Effectiveness of Structured Teaching Programme on Knowledge of Students Regarding the selected hazards of smoking and its Prevention in selected schools at K. R. Puram, in Hassan District, Karnataka.

Mr. Shrishail S.Gouri¹, Mrs Bernice Margaret²

¹Associated Professor, HOD of Community Health Nursing, MES College of Nursing,

Ghanekunte, Lote, Maharashtra.

²Principal of NDRK College of Nursing, Hassan. Karnataka.

*Corresponding Author E-mail: shrishailgouri@gmail.com

ABSTRACT:

The research approach adopted for this study was an evaluative and educative approach. The research design adopted for this study was a True-experimental design for assessing the knowledge of school boys regarding the selected hazards of smoking and its prevention. The stratified random sampling technique was utilized for the selection of the school boys. 100 school boys were selected for the study, among them 50 experimental groups and 50 control groups by using the lottery method. Data was collected by using a semi-structured questionnaire on the selected hazards of smoking and its prevention. The results of the study find that pre-test percentage on knowledge of the selected hazards of smoking and its prevention and knowledge score in the experimental group was 1.87(12.60%) of the school boys. Percentage of post-test knowledge on the selected hazards of smoking and its prevention includes knowledge score in the experimental group which is 1.54 (22.70%) of the school boys. Hence comparison in pre-test and post-test percentage of the selected hazards of smoking and its prevention in the knowledge score of the experimental group of the school boys is approximately 10.1% of difference during assessment. The overall mean post-test knowledge score of the school boys in the experimental group was significantly higher than the pre-test knowledge score of the school boys. The paired student‘t’ test value was 33.90 which is significant at p=0.001 level. In the Control group was 1.87(12.60%) of the school boys. Percentage of post-test knowledge on the selected hazards of smoking and its prevention includes knowledge score In the Control group. Which is 1.71 (13%) of the school boys. Hence comparison in pre-test and post-test percentage of the selected hazards of smoking and its prevention in the knowledge score of the control group of the school boys is approximately 0.4% of difference during assessment. The overall mean post-test knowledge score of the school boys in the control group was slightly higher than the pre-test knowledge score of the school boys. The chi-square test shows that there was significant association between post-test knowledge score in the experimental group and control group between Classes, residence, type of family, educational status of the father, smokers in the family and habit of smoking of the school boys. A study concluded that the selected hazards of smoking and its prevention is an evaluative approach. Overall pre-test percentage of knowledge in experimental group was 12.60% and in control group it was 12.60%. Post-test knowledge score in experimental group was 22.70% and in control group it was 13%. Comparison of overall knowledge score between pre-test and post-test shows, there is a significant difference between before structured teaching programme and after structured teaching programme regarding the selected hazards of smoking and its prevention..

KEY WORDS: Effect, school boys, knowledge, hazards, smoking, prevention, structured teaching programme.

INTRODUCTION:

“Train up a child in the way he should go: and when he is old, he will not depart from it”

It is a time to have a close relationship and being accepted in to a peer group is very important. More time spent with friends gives school boys more chance to try new things. He may try to smoke, drink alcohol and indulge in sexual activities¹. Adolescence is a period of rapid changes in physical, emotional, cognitive and social aspects. It is a time to prepare an individual for performing an adult role in all regions of life including marriage, breadwinner and also for parenthood. Additionally this is a period that is critical to the development of attitude and behaviors related to diet, exercise, sexual practices and habits of using tobacco, drugs and alcohol. According to global smoking statistics (28^th may 2002) between 80,000 to 1, 00,000 children worldwide start smoking everyday roughly half of whom live in Asia. Evidence also shows that around 50% of those who start smoking in adolescent years continue to smoke for 15 to 20 years³. One out of every 10 Indian adult is dying of tobacco related diseases. In every 2 seconds, one Indian child tries tobacco for the first time³. Most of the States had minimized the age to 18 years for purchasing cigarettes. Small stores are the most commonly mentioned sites for the purchase of cigarettes, as almost 80% of youth in the age 12-15 years and 87% of youth in the age 16-17 years are reported at buying cigarettes from small stores³. The anti-tobacco act was endorsed by parliament in 2002. Former Indian President Mr. APJ Abdul Kalaam signed it as a law. One of the main objectives of the law is to protect adolescents and passive smokers from hazards of smoking. The Union Cabinet has improved the enactment of a new law to ban tobacco advertisement of any kind in public places or sale of tobacco products to minors⁴.

