Effectiveness of Structured Teaching Programme on Knowledge and Attitude regarding Organ Donation and Transplantation among Adolescents in Selected Junior Colleges of Guntur (Dt), AP

 

S J Devi¹, B Nirmala Jyothi²

¹Lecturer, Department of Community Health Nursing, NRI College of Nursing, Guntur District, Andhra Pradesh

²PhD Scholar/Professor, Department of Community Health Nursing, NRI College of Nursing, Guntur District, Andhra Pradesh

 

ABSTRACT:

Background: Hundreds of people die due to organ failure every year simply because of lack of organ donors. Adolescents are key actors in the organ donation process. Therefore the objective of this study was to assess the knowledge and attitude regarding organ donation and transplantation among adolescents before and after administering STP to determine its effectiveness. Materials and Methods: A Quasi experimental study, non equivalent pre and post-test control group research design was adopted for the study. The study was conducted among adolescents at selected junior colleges, Guntur District, Andhra Pradesh. Hundred subjects were selected by using purposive sampling technique who were grouped into experimental group (n=50) and control group (n=50). The level of knowledge was assessed by using semi structured questionnaire and attitude was assessed by modified 5 point likert’s scale. Descriptive and inferential statistics were used to analyze the data. Results: The findings of the study had revealed that the majority of samples were in the age group of 17 years (58%) in experimental group and (42%) were in control group and (76%) of the respondents were belongs to nuclear family in both experimental and control groups. Almost (86%) of participants had heard about organ donation.  The pre-test mean knowledge score was 22.82±6.33 of experimental group and 21.7±6.46 of control group whereas post-test mean knowledge score was 33.74±3.84 of experimental group and 22.52±6.36 of control group. The pre-test mean attitude score was 63.20±5.88 in experimental group and 67.76±7.84 in control group whereas post-test mean attitude score was 81.80±5.90 for experimental group and 69.52±7.37 for control group. A positive correlation exited between the post-test knowledge and attitude (r=0.35, p>0.05) in experimental group. The study had found that there was no significant association between knowledge and attitudes with selected variables. Conclusion: It was apparent from the study that the respondents were reluctant to donate organs due to myths and religious beliefs. One of the best ways is to educate adolescents. Hence it was concluded that STP had a positive impact and was effective in improving the knowledge and attitudes of the subjects regarding organ donation.

 

 

 

INTRODUCTION:

There is a saying that the best among all donations is the food donation. But organ donation stands above all because it saves the life of the person and makes him/her enjoy other benefits¹. Organ donation is the selfless act of donating one’s organs to another person, who is in dire need of those organs. It is defined by the WHO as “donating human cells, tissues, and organs intended for human applications”. Donating an organ can lead to the saving and/or improving the quality of life of another person. Unfortunately, the number of people that are in need of an organ greatly surpasses the number of actual donors².

 

Organ donation is the donation of biological tissue or an organ of the human body from a living or dead person to a living recipient in need of a transplantation. Organ and tissue transplantation has become literally a life saving hope for many people. One organ donor can save 8 lives and change the life of more than 50 people^3,4. There are many terminal diseases like heart failure, lung illnesses, kidney failure etc., can be cured by the transplantation. The organs you can donate include are kidneys, heart, liver, pancreas, intestines, lungs, skin, bone/bone marrow and cornea. People of all ages can become the organ donors. Men, women, and children of all ages, all ethnicities, and all walks of life could have organ transplants^5,6,.

 

The data from various states in India revealed that a total number of organ donors from Andhra Pradesh are 41, Kerala 44, Delhi 27 and Tamilnadu 110 only. This number is awfully less to meet the demands of organ donation^7,8. The annual deaths are approximately 5,00,000 because of non availability of organs and of whom 20,000 people die of liver diseases; 50,000 people die from heart diseases. At least 1,50,000 people await a kidney transplant but only 5000 get organs and almost 10,00,000 people suffer from corneal blindness and await transplant and 1,00,000 livers are needed every year but only 2 to 3% of requirement is fulfilled. There is a great need for human organs as there is critical shortage of the same for transplantation. Almost 1.5 lakh people in India need a kidney; however, only 3000 of them receive it one. Only 1 out of 30 people who need a kidney receive one. Ninety percent of people in the waiting list die without getting an organ. India’s annual liver transplant requirement is 25,000, but we manage only about 800. About 70% liver transplants are taken care of by a live donor, but 30% are dependent on cadaver donations^9,10,11,12.

