm hg,
p < 0.001, diastolic 91 < 9 to 86 < 9, p < 0.001) 65% patients learned for the first time
how to perform blood pressure self-monitoring during the programme.
Sawicki PT (1993) conducted a study to assess the improvement of
hypertension care by a structured treatment and teaching programme. This programme
aims at improving of patients compliance to antihypertensive therapy and is based on
four groups sessions mainly conducted by paramedical personnel. This programme was
evaluated in three different settings in patients with hypertension, diabetes mellitus and
poor compliance to anti-hypertensive drug therapy. In all three studies a significant
improvement in compliance to anti-hypertensive therapy were found.
2.3
13
2.4
SUMMARY
This chapter deals with the review of literature. There are 15 review of literature
14
3. RESEARCH METHODOLOGY
This chapter deals with the methodology selected by the investigator to study
the research problem.
Research methodology is the systematic way of doing a research to solve a
problem. It contains statement of the problem, objectives of the study, assumptions
which have been formulated, methods used for data collection and the statistical method
used for analyzing, he data and the logic behind it (Kothari, 1998)
3.1
Research Approach
The study aims at determining the effectiveness of structured teaching
3.2
RESEARCH DESIGN
Pre-test post-test research design will be adopted for the studyPre- test
Treatment
O1
Post- Test
O2
15
16
3.3
VARIABLES
3.4
SETTING
Settings are the more specific places where data collection will occur. The
setting for the present study is conduct in Peoples Hospital in Bhopal city
3.5
POPULATION
Population is a group whose members possess specific attributes the researcher
3.6
SAMPLING PROCESS
Sample
A sample is a subject of a population selection to participate in a research study.
(Polit and Hungler, 1999). In this study the sample consisted of 30 subjects who were
diagnosed with hypertension and were present at peoples hospital and who fulfilled the
inclusion criteria.
Sampling Technique
In the present study purposive sampling technique was used to select the
sample. Purposive sampling is a type of non-probability sampling method in which the
researcher selects, participants for the study on the basis of personal judgement about
those who will be more representative or productive also referred to as judgement
sampling, patient were identified till the investigator found a client with hypertension
who met the inclusion criteria.
17
Sample size
In this study, the sample comprised of 30 hypertensive patients in peoples
hospital fulfilling the inclusion criteria.
3.7
Inclusion Criteria
1.
2.
3.
4.
3.8
teaching pamphlet used by the research to measure the variables and knowledge in the
research problem.
Selection of Tools
The data collection technique was questioner schedule. It is considered to be
appropriate the elicit the response from adults.
The researcher included the following criteria.
Development of Tools
The tools used in this study is a structured questionnaire with
Section A
Section B
Socio-Demographic Data.
Assessing the knowledge about hypertension
Review of literature provided adequate content for the tool preparation. Personal
experience of the investigator was an added benefit in the tool construction. Prior to the
development of the tool the investigator consulted the experts in Peoples Hospital.
18
Based on the valuable suggestions of the experts and the review of literature the
investigator , prepared and organized the items of the tool under the respective areas.
Section A Socio Demographic Data
Section A consist of 8 items of the sample structured interview schedule to
collect baseline data, which consisted of socio demographic data for obtaining
formation about selected factors such as Age, Sex, education,
Occupation,
3.9
19
20
The analysis of the pilot study revealed that objectives of the study would be
fulfilled. Based on this information, the investigator proceeded with the actual data
collection for the main study.
21
4. The significant difference between the mean pre-test and post-test knowledge
scores.
5. The data would be represented in the form of tables, bar diagram and pie
diagram.
3.14 SUMMARY
Research Methodology revealed the overall plan of research in a systematic and
scientific manner. This chapter dealt with description of the research design ,variables ,
settings , population ,sample & sample size sampling technique , sampling selection
,criteria, development and description of the tool , pilot study , procedure for data
collection and plan for data analysis . The analysis and interpretation of the same
method presente in
22
2.
3.
4.
Hypothesis
H1.
H2.
There will be significance difference between pre & post test score
4.1
INTERPRETATION OF FINDINGS
The data collected was organized and presented under the following sections.