NEED FOR THE STUDY:

The rising world phenomenon of smoking among the younger generation and particularly among students, in an epidemic form has been causing great public concern. It has already engulfed the vulnerable sections of societies in different parts of the globe.

Indian youth is literally drowned in smoking and drugs today. No special function or party is considered a success unless expensive brands of whiskey, scotch and beer flow freely with clouds and puffs of smoke. High school boys and girls celebrate their birthdays and Valentine day with cigarette and champagne.

Unlike a decade ago, when smoking was a taboo, now there is a social sanction in favor of cigarette smoking in adolescents. Smoking can be seen in peer groups by ashing cigarettes on the roads and road circles among adolescents⁵.

According to a report issued by the office of the surgeon general, 4, 00,000 adults die every year from smoking related illnesses, making smoking the number one cause of preventable disease and death in the nation⁶.

A pack a day smoker takes more than 70,000 puffs per year. Each puff delivers a rich amount of chemical assortment of lung and blood stream. Each puff also reinforces the habit of a little more and slowly produces a milieu and context of a meal with a cup of coffee or cocktail. Nicotine fulfils all the criteria of drug addiction and reinforces the smoking behavior⁷.

An article reported that in every 15 minutes 1 person is diagnosed as lung cancer associated with smoking in India. Every cigarette takes about 11 minutes of a person’s life. In women and men the chances of infertility is also associated with smoking⁸.

Recent studies have shown that smoking can cause more harm to women than previously known. It not only turns them in to a storehouse of diseases but can also affect their offspring’s health too⁹.

A study was conducted to assess the perception of tobacco products and patterns of tobacco use among male students. It found that tobacco consumption were less in smokers. Students of professional colleges like medical, law and engineering was higher than other courses for smoking habits. Their adaptation to smoking was a result of adopting the western culture and media effect¹⁰.

In February 2003, India’s cabinet approved legislation banning tobacco advertisements and seeking to regulate production and sale of tobacco products.

Based on so much literature and the investigators experience, it was felt that providing knowledge on the selected hazards of smoking and its prevention among school boys is important because this is the age which is critical in development, attitude and high risk to adopt the habits like smoking, drinking drug abuse and increase the awareness in relation to health status and prevent smoking. The study is designed to give a structured teaching programme on the selected hazards of smoking and its prevention among school boys.

STATEMENT OF PROBLEM:

“Effectiveness of structured teaching programme on knowledge of students regarding the selected hazards of smoking and its prevention in selected schools at K. R. Puram, in Hassan district, Karnataka.”

OBJECTIVES:

1. To assess the knowledge of students regarding the selected hazards of smoking and its prevention before the administration of structured teaching programme among experimental and control group.

2. To develop and administer structured teaching programme regarding the selected hazards of smoking and its prevention on experimental group.

3. To evaluate the effectiveness of structured teaching programme by comparing pre-test and post-test knowledge score on experimental and control group.

4. To identify the association between selected demographic variables with post-test knowledge scores regarding the selected hazards of smoking and its prevention on experimental and control group.

OPERATIONAL DEFINITION:

1. Effectiveness: -

It is defined as a significant increase in the level of knowledge among the school boys regarding the selected hazards of smoking and its prevention.

2. Structured teaching Programme: -

It is a systematically prepared teaching programme for school boys regarding the selected hazards of smoking and its prevention with the use of LCD planned for 45 minutes.

3. Knowledge:

It refers to the correct responses from the school boys towards structured questionnaires regarding the selected hazards of smoking and its prevention.