 

Organ donation is legal by law because the government of India has enacted “The Transplantation of Human organs Act 1994” Act no.42, which has allowed organ donation and legalized brain death. Lacks of knowledge and understanding about organ donations, religious attitudes, and superstitious beliefs have generated fear and mistrust in the minds of the common man has added to the low percentage of organ donation^13,14,15. Adolescents represent the future of the society and have a direct influence on family members and friends. Hence the investigator felt a legitimate curiosity and interest towards the STP on “Organ Donation and Transplantation” to improve the knowledge and also to develop favorable attitude regarding organ donation and transplantation among adolescents.

 

OBJECTIVES:

1.    To assess the knowledge and attitude regarding organ donation and transplantation among adolescents before STP in experimental group and control group by conducting pre test.

2.    To develop STP on knowledge and attitude regarding organ donation and transplantation and educate adolescents in experimental group.

3.    To evaluate the knowledge and attitude regarding organ donation and transplantation among adolescents after STP in experimental group and control group by conducting post test.

4.    To determine the association between the knowledge and attitude regarding organ donation among adolescents in experimental group before and after STP.

5.    To analyze the association between the knowledge and attitude regarding organ donation among adolescents with selected socio-demographic variables in experimental and control group.

 

HYPOTHESES:

H₁ The mean post-test knowledge and attitude score regarding organ donation will be significantly higher in experimental group than control group.

H₂ The higher the knowledge of adolescents regarding the organ donation and transplantation the higher the attitude of organ donation among adolescents. 

H₃ There will be a significant association between knowledge and attitudes of adolescents about organ donation with selected socio demographic variables.

 

MATERIALS AND METHODS:

The researcher has adopted a Quantitative research approach and Quasi experimental research design with nonrandomized control group design or nonequivalent control group design. The study was conducted in two junior colleges namely Hindu College and Andhra Christian College, Guntur, Andhra Pradesh. The size of the sample comprised of 100 adolescent students, out of which 50 adolescents for experimental group were included from Hindu college and 50 adolescents for control group from Andhra Christian College. Non probability Purposive sampling technique was used to select the adolescents who belongs to age group of 16-19 years who were willing to participate and available at the time of data collection. A semi structured questionnaire was developed consisting of three parts. Section- A consisted of socio demographic characteristics and Section-B consisted of 20 questions with multiple options on knowledge regarding organ donation and transplantation. Each question carries two options yes or no. Each correct option was assigned a score of 1, the maximum score was 43. Section - C comprised of attitude scale with 20 statements of 11positive and 9 negative items. Each statement has 5 point scale and each point carries a score ranging from strongly agree (5) to agree (4), neutral (3), disagree (2) and strongly disagree (1). The minimum and maximum score was 20-100.

 

Validity and reliability:

The content validity of the tool was done by experts from the department of community health nursing, community medicine and department of Jeevandan. Modifications and suggestions were incorporated into the final tool. The tool was administered to 10 adolescent students and reliability was established by using test and retest method. The correlation coefficient was computed and the reliability for questionnaire on knowledge was 0.84 and for attitude was 0.86. The tool was considered as highly reliable for the study.

RESULTS:

The collected data was analyzed by using descriptive and inferential statistics. The table -1 describes the socio demographic characteristics of adolescents; Majority of samples were in the age group 17 years (58%) in experimental group and (42%) were in control group. The greater part (66%) of samples were females in experimental group and (62%) of samples were males in control group. Most (76%) of the respondents were belongs to nuclear family in both experimental and control groups. The preponderance (60%) of subjects were Christians in both experimental and control groups. Almost (86%) respondents have heard about organ donation in experimental group and (66%) were in control group. Just more than half (58%) of the adolescents were belongs to upper lower class in experimental group and (62%) samples were in control group.

 

 

 

Table-1: Frequency and percentage distribution of socio-demographic variables of study sample. n_1=50, n₂₌₅₀