Section I
Section II
23
Table No.1
Frequency and percentage distribution of subjects according to
Demo-graphic variables
N=30
Demographic Variables
Freque
ncy
Percentage
6
11
10
3
20%
36.66%
33.33%
10%
13
17
43.33%
56.66%
15
3
6
4
2
50%
10%
20%
13.33%
6.66%
28
0
2
0
93.33%
0%
6.66%
0%
5
4
8
5
8
16.66%
13.33%
26.66%
16.66%
26.66%
8
9
12
1
26.66%
30%
40%
3.33%
13
17
1
8
14
7
43.33%
56.66%
3.33%
26.66%
46.66%
23.33%
Age
20-35
36-50
51-65
66-80
Years
Years
Years
Years
Sex
Male
Female
Education
Illiterate
Primary
Secondary
Graduate
Post graduate
Marital status
Married
Unmarried
Divorced
Widow
Occupation
Farmer
Government job
Private job
Business
Unemployment
Income/month
< 5000
5001 10,000
10001 15000
> 15001
Dietary habit
Vegetarian
Non vegetarian
Previous knowledge
Mass media
Friend and Relatives
Health professional
Other
24
In this study 13 (43.33%) of the subjects were female and only 17 (56.66%) of
subjects were male because most of the male went for work and they were not available
during the data collection period.
Regarding education most of the subjects 15 (50%) subject were illiterate, 03
(10%) subjects were primary education, 6 (20%) subject were secondary,4 (13.33%)
subject were,2 (6.66%) post graduate.
Regarding marital status most of the subject 28 (93.33%) subject were married,0
(0%) subject were unmarried,2(6.66%) subject were divorced,0 (0%) widow
Regarding occupation 5 (16.66%) subjects were farmer, 4 (13.33%) subjects
were government job, 8 (26.66%) subjects were private job, 5 (16.66%) subject were
business, 8 (26.66%) subject were unemployed.
Most of the subject were 8 (26.66%) monthly income less than Rs.5000/-, 9
(30%) subjects had Rs.5001-10,000/- and 12 (40%) subjects had income Rs.1000115000 per month 1 (3.33%) subject had income above> Rs15000.
Regarding dietary habit, 13(43.33%) were vegetarian and subjects 17 (56.66%)
were non vegetarian. Regarding most of the previous knowledge 1(3.33%) subject
were mass media, 8 (26.66%) subject were friends and relatives, 14 (46.66%) subject
were health professionals ,7 (23.33%) subject were other were.
25
SECTION I
DISCRIPTION OF SOCIODEMOGRAPHIC DATA
Frequency and percentage distribution of age
N=30
26
PETRSENTAGE (%)
60
50
40
PETRSENTAGE (%)
30
20
10
0
Female
Male
27
28
PERCENTAGE ( % )
LITTIRATE
PRIMARY EDUCATION
SECONDARY EDUCATION
GRADUARTE
POST GRADUATE
29
N=30
PERSENTAGE ( % )
Married
unmarried
Divorced
Widow
30
PERSENTAGE ( % )
Farmer
Government job
Privet job
Business
Unemployment
31
PERSEN
N=30
32
Figure 8 -Pie diagram showing showing sample distribution according to dietary habit
N=30
33
PERCENTAGE (%)
27%
3%
40%
<50000
5001-10000
10001-15000
>15001
34
N=30
PERCENTAGE( % )
3%
23%
27%
massmedia
health personal
frinds
other
47%
35
36
Demographic
variable
Age
Sex
Education
Marital status
Occupation
Income
Dietary habit
Previous
knowledge
D
F
6
2
8
2
8
6
2
Chi square
value
5.80%
2.05%
3.13%
4.36%
8.80%
5.36%
0.17%
4.15%
probability
inference
0.46%
0.36%
0.93%
0.11%
0.36%
0.50%
0.92%
NS.
NS.
NS.
NS.
NS.
NS.
NS.
0.657
NS.
Table -2 reveals that the computed chi- square value shows significant association
between pretest knowledge regarding hypertension with hypertensive patient at the
level of > 0.05 and not found any significant association between pre-test knowledge
with other demographical variable like age , sex, education, status, occupation,
income ,dietary habit and previous knowledge2
NS = Not Significant Table t value p < 0.05 12.59 significant
No significant association was found between knowledge and selected demographic
factors/variables.
Section III
37
N=30
Pre- test Knowledge
Frequency
Percentage
Poor
14
46.66%
Average
Good
13
3
43.33%
10
Mean
Score
X= 9.33
SD
SD
=5.577
percentage
50.00%
45.00%
40.00%
35.00%
30.00%
25.00%
20.00%
15.00%
10.00%
5.00%
0.00%
percentage
poor
average
good
38
39
N=30
Post- test
Knowledge
Poor
Mean
Frequency
Percentage
SD
Score
Average
10
33.33%
Good
20
66.66%
X=
SD=
17.83
3.410
Chart Title
25%
20%
15%
10%
5%
0%
poor
average
good
40
4.2
SUMMARY
Research Methodology revealed the oven of the research in a systematic and
scientific manner. This chapter dealt with description of the research design , variables
, settings , population , sample and sample size , sampling technique sampling
selection , criteria, development and description of tool , pilot study procedure for data
collection , and plan for data analysis .The analysis and interpretation of the same
method presented in the following chapter.
