Effectiveness of planned teaching program on knowledge regarding care of the neonate under phototherapy among diploma internship nursing students in selected nursing schools at Gujarat state

Tejas Pandya¹*, Ravindra H.N.²

¹Student, Sumandeep Nursing College, Sumandeep Vidyapeeth, Piparia, Vadodara-391760 Gujarat India

²Professor cum Principal, Sumandeep Nursing College, Sumandeep Vidyapeeth, Piparia, Vadodara-391760 Gujarat India.

*Corresponding Author’s Email: tejaspandya1988@gmail.com

ABSTRACT:

Introduction: Children are like buds in a garden and should be carefully and lovingly nature, as they are the future of nation and citizen of tomorrow.(Jawaharlal Nehru). A child is the gift of god or greatest treasure of mankind. Childs health, wellbeing, safety and future are in the hands of parents from birth to death. The first year of child life is crucial laying the foundation to good health. At this time certain specific care and precautions are essential to ensure the survival of health of child to a future adult. Objectives: To assess pre-existing knowledge regarding care of the neonate under phototherapy. To evaluate the effectiveness of the planned teaching program on care of the neonate under phototherapy. To find association between pre-test knowledge score regarding care of the neonate under phototherapy with demographic variables. Materials and Methods: The investigator used to pre-experimental research designed used (one group Pre-test Post-test design group). Nonprobability purposive sampling technique were used, sample size were 60 diploma internship nursing students at Gujarat state. The investigator used planned teaching program to assess the knowledge of diploma internship nursing students at Gujarat state. The conceptual framework for this study based on modified Health Belief Model from Becker M.H and Miaman L.A. Medicare Prepared. The data was analysis by using descriptive and inferential statistics. Paired t-test was used for evaluate effectiveness of planned teaching program. Results: In the group of the students pre-test knowledge mean score was 15.18 (51.93%) and post-test mean score was 25.71(85.72%) and t-test value was 29.81 at the significance level 0.05 level df value was 59. So hypothesis H₁ was accepted and hypothesis H₂ was only associate with gender. Conclusion: Hence planned teaching program was affected for the diploma internship nursing students regarding care of the neonate under phototherapy.

KEY WORDS: Planned Teaching Program, Neonate, Phototherapy, Diploma internship Nursing Students

INTRODUCTION:

Children are like buds in a garden and should be carefully and lovingly nature, as they are the future of nation and citizen of tomorrow.

Jawaharlal Nehru

A child is the gift of god or greatest treasure of mankind. Childs health, wellbeing, safety and future are in the hands of parents from birth to death. The first year of child life is crucial laying the foundation to good health. At this time certain specific care and precautions are essential to ensure the survival of health of child to a future adult.At this time certain specific care and precautions are essential to ensure the survival of health of child to a future adult. Development of infant depends on enjoying their good health.¹Among these problems of neonates hyperbilirubinemia is the commonest problem among infants in neonatal period. High levels of bilirubin can occur in the blood called hyperbilirubinemia.In most cases, the etiology of this disorder is multifactorial. Several factors must be considered before treatment is begun in icteric newborns. First, it is important that the obstetric history of the mother and delivery be analyzed to allow identification of the factors that may be contributing to the occurrence of hyperbilirubinemia, such as drugs taken by the mother (diazepam, oxytocin’s), type of delivery (forceps, pelvic, cesarean section), delay in umbilical cord clamping, blood type, Rh factor, and maternal Coombs' test.¹

During this process of the physiological process or adaptation for its survival of the infants life or neonates have to face many life threatening problems such as asphyxia, hypothermia, hyperthermia, infections and hyperbilirubinemia etc. So the assessment and care of newborn is very essential.³

Among these problems of neonates hyperbilirubinemia is the commonest problem among infants in neonatal period. It is in two forms, namely physiological and pathological jaundice. Physiological jaundice is normal physiologic occurrence between the second and third days of life, appearing in about 60% of all neonates (new born babies).⁴

NEED FOR THE STUDY:

The investigator has observed the number of neonates admitted in Neonatal Intensive Care Unit with hyperbilirubinemia, in Dhiraj General Hospital, Vadodara. The pediatricians prescribe phototherapy with various drugs and refer to the Neonatal Intensive Care Unit Nurses for providing phototherapy to neonates who are in need of it and they vary in number. The Neonatal Intensive Care Unit nurses are giving chance or opportunity to the student Nurses who are posted for their clinical experience to administer phototherapy to neonates with hyperbilirubinemia.

The investigator has seen that student nurses are performing the phototherapy by improper use of drug doses, improper use of technique, lack of pre and post procedure care of the devices and neonates. Hence the investigator felt that these problems are due to the lack of knowledge among the student nurses. All the above factors had created an interest within the investigators mind and made the investigator to take final year internship diploma nursing students. Nursing students to improve their knowledge and skill with the help of Planned Teaching Programme, because they are going to become future nurses of tomorrow. Once student nurses have good knowledge and skill about each aspect of phototherapy obviously they will become skillful nurses in performing phototherapy for neonates with hyperbilirubinemia.