Sl. No	Socio-demographic variables	Experimental group		Control group
		(f)	(%)	(f)		(%)
1.	Age of the respondents in years
	a)      16 years	12	24%	10		20%
	b)      17 years	29	58%	21		42%
	c)      18 years	7	14%	11		22%
	d)      19 years	2	4%	8		16%
2.	Gender
	a)      Male	17	34%	31		62%
	b)      Female	33	66%	19		38%
3.	Type of family
	a)      Nuclear family	38	76%	38		76%
	b)      Joint family	4	8%	6		12%
	c)      Extended family	8	16%	6		12%
4.	Area of residence
	a)      Rural	22	44%	25		50%
	b)      Urban	28	56%	25		50%
	c)      Tribal	00	00%	00		00%
5.	Religion
	a)      Hindu	19	38%	17		34%
	b)      Muslim	11	22%	13		26%
	c)      Christian	20	40%	20		40%
	d)      Any other(specify)	00	00%	00		00%
6.	Have you ever heard about organ donation?
	a)      Yes	43	86%	33	66%
	b)      No	7	14%	17	34%
7.	Sources of information regarding organ donation
	a)      Mass media (TV, internet)	33	66%	31	62%
	b)      Print media (news paper, pamphlets and relatives)	11	22%	10	20%
	c)      Family members and relatives	2	4%	2	4%
	d)      Health care professionals (doctors, nurses and technicians)	4	8%	7	14%
8	Do you know someone who is on the waiting list for an organ to receive?
	a)      Yes	7	14%	5	10%
	b)      No	43	86%	45	90%
9.	Do you actually know someone who has donated an organ?
	a)      Yes	11	22%	4	8%
	b)      No	39	78%	46	92%
10.	Socio economic status the family
	a)       Upper class	0	0%	0	0%
	b)       Upper middle	6	12%	7	14%
	c)       Lower middle	15	30%	12	24%
	d)       Upper lower	29	58%	31	62%
	e)       Lower	0	0%	0	0%

 

Table-2: Association between pre-test and post-test knowledge and attitudes among adolescents regarding organ donation and transplantation by using paired ‘t’ test                                                                      n_1=50, n₂₌₅₀

    *** Highly significant at p>0.05

 

Table - 3: Correlation between the knowledge and attitudes among adolescents in both experimental and control groups.         n_1=50, n₂₌₅₀

Reference group	Variables	Knowledge		Attitude		‘r’ value	Inference
		Mean	SD	Mean	SD
Experimental group	Pre-test	22.82	6.33	63.20	5.88	-1.16	NS
	Post-test	33.74	3.84	81.80	5.90	0.35	p>0.05*
Control Group	Pre-test	21.70	6.46	67.76	7.84	0.09	NS
	Post-test	22.52	6.36	69.52	7.37	0.19	NS

Significant at p>0.05*

 

The table-2 demonstrates the calculated ‘t’ value for association between pre-test and post-test knowledge and also attitudes were found to be highly significant at t=16.67(p<0.05***) for knowledge and for attitude t=15.35(p<0.05***) which were greater than the table value i.e. t=2.02 in experimental group. But in control group the calculated ‘t’ value was t=2.18 for knowledge was relatively equal and t=1.93 for attitude was less than the table value i.e. t=2.02, that reveals the association between pre-test and post-test knowledge and also attitudes were not significant. This indicates that the STP intervention on experimental group regarding organ donation and transplantation was found effective.

 

The table -3 reveals that the coefficient correlation between knowledge and attitude for post test among experimental group, the obtained ‘r’ value 0.35 was greater than the table value of 0.288 at p>0.05. Therefore it determines there was a significant relationship between knowledge and attitude of adolescents regarding organ donation and transplantation. Hence H₂ i.e., the higher the knowledge regarding organ donation and transplantation the higher the attitudes among adolescents was accepted.

 

The chi-square test was computed; the results showed that there was no significant association between the knowledge and attitudes among adolescents with selected socio demographic variables. Hence the H₃ i.e. there was a significant association between the knowledge and attitudes among adolescents regarding organ donation and transplantation with selected socio demographic variables has been rejected.

 

 

Fig:1- reveals that the majority 68% of adolescents in experimental group and 60% of adolescents in control group were falling with in the average level of knowledge in pre-test scores.

 

 

Fig:2- illustrates that the total 100% of adolescents in experimental group and  92% of adolescents in control group shows favourable attitude in pre-test scores.

 

 

Fig:3- shows that the post-test knowledge scores, majority 84% of adolescents were in the range of good knowledge in experimental group and 64% of adolescents were in the range of average knowledge in control group.

 

 

Fig:4- shows that the post-test attitude scores, majority 86% of adolescents were in the range of highly favorable attitudes in experimental group and 82% of adolescents were in the range of favorable attitudes  in control group.