41
5. DISCUSSION
Discovery consists of seeing what everybody has seen and thinking what nobody
has thought.
(Albert Szent)
In this chapter findings of the study are discussed in line with objectives ,
review of literature and of other studies. Discussion of findings is based on the sample
characteristics, clinical information, knowledge of patients about hypertension,
effectiveness of individual planned teaching programme, association of knowledge and
selected variables.
42
of
the
subject
previous
knowledge,
(3.33%)mass
media,8
hypertension, samples was collected from 10 patient, 20 patients in the test group
received a structured education programme and received the usual information.
Comparison of the pre-test and post-test of the test group revealed a significant
increased in knowledge level at the time of discharge from hospital. The study showed
that a structured approach to health education is more effective in improving patients
knowledge.
The above findings is supported by Jasmine J. (1998) conducted a study to
assess the effectiveness of structured teaching on knowledge and life style adopted by
hypertensive patients. The samples were 30 male and female hypertensive patients
belonging to the age group 20-80 years.30 patients in Peoples Hospital Bhopal.
Findings of study revealed that patients who were exposed to structured teaching have
gained more knowledge and favorable
III - Evaluate effect of structured teaching among hypertensive patients.
Evaluate the effectiveness of Structured teaching among hypertensive patient
The findings of study revealed that high knowledge scores mean (9.33) in post-test
when compared to their pre-test scores mean (17.83). The mean difference (5.577) SD
(23.410) and shows a highly significant improvement in the knowledge scores, thus the
structured teaching pamplet was effective.
5.1
IMPLICATIONS
The findings of the present study have several implications in the field of
44
Prevention is better than cure. The health care personnel should be given an
opportunity to update their knowledge regarding hypertension, which is influenced by
hypertensive patients emotional make up, sociological, dietary habits and cultural
background and even his/her willingness to accept or reject of disease. Nurse educators
need to know about causes of hypertension, signs and symptoms, complications,
treatment and prevention of the hypertension. The effectiveness of structured teaching
programme through pamplet was informational aid to hypertensive patients for
prevention of complications.
Nursing Administration
The study helps to raise awareness among nurses and nurse educator to acquire
knowledge and to understand the importance of care of hypertensive patient.
Nursing Administration
The nursing administrators may use the structure teaching pamphlet to improve
their knowledge in order to ensure that the nurses may assume responsibility and
accountability of hypertensive patients under their care. A copy of the structured
teaching pamphlet may be provided to health worker and nurses planning to work in
any
peoples
hospital
5.3
LIMITATIONS
1. Purposive sampling was done which restricts the generalization of the study.
2. The size of the sample was only 30 patients hence
3. it is difficult to make a broad generalization.
4. A structured questionnaire schedule was used for data collection which
restricted the amount of information that could not be obtained from the patient.
5. No attempt was made to measure the retention of knowledge after the pre-test
and post-test i.e. feed-back due to time short.
5.3
RECOMMENDATIONS
On the basis of the findings of the study following recommendations have been
made further study.
1. A similar study may be replicated on a larger scale.
45
5.4
SUMMARY
The findings of the present study were analysed and discussed with the findings
of the similar studies. This helped the investigator to proved that the findings were true
and the structured teaching pamplet was effective in improving knowledge.
It includes statement, objective, hypothesis, tool used for the study and the findings.
A study to evaluate effectiveness of structured teaching regarding hypertension
among hypertensive patients at selected Peoples Hospital Bhopal. The study made us
approach with one group pre-test post-test design. The population of the study consisted
of hypertensive patients at selected peoples hospital. Purposive sampling technique
was utilized to selected 30 hypertensive patients based on certain predetermine criteria.
Pre-test knowledge score and selected demographic factors/variables .
1.
2.
3.
4.
HYPOTHESIS
H1. There will be same knowledge regarding hypertension among hypertensive
patient.
H2.
There will be significance difference between pre and post test scores.
The present study attempted to assess the knowledge regarding hypertension
among care hospital in hypertensive patient peoples hospital . The study made to use of
evaluator y approach with descriptive pre- test and post - test probability stratified
random sampling technique was 30 sample form peoples hospital Bhopal knowledge
46
5.5
CONCLUSION
After the detailed analysis, this study leads to the following conclusions
Pre test mean knowledge score of hypertensive patient was 43.33(9.33) and
post- test mean knowledge score was 33.33 (17.83%).