On 1^st Feb 2009 at Patiala, five infants including two girls were burnt alive while five others were critically injured in a fire that broke out due to an electric short circuit at the Government Rajindra Hospital. This tragic accident shouldn’t happen again, for that continous monitoring and nursing care is very essential in the intensive care units.⁵

STATEMENT OF PROBLEM:

Effectiveness of planned teaching program on knowledge regarding care of the neonate under phototherapy among diploma internship nursing students in selected nursing schools at gujarat state.

OBJECTIVES OF THE STUDY:

1) To assess pre-existing knowledge regarding care of the neonate under phototherapy.

2) To evaluate the effectiveness of the planned teaching program on care of the neonate under phototherapy.

3) To find association between pre-test knowledge score regarding care of the neonate under phototherapy with demographic variables.

HYPOTHESIS

H₁: The mean post-test knowledge score for diploma internship nursing students regarding the care of the neonate under phototherapy will be significant higher than their mean pre-test knowledge score.

H₂: There will be significant association between pre-test knowledge of internship nursing students with their selected demographic variables.

ASSUMPTION

It is assumed that diploma internship nursing students may have some knowledge about the care of the neonate under phototherapy.Planned teaching program enhance the knowledge of care of the neonate under phototherapy.

INCLUSION CRITERIA

1. Students who are

2. Willing to participate in the study

3. Able to understand English or Guajarati

4. Available during the period of data collection

5. Who are mentally and physically fit

EXCLUSION CRITERIA

Those who are not studying in diploma internship nursing students.

Age more than 25years.

MATERIAL AND METHOD:

RESEARCH APPROACH:

The research method adopted for the present study was pre-experimental approach as the study aimed at development of an intervention (Planned teaching programme on care of neonate under phototherapy) for diploma internship nursing students, of selected areas of Gujarat state and determining its effectiveness statistically. This approach would help the investigator to evaluate the effect of the specific intervention that is ‘Planned teaching programme’ on the variable that is ‘knowledge’ of diploma internship nursing students.

RESEARCH DESIGN:

In the present study the investigator selected pre-experimental approach, one group pre-test and post-test design, keeping in the view the objectives of the study, the investigator, observed the groups prior to the intervention (the pre-test). After pre-test, intervention (Planned teaching programme) was administered to the same group and was then again assessed (the post-test).

SETTING:

The study will be conducted in selected Nursing schools at Gujarat state.

VARIABLE:

I. Independent Variables

In this present study Planned teaching programme on care of the neonate under phototherapy.

II. Dependent Variable

In this present study Knowledge level of diploma internship nursing students.

III. Demographic Variable

Age, gender, medium of study, previous knowledge, source of information, marital status, religion.

POPULATION:

In this study the target population consists of the diplomainternship nursing students at Gujarat state.

SAMPLE:

The samples for the present study were students studying in diplomainternship nursing students in selected nursing schools in Gujarat state.

SAMPLE SIZE:

In the study the sample size constitutes of 60 diplomainternship nursing students at Gujarat state

SAMPLING TECHNIQUE:

The samples of the study will be selected by using non-probability purposivesampling technique according to inclusive criteria as availability of samples.

DATA COLLECTION INSTRUMENT

In this study data collection instrument was structured knowledge questionnaire.

DEVELOPMENT OF THE TOOL

After an experience review of literature and discussion with the experts, a structured knowledge questionnaire was prepared to assess the knowledge on care for neonate under phototherapy among the diploma internship nursing students.

The following steps were carried out in preparing the tool:

ª Literature review

ª Validity of tool

ª Reliability

ª Experts opinions and discussion, personal experiences, and discussion with peer groups

DESCRIPTION OF TOOL

On modifying the tool as per the expert’s suggestion the final tool consists of two parts.

Part I

Information on demographic variables of respondents containing four items such as age, sex, medium, religion, marital status, previous experience, and previous information regarding phototherapy care.

Part II

Structured knowledge questionnaire consisting 30 items on knowledge about care for neonate under phototherapy.

The items are based on varies areas which includes – 13 items and care for neonate under phototherapy – 17 items.

All items are given score of one for each correct answer and zero for wrong answer.

Scoring interpretation

Excellent above 80%

Good 65-80%

Average 50-65

Poor below50%

CONTENT VALIDITY

Content validity was established by experts comprising of 06 nursing experts from child health nursing and

SECTION A: DESCRIPTION OF THE DEMOGRAPHIC VARIABLES OF INTENSHIP DIPLOMA NURSING STUDENTS (N=60)

TABLE: 1 Frequency And Percentage Distribution Of Students According To Their Personal Characteristics (Demographic Variables)

(N=60)

