bsc nursing research

8/20/2019 bsc nursing research

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INTRODUCTION

‘’Infectious disease will last as long as humanity itself ‘’

-K .Park

In the world, continuous change of new concepts is bound to emerge based on

new patterns of thought. Health concept will differ from people to people. Health

means freedom from any sickness of disease or it may mean harmonious functioning

of all body systems.1 There is a popular saying ``Health is wealth’’.A healthy person

has a sound body and he is happy and contented, but health continuous to be a

neglected entity despite lip serice.!

"engue syndrome is a arboiral mos#uito borne disease which may present as

$a%classical dengue feer $b% dengue hemorrhagic feer without shock $c% dengue

hemorrhagic feer with shock. &a'ority of cases present as dengue feer which is a

self(limiting disease.)

"engue feer is mainly caused by Arbo irus and is mainly transmitted to

human by aedesegypti and aedesalbopictus mos#uito which fed during the day.)

The incidence of dengue feer has grown dramatically around the world in

recent decades. Around !(* billions of people in world population are now at risk

from dengue. +H currently estimates there may be *- million dengue infection

worldwide eery year.

In India dengue infection occured seeral times. "engue sureillance units

shows current statistical report of )-- cases of dengue feer reported around 11

states of India. "engue sureillance unit shows there are more incidence in /ew

"elhi. /early it is more than *0- positie cases, *-- cases including death in

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2arnataka state and )** suspected cases and *0 positie cases of dengue feer in

2olar district.*

In 2erala Triandrum district was the most affected. In !--1 there are about

1!31 cases of "engue feer identified and 1- death occurred in 2erala. In !-1! there

are about * cases reported in Thaluk head#uarters hospital 2ottarakara in the month

of 4une and 4uly.

The clinical features of dengue feer can be studied under three headings.

• "engue iral feer $"56%

• "engue hemorrhagic feer $"H6%

• "engue shock syndrome$"77%

In dengue iral feer manifestation include feer ,chills, malaise, intense

headache, colicky pain, abdominal tenderness, depression, post orbital pain lead to

photophobia, sore throat, pain in e8tremity, myalgia and arthralgia.9

In dengue hemorrhagic feer, a seere form of dengue feer inoled in

anore8ia, nausea, omiting, epigastric discomfort, pharyngitis, cough, petechial rash

appears on third day of illness and tenderness at right costal margin. 9

"engue shock syndrome occurs between !(9 days and often suddenly occurs

between cold and clammy e8tremities, weak thready pulse, epista8is, malena,

haematamesis, subarachanoid hemorrhage and petechial purpura at site of in'ection 9

There is no accine is currently aailable for dengue feer. :ut symptomatic

management is posible. The ector control is implemented using enironmental

hygiene and chemical methods. ;roper solid waste disposal, elimination of stagnant

water in domestic enironment and chemical methods such as aerosol and li#uid spray

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for mos#uito, mos#uito coils and electrical nets etc. ;ersonal protection by wearing

long sleeed cloths and long trousers when going outdoors, using mos#uito nets and

aoid staying in scrubby area are commonly used mos#uito control methods.

NEED AND SIGNIFICANCE

"engue iral infection increasingly recogniast

&editerranean, 7outh >ast Asia ?+estern ;acific. Today dengue feer is considered

one of the most important arthropod borne iral diseases in human in terms of

morbidity and mortality.3

"engue feer was first reported in 2erala in 100 in 2ottayam district. 6irst

epidemic occured in !--) with )*9 cases and 93 deaths. Triandrum was the most

affected district. "engue feer was endemic in 2erala. In !--0 there were 1!*cases

identified and 9 deaths occurred in the same year. In !-1- about !*0 cases were

identified and 1 deaths were reported. In!-11 about 1!31 cases of dengue feer

identified and 1- deaths occurred in 2erala.

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A health personnel with adapted knowledge of preentie concept has a ma'or

role in reducing intensity of complication caused by dengue feer and preent death

of affected ictims.

The aboe facts and studies created in insight in the inestigators mind that by

improing the knowledge of patient in the outpatient department and medical ward of

&ercy Hospital , 5alakom will reduce the inscidence of dengue feer in the

community. "uring our clinical posting in &ercy Hospital, 5alakom we witnessed

seeral patients, admitted with the case of dengue feer and most of them were

unaware of contributing factors and mos#uito control measures. In these

circumstances we selected the study.