Structured teaching through pamplet was an effective method of improving
knowledge of hypertensive patients.
There was no significance association was found between knowledge and
demographic factors/variables like age, sex, education, occupation, income,
marital status dietary habits and previous knowledge.
47
6. REFERENCES
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
Saunders Co.
Macleod John, (1974), Principles and Practice of Medicine. 11th ed, The
19.
20.
21.
22.
23.
New York.
Parker; Marilyn E; Nursing Theories and Nursing Practice; Philadelphia; F.A.
24.
Davis Company.
Philip Wilma & Shafers J. (1980), Medical Surgical Nursing, 7th ed. St. Lewis,
25.
26.
27.
Nursing Avadi.
Smeltzer Suzanne, C. Medical Surgical Nursing, 10th edi.; Lippincott Williams
28.
Wilkings.
Swaminathan M. (2001), Food and Nutrition Volume II; The Banglore printing
29.
30.
31.
49
JOURNALS
1. Biswas Tamal Kumars (2003). Managing Hypertension A real Challenge in the
New Millennium, J. Indian Med ASSOC Vol. 101, No. 4 pp 250-252.
2. Linnethe, Jutiana (2002). Conducted a study to evaluation of a problem based
Learning Package on Pregnancy Induced Hypertension for B.Sc. Nursing
Students, The Nursing Journal of India, Volume No. 11, pp 261-262.
3. Jaya Kumar R.V., (2004) Hypertension and Diabetes Mellitus, Health Action,
Volume No. 101, pp. 254-256.
4. Lee Young Shin, Laffery Shirley Clourier, (2006), conducted of study of
Physical Activity in older. Adults with Borderline Hypertension. Nursing
Research. March-April 2006 Vol. 55, No. 2 pp 110-112.
5. M. Prakasamma, (1997). Conducted a study to assess the knowledge and
learning needs of clients with hypertension; The Nursing Journal of India.
Volume No. 4, pp 74-76.
6. Soya, K. (2003). Conducted Study to Self care Activities of pregnancy induced
Hypertension and maternal outcome. The nursing Journal of India. Volume No.
3, pp. 58-60.
7. Yadav Rohtas K. (2002). A profile of Renal/Renovascular Abnormalities in
patients of Hypertension, J. Indian Med. Assoc Vol. 100, No. 6 pp 363-364.
ONLINE PERIODICALS
1. Eoin O Brien; Neil Atkins; Jan Staessen. (1995). A Review of Ambulatory
Blood Pressure monitoring Devices. Retrieved on 2nd Feb. 2007, from
http://www.ncbi.ncm.nih.gov/entrez/guery.
2. Singh R.B. (1990), Effect of diet and weight reduction in hypertension, 6 (4);
297-302,
Retrived
on
2nd
2007,
from
http://www.medscap.com/medline/abstract.
3. Vasam R.S. (1966), The progression from hypertension to congestive heart
failure,
Retrived
on
3rd
Feb.
2007,
from
http://www.medscap.com/
medline/abstract.
4. Zernike W. (1998), conducted a study to evaluating the effectiveness of two
teaching strategies for patients diagnosed with hypertension, 7 (1) : 37-44.
Retrived on 2nd Feb. 2007, from http://www.medscape.com/medline/abstract.
ANNEXURE - I
LETTER SEEKING PERMISSION FOR CONDUCT THE STUDY
50
To,
Subject - Request permission to conduct the pilot study and main study.
Respected mam,
We Bs.C (N) IVth year student of Peoples College Of Nursing And Research
Centre, Bhopal selected the following topic for research project to be submitted to
Barkatullah University ,Bhopal in partial fulfilment of the university of the university
requirement for the award of the Bachelor of Science in Nursing Degree.
Topic- A study to assess the effectiveness of Structured Teaching Programme
regarding hypertension among hypertensive patients
at Peoples Hospital Of
Bhopal City
Kindly grant permission to conduct the pilot study and main study on adults at
your area.
Thanking you
Yours Sincerely
Prof. (Mrs.) Karesh Prasad
Principal
PCN & RC, BHOPAL
ANNEXUR-II
51
Nursing And Research Centre, Bhanpur, Bhopal have taken a research project on A
study to assess effectiveness of
opinion and suggestion for any modification and improvement. We also request your to
kindly sig the certificate that you have validated the tool. Your kind co-operation and
expert opinion will be very much appreciated.