SR. NO	CHARACTERITIC	CATEGORIES	FREQUENCY	%
1	AGE	18-20 20-22 22-25	09 41 10	15% 68.33% 16.67%
1	AGE	TOTAL	60	100%
2	GENDER	Male Female	06 54	10% 90%
2	GENDER	TOTAL	60	100%
3	MEIUM OF STUDY	Gujarati English	60 00	100% 00%
3	MEIUM OF STUDY	TOTAL	60	100%
4	PREVIOUS KNOWLEDGE	Workshop attended Training Lecture attended	00 00 60	00% 00% 100%
4	PREVIOUS KNOWLEDGE	TOTAL	60	100%
5	SOURCE OF KNOWLEDGE	Yes No If yes Specify	60 00	100% 00%
5	SOURCE OF KNOWLEDGE	TOTAL	60	100%
6	MARITAL STATUS	Married Unmarried Widow	03 57 00	5% 95% 00%
6	MARITAL STATUS	TOTAL	60	100%
7	RELIGION	Hindu Muslim Christian	54 04 02	90% 6.67% 3.33%
7	RELIGION	TOTAL	60	100%

SECTION B: ASSESSMENT OF PRE TEST KNOWLEDGE SCORE OFDIPLOMA INTERNSHIP NURSING STUDENTS (N=60)

Table No: 2 Pre-Test Knowledge Score Regarding Care Of Neonate Under Phototherapy.

Percentage and Mean of the Pre-test
	N	Minimum	Maximum	Mean	%	S.D	S.D %
Total	60	9	22	15.58	51.93%	3.274	10.91%
Valid N (list wise)	60

Table-4 Association of Demographic Variable with the Level of Pre-Test Knowledge Score of Diploma Internship Nursing Students

Demographic Variable		c²	D.F	Level of Significance at 0.05 level
Age in year	18-20years	4.94	4	4.49<9.49 _calc²<_tabc² NS
	20-22years
	22-25years
1. Gender	Male	8.98	2	8.98>5.99 _calc²>_tabc² S
	Female
2. Medium of Study	Gujarati	0.0	2	0.0<5.99 _calc²<_tabc² NS
	English
3. Previous Knowledge	Workshop attended	0.0	4	0.0<9.49 _calc²<_tabc² NS
	Training
	Lecture attended
4. Source of knowledge	Yes	0.0	2	0.0<5.99 _calc²<_tabc² NS
	No
5. Marital status	Married	7.04	4	7.04<9.49 _calc²<_tabc² NS
	Unmarried
	Widow
6. Religion	Hindu	3.43	4	3.43<9.49 _calc²<_tabc² NS
	Muslim
	Christian

Variables of age (χ2=4.49), Gender (χ2= 8.98), medium of study (χ2=0.0), previous knowledge (χ2=0.0), source of knowledge (χ2=0.0), marital status (χ2=7.04), Religion (χ2=3.43)was found significant at 0.05 level of significance , Thus it can be interpreted that there is a significant association between knowledge of diploma internship nursing students with their gender, and there is no significant association between knowledge of diploma internship nursing students with selected sociodemographic variables such as age, previous knowledge, religion, source of information, marital status.

So we conclude that from the entire variable only one variable that is significantly associated with pre-test knowledge hence the hypothesis (H₂) was accept with only gender.

DISCUSSION:

The present study was undertaken to evaluate the effectiveness of PTP on care of neonate under phototherapy among diploma internship nursing students. Pre experimental research design with single group pretest posttest design approach was adopted in order to achieve the objectives of the study. The samples were selected using purposive sampling technique. The sample size was 60 and the data was collected from them by using a structured knowledge questionnaire before and after administration of PTP.

A study was conducted on transepidermal water loss and skin hydration on 31 preterm infants (gestational age 25 to 36 weeks) during phototherapy in Israel. Transepidermal water and skin hydration was measured in 7 body areas before and during phototherapy. The study findings revealed that there was a mean increase of 26.4% in transepidermal water loss during phototherapy.

CONCLUSION:

Care of the neonate under phototherapy it was very helpful for the students during their clinical experience as well as their working area. Also the neonate care during phototherapy it must important and prevent complications due to the phototherapy.

REFERENCES:

1. Patricia A, potter, Anne Griffin Perry. “Fundamentals of Nursing”, 6^th edition, Mos by 2005; Page No.74.

2. Dorothy R Marlow, Barbara and Redding .A. “Text book of Pediatric”; 6^th edition, 1998, Page No 445-447.

3. Ogun Fowora OB, Danial OJ, neonatal jaundice and its management. Olabisionabaryo University. P.M.B. 2022. Nigeria.

4. Goulet L, Fall A, D’Amour D, Pineault R. Comparing postpartum models 9-care. [serial online] 2007 Jun [cited on 2007 Nov 3]; 34(2): 131-9. Available from: URL:http://www.ncbi.nlm.nih.gov.

5. Rguhs.ac.in. [Internet]. 2015 [cited 5 March 2015]. Available from: http://www.rguhs.ac.in/cdc/onlinecdc/uploads/05_N014_ 13910.doc

Received on 16.03.2015 Modified on 02.04.2015

Int. J. Adv. Nur. Management 3(2): April- June, 2015; Page 75-80

Paired Sample Statistics: Effectiveness Of Planned Teaching Program
	Mean	Mean Difference	%	SD	Coefficient of correlation	T	P	Significance Level
Pre-test Score	15.58	10.13	51.93%	3.27	0.291	29.8	0.05	Significant
Post-test score	25.71	10.13	85.72%	2	0.291	29.8	0.05	Significant