Statement of the problem

@A 7tudy to assess the knowledge regarding "engue feer among patients in out

patient department and medical ward of &ercy Hospital,5alakom.

Objectives of St!"

B Assess the leel of knowledge among patients in outpatient department and medical

ward of &ercy Hospital, 5alakom regarding dengue feer.

B To find out the association between the leel of knowledge regarding "engue feer

and selected demographic ariables.

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Operational Definitions

Assess

The act which is planned by the researcher to ealuate the leel of knowledge

regarding dengue feer among patients in outpatient department and medical ward of

&ercy Hospital, 5alakom

#no$le!%e

It refers to correct responses from participants on causes, signs and symptoms,

management and preention of dengue feer as elicited through closed ended multiple

choice #uestionnaire.

Den%e fever

It is a iral disease of group : arbo irus which is transmitted by bites of mos#uito

Aedesaegypti characteri


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Asssmption

• The instrument which is prepared by the researcher is ade#uate to measure the

knowledge regarding dengue feer .• The self(instructional module which is prepared by the researcher is ade#uate

to create knowledge regarding dengue feer.

• 2nowledge create awareness .

Awareness promotes practice in life(

Delimitations

• The study is limited to the patients came in outpatient department and medical

ward of &ercy Hospital, 5alakom

• 7ample si


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RE)IE* OF +ITERATURE

INTRODUCTION

Ceiew of literature is a key step in research process. Ceiew of

literature refers to an e8tensie, e8haustie and systematic e8amination of

publications releant to the research pro'ect.-

The reiew of literature should be focused, selectie and directed

towards the specific purpose. The researcher has to select the kind of literature to be

reiewed and determine the purpose for which he has to study.-

RE)IE* RE+ATED TO INCIDENCE OF DENGUE FE)ER

A study was conducted on Dueensland Eniersity of Technology in Australia

F!--*G to reiew the scientific eidence about impact of climate change and socio(

enironmental factors on dengue transmission particularly in the Asia(;acific region.

Howeer, empirical eidence linking dengue feer to climate change is inconsistent

across geographical locations and absent in some countries where dengue is

endemic.1-

A study was conducted in 2asturba hospital &anipal F!--G to assess the

incidence of dengue feer shows that ,out of 1-- clinically suspected cases of

dengue feer , were tested positie for dengue Ig& antibody.11

A study was conducted in rural background in 2anyakumari ,Tamilnadu

F!--1G , to assess the incidence of dengue feer by collecting a total of 9 plasma

samples screened for the presence of Ig& antibodies by pan bio >lisa kit ,reealed

that 1* were found positie for dengue irus antibody.1!

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A study was conducted in =hristian medical college ,5ellor F!--)G to

demonstrate specific antibodies in blood and samples were obtained oer a period of *

years , shows that, out of 1)- samples, !) F!0.*G samples were positie for

dengue Ig&.1)

A study was conducted in all the localities in "elhi ,India F!--)G to

demonstrate effect of seasonal fluctuation of dengue feer ector reealed that out of

1-),3 houses sureyed, !-,*1) houses and ),* containers were reported positie

for Aedesaegypti.1

A study was conducted in coastal district of 2arnataka F!--!G to determine the

clinical manifestations, trend and outcome of all confirmed dengue cases admitted in

a tertiary hospital shows that among 99 patients, the most common presentation was

feer, myalgia, omiting, headache and abdominal pain and most common

hemorrhagic manifestation was petechiae.The increasing number of dengue cases

seen during peri( monsoon period.1*

A study was conducted in India F!--*G for epidemiological analysis of dengue

infection, shows that, out of 1**- suspected cases 30)F*.9G cases were confirmed

as serological positie for dengue Ig&. Highlighted rain, temperature and relatie

humidity are the ma'or and important climatic factors for the outbreak of dengue

infection.19

A study was conducted in 5eerannapet illage, AndhrapradeshF!--G on an

outbreak of dengue feer.The study showed that all age groups and both se8es were

affected with the disease ut of 10 serum samples, fie samples were positie for

Ig& antibodies to dengue irus.1

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A study was conducted in Joernment 7tanley hospital, =hennai F!--1G to assess

the correlation between platelet counts and bleeding in classical dengue cases, shows

that feer, omiting, bleeding, body pain and hepatomegaly are commonest clinical

features of dengue feer and eleated lier enrnakulam districts reporting - cases, followed by !10 cases in !--! .!-

