RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES …



RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES BANGALORE, KARNATAKA.

ANNEXURE-II

SYNOPSIS PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION.

|1 |NAME OF THE CANDIDATE AND ADDRESS |Ms.THRUPTHI RAJ.A.N. |

| | |1ST YEAR M.Sc. NURSING STUDENT |

| | |RAJEEV COLLEGE OF NURSING, HASSAN, KARNATAKA. |

|2 |NAME OF THE INSTITUTION |RAJEEV COLLEGE OF NURSING HASSAN, KARNATAKA. |

|3 |COURSE OF THE STUDY |MASTER OF SCIENCE IN NURSING, |

| |AND SUBJECT |COMMUNITY HEALTH NURSING |

|4 |DATE OF ADMISSION TO COURSE |07-07-2010 |

|5 |TITLE OF THE TOPIC | |

| | |STRUCTURED TEACHING PROGRAMME ON PREVENTION OF BRONCHITIS AMONG KMF CATTLE |

| | |FEED INDUSTRIAL WORKERS AT HASSAN , KARNATAKA |

|5.1 |STATEMENT OF THE PROBLEM |A STUDY TO EVALUATE THE EFFECTIVENESS OF STRUCTURED TEACHING PROGRAMME ON |

| | |PREVENTION OF BRONCHITIS AMONG KMF CATTLE FEED INDUSTRIAL WORKERS AT HASSAN |

| | |, KARNATAKA” |

6. BRIEF RESUME OF THE INTENDED STUDY:

INTRODUCTION

“prevention is better than cure”`

k.park

India being a developing country is faced with traditional public health problems like communicable diseases, malnutrition and inadequate medical care on one hand, while globalization and industrialization has resulted in emergence of occupational health related issues which adds to burden of effectively addressing health care in India. The major occupational diseases or morbidity of concern in India are COPD (bronchitis, emphysema), pneumoconiosis etc.which continue to cause permanent disabilities and deaths. .1

Bronchitis is inflammation of mucus membrane of the airways that carry airflow from trachea into lungs. It can be classified into two categories, acute and chronic each of which has unique etiologies, pathologies and therapies. It is mainly caused by virus, bacteria, smoking or inhalation of chemical pollutants or dust. Smoking is main cause 80%of all cases .Bronchitis occurs when cells of bronchial lining tissues are irritated, the tiny hair with in them which normally traps and eliminate pollutants such as smoke, dust etc.,. 2

It is a contagious may spread by direct or indirect contact. viruses causes about 90%of cases of acute bronchitis while bacteria account for less than 10% .The most common symptoms are cough ,low grade fever, sore throat, nasal congestion, malaise, wheezing and shortness of breath2.

According to WHO the Asia and West pacific region has a rate of non communicable respiratory diseases such as chronic bronchitis and emphysema nearly 2-5 times higher than rest of world. Bronchitis takes a major toll in India; it has recorded to be highest in Karnataka and lowest in Punjab3.

If any one have frequent or repeated attacks of bronchitis, he or she may be the environment of where they live or work in. combination of cold, damp locations, pollutions or smoke can make them susceptible to bronchitis whether it is acute or chronic prevention is better than cure always and preventing bronchitis can be done by avoiding the substances that can cause it. .some of the measures to prevent bronchitis are avoid people who have cold, cough, the flu and other respiratory problems, good hygiene, avoid tobacco smoke, ask doctor about pneumonia shot, get an annual flu shot. 4

6.1. NEED FOR THE STUDY

Grain dust is a complex material with a long history of causing respiratory diseases ranging from bronchitis and COPD through immediate allergy, asthma and allergic alveolitis to organic dust toxic syndromes. The different conditions are compared and contrasted and roles of different components of worker health and safety in concentrated animal feeding operations. 5

There are approximately 2,38,000 animal feeding operations nationwide producing 575 million tons of manure each year (federal register, 2003). Since 1960, there has been a 59% reduction in cattle operations, a 94% reduction in dairy operations and a 95% reduction in hog forms in U.S (centner 2003) .there has been a consistent and increasing growth in number of CAFO since early 1980’s5.

According to WHO, world health report 2002, there are 1,829,000 COPD cases in developing countries and 748,000 cases in developed countries have been found. According to centers for disease control there are 1,90,000 of residents with COPD, 13% of bronchitis deaths, 740 bronchitis deaths per 1,00,000 population. 59 per 1000 with chronic bronchitis, 11.4 million with COPD including 9.4million with chronic bronchitis, 3.6% of population self reported having bronchitis in Australia 20013.