4. Hazards:

It is the dangerous effect on health of an individual caused by smoking.

5. Smoking:

It is a visible vapour in the air produced by burning substances, which will cause many ill effects on the body system like oral cancer, lung- cancer and bladder cancer.

6. Prevention:

“Prevention is the creation of conditions opportunities and experiences that encourages and develops healthy, self sufficient school boys and that occur before the onset of smoking problems.

7. School boys:

School boys are students studying in the school (6^th, 7^th, 8^th, 9^thand 10^thstandards) in selected schools.

8. K R Puram:

It is the part of Hassan, consisting of 8 schools; each schools has a Principal and adequate staff members. Every school is has 400 students, distributed in 1-10 classes within different sections.

Hypothesis:

H₁:

The mean post-test knowledge score of the school boys after administering the structured teaching programme in higher than the pre-test knowledge score.

H₂:

There is a significant association between the post-test knowledge scores and selected demographic variables.

Assumptions:

· There will be an influence of socio-demographic variables on the knowledge level of school boys regarding the selected hazards of smoking and its prevention.

· This study will enhance the knowledge on the selected hazards of smoking and its prevention among school boy.

Delimitation:

· The study is limited to school boys those who are studying in the 6^th, 7^th, 8^th, 9^th and 10^th standards.

RESEARCH METHODOLOGY:

Research Approach:

Evaluative and educative approach helps to understand the effect of independent variables on the dependent variables so the above-mentioned research approach is suitable for the study.

Research Design:

For this study the research design chosen is two group pre-test post-test designs. Which includes manipulation, randomization and control?

Variables:

The variables for the present study are:

Independent variable:

Structured teaching programme on the selected hazards of smoking and its prevention.

Dependent variable:

Knowledge of the school boys regarding the selected hazards of smoking and its prevention.

Extraneous variables:

In the present study, the extraneous variables are classes, residence, religion, type of the family, educational status of fathers, monthly income, smoker in the family and habit of smoking.

Population:

The present was conducted in Vasavienglish school and C.K.S english school at K.R puram, Hassan

Sample size:

100 school boys were selected for the study and were equally distributed: 50 school boys in the experimental group and 50 school boys in the control group.

Sampling Technique:

Stratified random sampling technique was used for the selection of the subjects by lottery method.

Criteria for selection of sample:

Inclusion criteria:

· The school boys who are willing to participate in the study.

· Those who are present at time of study.

Exclusion criteria:

The school boys other than from 6^th, 7th, 8^th, 9^th and 10^th standards are excluded from the study.

Plan for Data Analysis:

Data was collected from 50 school boys of the experimental group and 50 school boys of the control group studying at CKS English School, and Vasavi School Hassan. The collected data was Stratified random sampling by using lottery method and tabulated by applying descriptive and inferential statistics was planned for analysis which includes frequency, percentage, mean, standard deviation; inferential statistics which includes t-test and chi-square test.

RESULTS:

Section-I:

Table2: Demographic Profile (school boys) n=100

Sl. No	Demographic Variables		Experimental group		Control group
Sl. No	Demographic Variables		No	%	No	%
1	Classes	6^th standard	10	20%	10	20%
		7^th standard	10	20%	10	20%
		8^th standard	10	20%	10	20%
		9^th standard	10	20%	10	20%
		10^th standard	10	20%	10	20%
2	Residence	Rural	25	50%	24	48%
2	Residence	Urban	25	50%	26	52%
3	Religion	Hindu	33	66%	32	64%
		Christian	7	14%	8	16%
		Muslim	10	20%	10	20%
4	Type of the family	Nuclear family	33	66%	35	70%
4	Type of the family	Joint family	17	34%	15	30%
5	Education status of father	Primary education	26	52%	29	58%
		Secondary education,	7	14%	7	14%
		Higher education	7	14%	4	8%
		Collegiate	6	12%	5	10%
		Never attended school	4	8%	5	10%