Thanking you
Yours Sincerely
Principal
Group members -II
Prasad
Signature Of
Lt. col. (Mrs. ) Karesh
Principal, PCN&RC
Date:
Place: Bhopal
52
ANNEXURE-III
CERTIFICATE OF VALIDITY
This is to certify that the tool and Self Structured Teaching Programme by
group II, B.sc. Nursing 4th year student of Peoples College Of Nursing And Research
Centre, Bhopal (M.P.) to be
This tool is up to the mark and can be used for the above mentioned study.
Signature:
Name:
Designation:
Date:
53
ANNEXURE-IV
This is to certify that the tool used by the Research Group-II nd Medical Surgical
Nursing of B.Sc. Nursing 4th year of Peoples College of Nursing and Research
Centre ,A study to assess the effectiveness of structured teaching programme on
knowledge regarding hypertension among hypertensive patient at peoples hospital of
Bhopal city.
Bhopal for their data collection on the research study titled has been seen and
translated by us in Hindi. It yields the same meaning as in English.
SignatureNameQualification-
54
ANNEXURE-V
CONSENT FORM
I, Named.. agree to participate in the study, on A study to assess the
effectiveness of structured teaching programme on knowledge hypertension among
hypertensive patients at peoples hospital of Bhopal city. I have been explained and
made understood the purpose of the study. My participation in this study is entirely
voluntary and can withdraw from the study at any time as I wish .Researcher assured
that data will be kept confidential. However this information will be used in nursing
publication and presentations.
Place: Bhopal
Date:
Signature of Researcher
55
56
57
Date:
INSTRUCTIONS
1. Select only one alternative, which suits you, and tick mark ( ) against it.
2. Please do not leave any question unanswered.
3. Your answer will remain strictly confidential.
58
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a) <5000
(
b) 5001-10000
(
c) 10001-15000
(
d) >15001
(
7) Dietary habitsa) Vegetarian
(
b) Non vegetarian
(
8) Previous knowledge about hypertension is obtained through
a) Mass media (T.V. Newspaper)
(
b) Health professionals
(
c) Friends & relatives
(
d) Others
(
59
)
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)
)
)
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Date:
INSTRUCTIONS
1. Select only one alternative, which suits you, and tick mark ( ) against it.
2. Please do not leave any question unanswered.
3. Your answer will remain strictly confidential.
KNOWLEDGE REGARDING HYPERTENSION
1)
Meaning of hypertension
1) What is average range of blood pressure
a) 140/90mmhg
b) 120/80mmhg
c) 130/100mmhg
d) 150/100mmhg
2) What do you mean by hypertensiona) High blood pressure
b) Low blood pressure
c) Normal blood pressure
d) Average blood pressure
3) Which organs is affected by hypertension
a) Bone
b) Heart
c) Skin
d) Lungs
60
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CAUSES O HYPERTENSION
What is the cause of hypertension
a) Plevritis
(
b) Diabetes mellitus
(
c) Peptic ulcer
(
d) Shock
(
Which dietary factor can lead to hypertensiona) Pickle and papad
(
b) Gulab jamun
(
c) Tea & cold drinks
(
d) Chicken.
(
which systemic disease can cause hypertensiona) Renal disease
(
b) Skin disease
(
c) Respiratory disease
(
d) Reproductive disease
(
which type of medication increases the risk of hypertension
a) Birth control pills ( mala-D, Mala M)
(
b) Antipyretic ( Paracetamol )
(
c) Analgesic ( ibugesic plus )
(
d) Antiemetic( domperidone)
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SYMPTOMS OF HYPERTENSION
11) What is the average range og systolic blood pressurea) 100-110mmhg
b) 110-120mmhg
c) 120-130mmhg
d) 130-140mmhg
12) What is the average range of diastolic blood pressure
a) 160-70mmhg
b) 70-80mmhg
c) 80-90mmhg
61
d) 90-100mmhg
13) What is the main symptom of hypertension
a) Severe headache & dizziness
b) Blood spot in eyes
c) Itching & rashes
d) Loss of appetite
14) Which health problem is associated hypertension
a) Arthrosclerosis
b) Renal failure
c) Stroke
d) Arthritis
15) How can you identify that you have hypertension
a) Sweating, restlessness
b) Anxiety
c) Polyuria
d) Pyros is
16) Common methods used to diagnose hypertension
a) Checking B.P. at regular interval
b) USG
c) X-RAY
d) Blood test
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22) What are the most important long term goal for a client & hypertension62
63
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73
ANSWER KEY
NO. Of
Item
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
Correct Response
Maximum Score
B
A
B
C
B
B
A
A
A
C
B
B
A
A
A
A
A
D
D
D
D
D
A
D
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
74
75