The lock factory worker study in alighar showed that 73%of workers were suffering from chronic bronchitis and emphysema. Among tannery workers of lanpur industrial slums, occupational morbidity was recorded as 28%. These studies clearly indicate that occupational lung diseases in India needs to addressed in order to reduce the prevalence and deaths associated with it. Incidence of acute bronchitis is 4.6per 100 and 14.2million cases annually. Approximately 1 in 21 or 4.60%or 12.5 million people in USA. Incidence extrapolations for USA for acute bronchitis are 12,511,999 per year, 1,042,666 per month, 2, 40,615 per week, 34,279 per day, 1,428 per hour, 23 per minute, 0 per second. .1

Confinement dusts and gases can affect any exposed person with in a short time, and in extreme cases have caused sudden death. Responses often vary from person to person may affect respiratory tract. Potential responses include acute or chronic bronchitis, asthma, chronic airway obstructions. Bronchitis associated with cough, with sputum production, tightness of chest, generally occurs in buildings with poor environment. The patient must be protected by reducing dust and gas levels confinement house through engineering and management practices or by use of respirators6.

Prevention would play an important role in dealing with this problem since these diseases are mainly the result of inhalation of hazardous substances with most often workers are unaware off. Often occupational health is not given priority because very little research has been undertaken to study exposure to such hazards and its impact on health. .1 According to WHO in 1998, COPD was sixth leading cause of death and 12th most common cause of morbidity worldwide3.

Occupational health nurse with updated knowledge of preventive concepts has a major role in intensity of complication caused by bronchitis. She or he being one of the members of health team comes in contact with the community at various situations like home visiting, conducting survey and health programme. By understanding the importance of community participation it is the responsibility of the nurses to educate and provide finest counseling for the individual of the community and the community as a whole with the latest most correct information. 7 The above facts and studies created an insight in the investigator’s mind that by improving the knowledge of industrial workers through structured teaching programme reduce the incidence of some occupational health diseases especially bronchitis and its prevention.. The overall aim of the present study is to evaluate the effectiveness of structured teaching programme about the prevention of bronchitis among cattle feed industrial workers.

6.2 REVIEW OF LITERATURE

A study was conducted on relations between respiratory symptoms and sickness among workers in animal feed industry. The purpose of study was to investigate work related respiratory symptoms, the prevalence of chronic lung diseases and dust toxic syndrome and to study lung function and bronchial hyper responsiveness in workers of Ukrainian fodder production facilities. 240 workers have been examined. The prevalence of chronic bronchitis was 26.4 +/- 4.0% at first plant and 8.8 +/- 4.8% second time (p or =0.7. None of the tested workers had obstructive pattern in spirometry. The mean forced expiratory volume (1) % was )/vital capacity 77.1 +/- 10.2. These results suggest that wood dust exposure might not lead to significant pulmonary damage. These data do not corroborate that wood dust plays significant role in lung. Future studies of respiratory health among workers exposed to wood dust are needed. 12

A study was conducted to review the respiratory disorder burden of rural Indians by utilizing data on survey of cause of death. Data was mainly extracted from and quot: survey of causes of death and quot: annual report of Registrar General of India ,Census of India 2001, national family and Health survey and various community based studies. Trend of tuberculosis, asthma, bronchitis and pneumonia calculated by five yearly moving averages for period of 1966-94 rank wise distribution of leading cause of death during 1971-91 was reviewed. The analysis shows that poverty and unhealthy environment are strongly related to respiratory disorders. Bronchitis and asthma as leading cause. The asthma and bronchitis prevalence rate in Karnataka, Gujrat, Haryana, Madyapradesh, Uttarpradesh and Kerala are above national average. The result shows that Asthma and Bronchitis was a leading cause in last 3 decades accounting about 9-11% of all deaths13

A study on Mathematic analysis of risk factors influence on occupational respiratory diseases development] Analysis covered 1348 case histories of workers exposed to industrial dust in Urals region. The analysis applied mathematical processing of survival theory and correlation analysis. The authors studied influence of various factors: dust concentration, connective tissue dysplasia, smoking habits--on duration for diseases caused by dust to appear. Findings are that occupational diseases develop reliably faster with higher ambient dust concentrations and with connective tissue dysplasia syndrome. Smoking habits do not alter duration of pneumoconiosis development, but reliably increases development of occupational dust bronchitis.14 .