 

DISCUSSION:

The findings of study revealed that STP was being effective in enhancing the knowledge and attitudes of adolescents regarding organ donation and transplantation as evidenced by the scores obtained in the pre and post- tests. In experimental group the obtained post-test mean value of knowledge (33.74±3.84) was higher than the mean value of pre-test knowledge (22.82±6.82). While in control group the obtained mean value of post-test knowledge (22.52±6.36) was almost similar to the mean value of pre-test knowledge (21.70±6.46). These findings were supported by a similar study¹⁶ conducted at St. Stephen’s Hospital, Delhi, in that study for experimental group the obtained post-test mean value (31.21±3.12) was greater than the pre-test mean score value (19.69±3.32) ; Where as in control group of the obtained post-test mean value of knowledge (23.13±2.79) was slightly higher than pre-test mean score (20.47±3.25).

In the present study of the experimental group, the obtained post-test mean value of attitudes (81.805±5.90) was higher than the attitudes of pre-test mean value (63.20±5.88). The obtained calculated ‘t’ value (15.35*) more than the table value. It shows that there was significant difference between pre-test and post-test attitudes regarding organ donation and transplantation. While in control group, the obtained post-test mean value of attitudes (69.52+7.37) was less than the attitudes of pre-test mean value (67.76+7.84). The obtained calculated ‘t’ value (1.93) was less than the table value. It shows that there was no significant difference between pre-test and post-test attitudes regarding organ donation and transplantation. These findings were supported by a study⁸ was conducted at selected colleges of Jalandhar at Punjab had the post-test mean attitude score (42.56) in experimental group which was higher than the post test mean attitude score (36.86) in control group it was statistically significant at 5% level as calculated ‘t’ value (t=6.9408*) was more than table value at 5% level of significance. Pre-test and post-test of experimental group was also significantly related as calculated ‘t’ value (t=8.1311*) was more than the table value at 5% level of significance.

 

In the present study it was established that the higher the knowledge level results higher levels of attitude. In experimental group the post-test knowledge mean score was (33.74) and post-test attitude mean score was (81.80). Whereas in pre-test knowledge mean score was (22.82) and pre-test attitude mean score was (63.20). These findings were supported by a study⁸ conducted at selected colleges of Jalandhar, Punjab also has revealed that the post-test knowledge mean score was (19.14) and post-test attitude mean score (42.56) and pre-test knowledge mean score was (36.86) and pre-test attitude mean score was (36.88). Therefore it was proved that higher the level of knowledge higher the attitude.

 

LIMITATIONS:

The study was limited to adolescents in age group of 16-19 years and sample was limited to 100 subjects only. Small size of sample had limited the generalization of the study.

 

RECOMANDATIONS:

In view of the findings reported, the following recommendations were made.

·      A Similar study can be under taken on a large sample to generalize the findings.

·      A comparative study can be conducted to assess the knowledge and attitude regarding organ donation and transplantation between rural and urban population.

·      An exploratory study to assess the misconceptions regarding organ donation.

·        Future research needs to examine the impact of financial incentives on rates of deceased and living donors.

·        A survey can be conducted to assess the satisfaction level regarding organ donation among organ recipients.

 

CONCLUSION:

The study concluded that there was a significant improvement of knowledge and positive attitude towards organ donation and transplantation among adolescent of experimental group in post-test after administration of STP. Based on the findings of the present study, it could be concluded that the adolescents need to improve their knowledge and change their attitude regarding organ donation and transplantation. Structured teaching programme was an effective and accepted teaching strategy.

 

ETHICAL CLEARANCE:

Ethical clearance was obtained from NRI College of Nursing’ ethical research committee and principals of the respective colleges.

 

SOURCE OF FUNDING:

Self .

 

CONFLICT OF INTEREST:

None.

 

REFERENCES:

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2.     Haya Alkuwari et al. Knowledge and Attitude of Health Sciences and Non- Health Sciences Students towards Organ Donation in Ajman, UAE. GMJ, ASM 2015; 4(S2):54-62.

3.     Cited from https://en.wikipedia.org/wiki/Organ_donation.

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5.     Cited from https://www.nlm.nih.gov/medlineplus/organdonation.html

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10.   Annadurai K, Mani K, Ramasamy J. A study on knowledge, attitude and practices about organ donation among college students in Chennai, Tamil Nadu -2012. Prog Health Sci. 2013; 3(2):59-65.

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13.   Prasanna Mithraetal. Perceptions and Attitudes towards Organ Donation among People Seeking Healthcare in Tertiary Care Centers of Coastal South India. Indian J Palliat Care. 2013 May-Aug; 19 (2): 83–87.

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Received on 27.10.2018       Modified on 17.11.2018

Accepted on 03.12.2018       ©A&V Publications All right reserved