A descriptie study was conducted by Cachel "aniel, Ca'amohan and Aby

Lachariah ;hlip in 2ollam city of 2erala F!--)G on "engue feer shows that ,of the

!*- seroalogicallyconfirmed cases, 199F99.G conformed to "engue feer and 3

F)).9G to "engue Haemorragic feer and "engue 7hock syndrome. The disease

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incidence was e#ually distributed among both se8es that is 1)- males and 1!-

females.!1

RE)IE* RE+ATED TO #NO*+EDGE

A cross sectional surey was conducted in the ;arish of +est &oreland to assess

the knowledge regarding dengue feer in parents attending child health clinics

showed that out of 10! parents more than half of parents had good knowledge about

signs, symptoms and modes of transmission of dengue feer.!!

A cross sectional surey was conducted in 2arachi, ;akistan F!--!G among

selected communities with different socioeconomic background shows that, out of

- samples, knowledge about dengue feer is inade#uate in the low socioeconomic

status but better preentie practices prealent in the high socioeconomic groups!)

A study was conducted in =olombia F!-1-G to understanding dengue irus

replication shows that the epidemiology of dengue has undergone profound changes

in recent years, due to seeral factors such as e8pansion of the geographical

distribution of the insect ector, increase in traelling, and demographic pressure. The

recently ac#uired knowledge is an in(depth understanding of the molecular and

cellular biology of the irus which ishelpful to prepare efficient strategies for the

control of dengue.

!

A study was conducted in /etherlandF!--!G on dengue feer as an arthropod

borne disease of global importance, shows that increased incidence and geographical

distribution of dengue in last *- years, dengue becoming increasingly recogni


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the pathophysiology of seere dengue and address the importance of dengue irus

infection in those traelling to parts of the world where dengue in endemic. !*

A study was conducted on community and school based health education in rural

=ambodia F!--G for dengue control, suggested the need for sustained routine

education for dengue preention and control and the need for approaches to ensure the

translation of knowledge in to practice.!9

A study was conducted in :ra


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dengue, re#uired a strategy that took into account the peculiarities of the species, "r.

4oseph said. The Aedes species, also called `container breedersM, are known to hae

their blood meal during day(time as opposed to the habit of the Anopheles species of

entering households between * p.m. and 0()- p.m. and preying on humans at night or

during the wee hours. Capid urbanisation and densely populated habitats marked by

poor enironment hygiene had set up the perfect stage for an e8plosion in the density

of the ector population responsible for diseases ranging from malaria, dengue 7and

4apanese encephalitis, he said. The Aedes species could make breeding sites in

flowerpots, discarded tyres, cups, coconut shells and concrete slabs of construction

sites where water collects. ``&oreoer, the `plastic cultureM has been a ma'or

contributor to the e8plosion in the density of the ector population.!0

RE)IE* RE+ATED TO &RE)ENTION

A study was conducted in E.7 F!---G on an outbreak of dengue feer in

traelers, reealed increased risk of dengue infection in traelers and suggest

alternatie preentie methods such as proper clothing and use of mos#uito

repellents.)-

A study was conducted in 6lorida F!--0G on an outbreak of dengue feer,

reealed that improper sanitary measures are responsible for the outbreak and calls for

a suitable preention and engage the local community in ector control by using

sanitary measures.)1

A study was conducted on Taian at airports for the early detection of febrile

passengers with dengue infection F!--G to assess the performance of the airport

screening procedure, shows that N.0 of the confirmed imported dengue cases with

an apparent symptom in the iremicstage.The researchers recommended the

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reinforcement of mos#uito bites preention and household ector control in dengue

endemic or dengue competent hotspots during an epidemic season.)!

A study was conducted in E7A F!-11G to identify families at risk includes

screening of the underlying basis for reluctance to apply insect repellent, reealed

nurses and physicians can participate in a positie role by assisting families to

determine the proper prophyla8is by recommending insect repellent choices that are

economical, safe, and easy to use.))

