A Study to Determine the effectiveness of

Lecture cum
Demonstration on First Aid for Selected
Minor Injuries
among Accredited Social Health Activists
(ASHA) in
Selected Areas of Udupi District
Jane Maria Serrao1, Ansuya2, Malathi2
1Lecturer, Department of Community Health Nursing, St. Ann' s College of Nursing, Mulki,
Mangalore
2Assistant Professor, Department of Community Health Nursing, Manipal College of Nursing,
Manipal
ABSTRACT
Objectives: The study was conducted to assess the effectiveness of teaching through
lecture cum
demonstration on first aid for selected minor injuries among Accredited Social Health
Activists
(ASHA).
Materials and Method: Evaluative approach was used with pre experimental one group
pre test
post test design.
Results: Majority 63.3% the sample were serving as ASHA since 1-2 years, majority 83.3%
of them
had no previous experience of giving first aid and 100% of them had obtained information
about first
aid through various sources, majority 93.3% of them had not attended any training on first
aid. Study
found that the middle most 50% post-test knowledge scores were higher than the pre-test
knowledge
score indicating the significant improvement in the knowledge (z=6.755, p=0.001) on first
aid and
improvement in skills in first aid for open wounds, closed fracture of the arm, snake bite, dog
bite
and bee sting (z= 6.771 , 6.786, 6.801, 6.834, 6.818 respectively at p=0.001) after teaching
through
lecture cum demonstration.
Conclusion: Lecture cum demonstration on first aid measures was effective in enhancing
the
knowledge and skills of ASHA.
Keywords: Effectiveness, First aid, ASHA, knowledge and skill
MATERIALS AND METHOD
Settings and design
It was an evaluative study, conducted in five

Primary Health Centres coming under Brahmavara

Community Health Centre, Udupi district, Karnataka
in January 2011.
Sample size and sampling technique
Based on the pilot study findings, the samples
selected for this study were 60 Accredited Social Health
Activists (ASHA) from selected PHC by Non
probability Convenient Sampling technique.

International Journal of Nursing Education. July-December 2013, Vol. 5, No. 2 81

Study instrument
Mainly 3 tools were used to gather data from the
participants. Background information of the
participants was collected with the help of Tool 1:
Demographic proforma. Knowledge on first aid
measures was assessed by administering Tool 2:
Structured knowledge questionnaire on first aid for
selected minor injuries. First aid skills were assessed
by OSCE method using Tool 3: Observation checklists
to assess the skill in performing first aid for open
wounds, closed fracture of the arm, snake bite, dog
bite and bee sting. Reliability was established and pilot
study was conducted among ten ASHA.
Study variables
Independent variable in the study was Lecture cum
demonstration on first aid for selected minor injuries
and Dependent variables were Knowledge and Skills
on first aid measures. Extraneous variables included
in the study were Age, education, years of work
experience as ASHA, previous experience of providing
first aid, source of information regarding first aid and
any training attended on first aid.
Data collection procedure
The study was approved by the university ethical
committee and permission was obtained from medical
officers of respective PHC. Written consent was
obtained from all the participants.
Structured knowledge questionnaire on first aid
was administered along with demographic proforma
to all the participants following which the skill
assessment on first aid for open wounds, closed
fracture of the arm, snake bite, dog bite and bee sting
was done by Objectively Structured Clinical
Examination (OSCE) method using observation
checklists. There were ten stations (two of each skill in
order to cover up the timing) with one observer and a
simulated victim at each station. All the observers were
registered nurses and the simulated victims were
school children. Five minutes were allotted at each
station and each participant had to rotate to all five
stations. After the assessment of knowledge and skill,
teaching on first aid was provided using Lecture Cum
Demonstration method for 90 minutes with 10 minutes
break in between the session. Post test was conducted
on 8th day of the teaching session.
Statistical application

Data gathered were analyzed using SPSS 16.0

version in terms of frequency and percentages,
Wilcoxons Sign Rank Test and parametric tests like
Mann Whitney and Kruskel Wallis tests.
RESULTS
In the present study, majority 65% of the ASHA
were between 31 to 40 years of age, 55% of them had
completed secondary education, 63.3% were serving
as ASHA since 1-2 years, majority 83.3% of them had
no previous experience of giving first aid and 100%
had obtained information about first aid through
various sources, majority 93.3% of them did not attend
any training on first aid till now.
Study found that the middle most 50% post-test
knowledge (31) score was higher than the pre-test
knowledge (21) score. Z value computed (z=6.755,
p=.001) was significant for knowledge score indicating
that there was significant improvement in the
knowledge of ASHA after attending the teaching
session. [Table 1]

Table 1: Wilcoxon Sign Rank value of pre test and post

test knowledge scores of ASHA on first aid for
selected minor injuries. n=60
Knowledge scores Median IQR Z score p value
Pre-test 21 3 6.755 0.001*
Post-test 31 3
*p < 0.05

With regard to first aid skills, study found that the

middle most 50% post-test skill scores for all the first
aid measures were higher than the pre-test skill score
indicating the improvement in skills in first aid for
open wounds, closed fracture of the arm, snake bite,
dog bite and bee sting (z= 6.771 , 6.786, 6.801, 6.834,
6.818 respectively at p=0.001) with teaching
session.[Table 2]