Table2: Continued

Sl. No	Demographic Variables		Experimental group		Control group
Sl. No	Demographic Variables		No	%	No	%
6	Monthly income of the family	Rs.<1500	18	36%	19	38%
		Rs.1500-45000	15	30%	12	24%
		Rs.4500-8000	9	18%	9	18%
		Rs.>8000	8	16%	10	20%
7	The smoker in the family	Father	13	26%	14	28%
		Grand father	7	14%	8	16%
		Uncle	9	18%	10	20%
		Brother	8	16	9	18%
		No one	13	26%	9	18%
8	Habit of smoking	NO	50	100%	50	100%

SECTION-II:

Table: 3: Pre-test knowledge on each aspects of the selected hazards of smoking and its prevention (Experimental and control group) n=100

SECTION	Below 50% inadequate		51-75 % moderate		76 % Above adequate
SECTION	No	%	No	%	No	%
Section- A	15	30	35	70	0	0
Section-B	40	80	10	20	0	0
Section-C	31	62	19	38	0	0
Section-D	36	72	11	22	3	6

Distribution pre-test overall knowledge of experimental and control group n=100

Group	Below 50% inadequate		51-75 % moderate
Group	No	%	No	%
Experimental Group	25	50%	25	50%
Control Group	25	50%	25	50%

SECTION –III:

Pre-test and post- test mean knowledge score of experimental group n=50

SECTION	Mean		Standard deviation		t-value
SECTION	Pre –test	Post –test	Pre –test	Post- test	t-value
Section- A	2.60	4.36	0.67	0.66	16.14
Section-B	2.20	3.68	0.40	0.58	17.04
Section-C	3.12	5.28	0.87	0.90	16.35
Section-D	4.68	9.38	1.65	0.75	16.49

Pre-test and post-test overall mean knowledge score of experimental group. n=50

GROUP	Mean		Standard deviation		t-value
	Pre –test	Post –test	Pre –test	Post- test
Experimental group	12.60	22.70	1.87	1.54	33.90

SECTION-IV:

Improved pre-test and post-test mean knowledge score on different aspects of the selected hazards of smoking and its prevention. n=50

SECTION	Mean		Standard Deviation		Improved score		‘t’ Value
SECTION	Pre-Test	Post-Test	Pre-Test	Post-Test	Mean	Standard deviation	‘t’ Value
Section- A	2.60	4.36	0.67	0.66	1.76	0.77	6.14
Section-B	2.20	3.68	0.40	0.58	1.48	0.61	17.04
Section-C	3.12	5.28	0.87	0.90	2.16	0.93	16.35
Section-D	4.68	9.38	1.65	0.75	4.70	1.65	16.49

Improved pre-test and post-test overall mean knowledge score of experimental group. n=50

Group	Mean		Standard Deviation		Difference Mean	Standard Deviation	‘t’ Value
	Pre-test	Post-Test	Pre-test	Post-Test
Experimental	12.60	22.70	1.87	1.54	10.10	1.85	33.90

SECTION-V-:

Association between demographic variables and knowledge gain score of school boys of the experimental and control group. n=100

Demographic Variables	Below 50% Inadequate		51-75% Moderate		χ^{2 value}
Experimental Group	No	%	No	%	χ^{2 value}
Classes					0.092 No association
6^th	8	16	2	4
7^th	6	12	4	8
8^th	5	10	5	10
9^th	4	8	6	12
10^th	2	4	8	16
Total	25	50	25	50
Control Group	No	%	No	%	0.092 No association
Classes
6^th	8	16	2	4
7^th	6	12	4	8
8^th	5	10	5	10
9^th	4	8	6	12
10^th	2	4	8	16
Total	25	50	25	50
Experimental group	No	%	No	%	0.15 No association
Residence
Rural	10	20	15	30
Urban	15	30	10	20
Total	25	50	25	50
Control group	No	%	No	%	0.25 No association
Rural	10	20	14	28
Urban	15	30	11	22
Total	25	50	25	50
Experimental group	No	%	No	%	0.13 No association
Religion
Hindus	19	38	14	28
Non-Hindus	6	12	11	22
Total	25	50	25	50
Control group	No	%	No	%	0.23 No association
Hindus	18	36	14	28
Non-Hindus	7	14	11	22
Total	25	50	25	50
Type of the family					0.37 No association
Nuclear family	18	36	15	30
Joint family	7	14	10	20
Total	25	50	25	50
Control group	No	%	No	%	0.12 No association
Nuclear family	20	40	15	30
Joint family	5	10	10	20
Total	25	50	25	50
Experimental group	No	%	No	%	0.47 No association
Monthly income of the Family
RS<1500	11	22	7	14
RS. 1500-4500	7	14	8	16
RS.4500-8000 & RS>8000	7	14	10	20
Total	25	50	25	50
Control group	No	%	No	%	0.25 No association
Monthly income of the Family
RS<1500	12	24	7	14
RS. 1500-4500	4	8	8	16
RS.4500-8000 & RS>8000	9	18	10	20
Total	25	50	25	50