A study was conducted in Oatin America F!-1!G for dengue preention and

control and integrated ector management reealed that the concept of community

participation has been employed in &e8ico to raise awareness of the conse#uences of

dengue and training local people to identify, eliminate, monitor and ealuate ector

breeding sites systematically in household under their superision.)

A study was conducted in =uba F!-1!G to test the effectieness of a

community empowerment strategy interwined with the routine dengue ector control

programmereealedthat the empowerment strategy increased community inolement

and added effectieness to routine aedesaegypti control.)*

A study was conducted in /ew "elhi, India F!--)G on an outbreak of dengue

feer, reealed more stringent measures in the form of ector control, improed

sanitation and health education are needed to decrease morbidity, mortality and health

care costs caused by a preentable disease.)9

A study was conducted in =&=,5elloreF!---G on an outbreak of dengue feer

reealed the occurance of recurrent epidemic in this region in the last few years with

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associated high case fatality emphasi


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stagnant water and health education for the people. They also took measures to aoid

the spreading of mos#uitoes in town. The health department are planning strict actions

against the hotels,andrestaurants that drain pollutant water into the public sewage

system.)0

Smmar"

Review of literature is a beacon, lighting the way for the

investigator to a greater unerstaning of the research !roble" an

its "ain as!ects# $his cha!ter covers the stuies relate to

incience of engue fever , %nowlege regaring engue fever an

!revention relate to engue fever #

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,ET'ODO+OG-

The methodology of research indicate general pattern of the procedure for

gathering alid and realistic data for the purpose of inestigation. -

In this chapter, methodology include research design and approach, setting,

sample, sampling techni#ue, deelopmental description of tool, method and plan for

data analysis.

RESEARC' DESIGN AND A&&ROAC'

The research design is the plan, structure and strategy of inestigation of

answering the research #uestion and oerall plan or blueprint the researcher select to

=arry out their studies.1

A descriptie design with cross sectional surey approach is used to assess the

leel of knowledge regarding dengue feer among patients in outpatient department

and medical ward of &ercy Hospital,5alakom.

SETTING OF T'E STUD-

The study was undertaken in &ercy Hospital,5alakom.

&O&U+ATION

;opulation is defined as the entire set of indiidual or ob'ects haing some common

characteristics.-

The patient present in outpatient department and medical ward of &ercy

Hospital,5alakom was selected as population for the present study.

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Sample .samplin% techni/e

Samples

7ample is a subset of population selected for a particular study and the

members of sample are the study sub'ect-. *- patients present in outpatient

department and medical ward of &ercy Hospital, 5alakom were the sample for the

study.

Sample si0e

The sample si


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• ;atients who are admitted in pediatric ward and casualty

• =hildren below 1* years of age.

Development of tool

=losed ended #uestionnaire was used to assess the knowledge regarding dengue

feer among patients in ;" section ?medical ward of &ercy Hospital, 5alakom.

The steps of preparing the tool were,

• After receiing the related literature.

• Juidance and consultation with e8perts internet based research.• :ooks , 'ournals , maga


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&reparation of the final !raft(

6inal draft of the tool was prepared after consultation with research guide and

e8perts.

Description of the tool

The closed ended #uestionnaire was prepared after receiing related literature

and in consultation with guide. The tool consist of two sections section A ? section

:.

Section A

It consist of demographic characteristics of patients such as age, se8, religion,

educational status, type of family, residence, preious knowledge about the topic and

its source.

Section 2

It consist of items pertaining to knowledge of patients in ;" and medical

ward in &ercy Hospital, 5alakom. >ach item has four options with one most

appropriate answer. In each item, the correct response carry the score `one’$1% and

wrong response carry `


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Table 3(4 sho$in% score of level of 5no$le!%e of samples(

GRADE &ERCENTAGE SCORE

;oor -(!* -(*

Aerage !9(*- 9(1-

Jood *1(* 11(1*

>8cellent 9(1-- 19(!-

)ali!it"

The content alidity of the tool was established in consultation with guide and

e8perts from &edicines, /ursing and :iostatistics

Data collection proce!re

• ;rior to the data collection written permission was obtained from concerned

authority.

• The sub'ects were informed the purpose of study to obtain permission to

participate.• Introduction related to tool was gien to facilitate co(operation.

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&lan for !ata anal"sis

The data collected was organi

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