82 International Journal of Nursing Education. July-December 2013, Vol. 5, No. 2

Table 2 : Wilcoxon Sign Rank value of pre test and post test skill scores of ASHA on first aid
for selected minor
injuries. n = 60
Area Median IQR Z value p value
Skill on first aid for open wounds
Pre test 4 1
6.771 0.001*
Post test 13 1
Skill on first aid for closed fracture
Pre test 3 1
6.786 0.001*
Post test 13 1
Skill on first aid for snake bite
Pre test 3 1
6.801 0.001*
Post test 12 1
Skill on first aid for dog bite
Pre test 3 0
6.834 0.001*
Post test 11 1
Skill on first aid for bee sting
Pre test 3 0
6.818 0.001*
Post test 11 1
* p < 0.05

Study revealed that years of work experience as

ASHA (t59=9.398, p=0.009) showed statistically
significant association with pre test knowledge [Table
3] and there was statistically significant relationship
between pre test knowledge and skill scores on first
aid for open wounds (r=-0.270, p= 0.037). No significant
relationship was found with knowledge and skill on
fracture of the arm, snake bite, dog bite and bee sting
[Table 4] n=60

Table 3: Association between knowledge score and selected demographic variables

Sl No Variable Test used df Test value p value
1 Age in years
30
31-40 Kruskal Wallis 2 1.67 0.434
41
2 Education
Primary
Secondary Kruskal Wallis 2 5.529 0.063
Pre university
3 Years of experience as ASHA
<1
1 to 2 Kruskal Wallis 2 9.398 0.009*
> 2 years
4 Previous experience of giving first aid
No
Yes Mann Whitney - 161 0.074
5 Any trainings attended regarding first aid
No
Yes Mann Whitney - 105 0.834
* p < 0.05

International Journal of Nursing Education. July-December 2013, Vol. 5, No. 2 83

Table 4: Relationship between pre test knowledge scores and pre test skill scores on first
aid for selected minor
injuries n=60
Variables r value p value
Knowledge and skill on first aid
Knowledge and skill on first aid
Knowledge and skill on first aid
Knowledge and skill on first aid
Knowledge and skill on first aid
* p < 0.05

for
for
for
for
for

open wounds -0.270 0.037*

closed fracture of the arm 0.087 0.509
snake bite 0.018 0.891
dog bite 0.060 0.647
bee sting -0.197 0.132

DISCUSSION
Present study found significant improvement in
post test knowledge and skill scores on first aid
compared to the pre test scores. It also revealed a
negative relationship between the pre test knowledge
and pre test skill on first aid for open wounds ( r = 0.270, p= 0.037 )
Fouziya conducted a similar study in 2007 in Udupi
district, Karnataka with One group pre test post test
design showed that the mean knowledge score was
14.6 in pre test and 22.1 in post test and pre test skill
score for first aid for bleeding wound, colder fracture
and poisonous snake bite was 4.71, 3.42 and 4.21
respectively and post test skill score for first aid for
bleeding wound, colder fracture and poisonous snake
bite was 8.39, 8.35 and 7.28 respectively. There was
significant difference in pre test and post test
knowledge and skill scores t(55) = 2, p < 0.05. The study
concluded that teaching on first was effective in
improving the knowledge and skill in performing first

aid measures for minor injuries. This study

contradicted the present finding as it revealed that the
knowledge and skill on first aid measures were
positively correlated.6
Present study found significant association between
the pre test knowledge on first aid for selected minor
injuries and years of work experience as ASHA
(p=0.009) and not with other variables like education,
previous experience of providing first aid or trainings
attended.
Svenson et al conducted a study to assess the
knowledge of oral radiology among Swedish dentists
showed that dentists with 5-25 years in practice had a
higher level of knowledge than those with fewer years
in practice.7
The strength of the study was that it empowered
the ASHA with first aid knowledge and skill with
which they can serve the needy in the community.
Researcher limited the study to first aid for only
five minor injuries: open wounds, closed fracture of
the arm, snake bite, dog bite, bee sting. Sampling
technique was restricted to non probability convenient
sampling and sample size was 60 which limited the
scope of generalization of the findings.
CONCLUSION
Present study made an effort to identify the existing
knowledge and skills of ASHA on first aid measures
and to provide them with structured teaching through
demonstrations to enhance their knowledge and skills
by which they can serve the community in an effective
manner. It was found that ASHA had lack of
knowledge and skills on first aid measures on selected
minor injuries in the pre test assessment which were
significantly improved after attending the lecture cum
demonstration. Hence the study concluded that the
teaching program was very effective in enhancing the
knowledge and skills of ASHA on first aid measures.
Source of Support: Nil
Conflict of Interest: None declared.
REFERENCES
1. National first aid science advisory board (online).
2001; Available from URL: http://
www.tmcnet.com/first aid need
2. First Aid: From Witchdoctors & Religious Knights
to Modern Doctors (online). Dec10, 2006 (cited
Nov 6, 2006); Available from URL: http://
www.wikpedia.com/managing _emergency
3. Gururaj G. Epidemiology of traumatic brain
injuries; Indian scenario. Neurological Research.
2000;24:24-28
4. Gururaj G, Thomas A, Reddi MN.
Underreporting of road traffic injuries in
Bangalore: Implication for road safety policies
and programmes. Proceedings of the 5th world

84 International Journal of Nursing Education. July-December 2013, Vol. 5, No. 2

conference in injury prevention and control; New

Delhi: Macmillan India Ltd. 2000.
5. Nedaa AK. A field study of first aid knowledge
and attitude of college students in Kuwait
University. College student journal. Dec 2006;5
6. Jawaid FQ. Effectiveness of planned teaching
programme on first aid for selected minor injuries
and emergencies for school children in selected
high schools of Udupi district. Unpublished
Master of Nursing thesis, Manipal Academy of
Higher Education: 2007
7. Svenson B, Soderfeldt B, Grondahl H.
Knowledge of oral radiology among Swedish
dentists. Journal of De