CONCLUSION:

Smoking is a habit, which induces physical, psychological, economical, social and cultural dangers not only for self but also to all the surrounding individuals.Based on the findings the result of the study shows that the pre-test knowledge of the mothers of under-five children of the experimental group was 50.40% and the control group was 50.401% which indicates that the school boys of both the experimental and control group had inadequate knowledge. The post-test knowledge of the school boys of the experimental group was 90.80% and the control group was 52.00%. The difference between experimental group and control group was 40.1%, which is a net benefit to the school boys of the experimental group due to effectiveness of structured teaching program. Based on the findings of the study there was an association between the knowledge score of the school boys in the experimental and control group with selected socio-demographic variables like classes, residence of the school boys, type of family, educational status of the father, monthly income of the family, smokers in the family and smoking habit of the school boys.

RECOMMENDATION FOR FURTHER STUDY:

1. A large sample can be included for the study from uneducated street children, foster homes, de-addiction centers and hospitals.

2. A study can be conducted in comparison between the Rural and Urban school boys.

3. A study can be conducted to assess the knowledge of the parents and their attitude regarding the selected hazards of smoking and its prevention

4. A similar study can be conducted in assessing the knowledge of the school boys with different subject groups like science, arts, economics, commerce, agriculture etc.

SUGGESTIONS OF THE STUDY:

The investigator emphasizes on the following suggestions:-

1. Periodical health check-ups, consultation with parents and periodical guidance is compulsory for the school boys in colleges and schools by the community nurse.

2. The community health nurse should conduct periodical community health education programmes for the parents and their school boys.

3. This study also suggests that all the school teachers should be well educated and have good character and must be ideal for the students.

4. The community nurse can provide education to the parents regarding the selected hazards of smoking and its prevention; school boys need mental make-ups and parental support as a friend.

REFERENCE:

1. www.99policies.com

2. Rao AR. The need and challenge of adolescent health. Health millions, 1995 May-Jun; 21(3): 26-8.

3. www.teenagesmoking.com

4. R. S. Bedi, Patiala. Report published The Tribune. March 27, 2006.

5. Baljeetsinghvirk. Addiction to alcohol and other drugs, .1^st edition, 2002; 12-14.

6. www.sciencefriday.com

7. www.sciencefriday.com

8. www.smokingzone.com

9. The Times of India. Thursday 26^th Oct 2006.

10. New Indian Express. Tuesday 12^th Dec 2006.

Received on 16.11.2016 Modified on 15.12.2016

Int. J. Adv. Nur. Management. 2017; 5(2):112-118.

DOI: 10.5958/2454-2652.2017.00025.7

Sl no	Type of assessment variables	Number of questions	Minimum score	Maximum score
1	General knowledge regarding the smoking cigarette and its contents	5	0	5
2	Knowledge related to ill effects of smoking	4	0	4
3	Knowledge related to Oral cancer, Lung cancer and Bladder cancer.	6	0	6
4	Knowledge related to the prevention and control of smoking	10	0	10
	Total	25	0	25