A study was conducted on Long-term effects of work cessation on respiratory health of textile workers: a 25-year follow-up study. To investigate changes in lung function and respiratory symptoms after cessation of textile work and to determine whether past exposure to cotton dust and endotoxin or smoking history modify the associations.They performed a prospective cohort study consisting of 447 cotton textile workers exposed to cotton dust and 472 unexposed silk textile workers, with a 25-year follow-up. Spirometry testing and respiratory questionnaires were conducted at 5-year intervals. Generalized estimated equations were used to model the average 5-year change in forced expiratory volume (1) and odds ratios of respiratory symptom prevalence. Years since cessation of textile work was positively associated with 11.3 ml/yr and 5.6 ml/yr gains in 5-year forced expiratory volume change for cotton and silk workers, respectively. Among male cotton workers, smokers gained more forced expiratory volume per year after cessation of exposure than did nonsmokers, and the risk of symptoms of chronic bronchitis and byssinosis was larger for smoking than for nonsmoking male cotton workers The positive effect of work cessation was greater for cotton workers than for silk workers. For cotton workers, the improvement in lung function loss after cessation of textile work was greater among smokers, but no differences were observed for silk workers. 15

STATEMENT OF THE PROBLEM “A study to evaluate the effectiveness of structured teaching programme on prevention of bronchitis among KMF Cattle feed industrial workers at Hassan”.

6.3 OBJECTIVES OF THE STUDY

To assess the knowledge of KMF cattle feed industrial workers regarding prevention of bronchitis before administration of structured teaching programme.

To assess the knowledge of KMF cattle feed industrial workers regarding prevention of bronchitis after administration of structured teaching programme.

To assess the effectiveness of structured teaching programme on knowledge of KMF cattle feed workers by comparing pretest and post test knowledge scores

To find the association between selected demographical variable and post-test knowledge scores regarding prevention of bronchitis.

6.3.1 Hypotheses

H1-There will be significant difference between pre-test and post-test knowledge scores

regarding prevention of bronchitis.

H2- There will be significant association between the post-test knowledge scores

with selected socio demographic variables.

6.3.2 Assumptions

* The KMF cattle feed industrial workers may have some knowledge regarding prevention of bronchitis.

* The structured teaching programme will improve the knowledge of KMF cattle feed industrial workers on prevention of bronchitis.

6.3.3 Operational definitions

Effectiveness :- Refers to the knowledge gain as determined by in significant difference between bpre test and post test knowledge scores.

➢ Structured teaching programme: -It refers to a organized teaching programme designed for industrial workers regarding prevention of bronchitis.

➢ Prevention:-Assisting the individual to follow the instruction to reduce the Incidence of bronchitis.

➢ Bronchitis: - It is the inflammation of mucus membrane of the bronchial airways that carry airflow from Trachea into Lungs.

➢ KMF cattle feed industry: - It refers to Karnataka Co- operation Milk Producers Federation Limited, cattle feed unit.

➢ Industrial workers:-It refers to the people working in KMF cattle feed industry.

6.3.4 conceptual frame work

“ Nola .J. Pender Health promotion model is planned to apply for this study”.

6.3.5 Delimitation of the study

This study is delimited to

• The KMF cattle feed industrial workers in Hassan.

• The sample size is limited to 60 KMF cattle feed industrial workers.

• The study period is limited to 4-6 weeks of duration.

7. MATERIALS AND METHODS OF STUDY

7.1 SOURCE OF DATA The data will be collected from KMF cattle feed industrial workers at Hassan , who present at the time of data collection..

7.1.1 Significance of the study The study signifies the importance of structured teaching programme to enhance the knowledge of industrial workers regarding prevention of bronchitis.

7.1.2 Research design

A Quasi-experimental research design with one group before after design will be used for the study.

|GROUP |PRE TEST |INTERVENTION |POST TEST |

|Industrial workers working in KMF |O1 |X |O2 |

|cattle feed industry at Hassan. | | | |

KEYS:

01 – Pre test knowledge level of industrial workers regarding prevention of bronchitis.

X - Structured Teaching Programme regarding prevention of bronchitis.

O2-post test knowledge level of industrial workers regarding prevention of bronchitis.

7.2 METHODS OF DATA COLLECTION

Data will be collected by structured interview schedule which consists of two

Parts.

Part 1 - consists of socio demographic variables such as age, sex, religion, Type of

Family, type of house, year of service, area of residence, cooking fuel, smoking

habit and income.

Part 2 – consists of structured interview schedule to assess the level of knowledge

Regarding prevention of bronchitis.

7.2.1 Sampling process Criteria for sampling selection

inclusion criteria

1. KMF cattle feed industrial workers at Hassan.

2. Both males and females are included in study.

3. Both literate and illiterate are included in study.

exclusion criteria

1. Workers who are not willing to participate in the study

2. Workers who are not available during the time of study

7.2.2 SAMPLING PROCEDURE

7.2.2.1. Population The population of the present study comprises industrial workers those who are working in KMF cattle feed industry in Hassan during the time of data collection.

7.2.2.2. Samples

KMF cattle feed industrial workers who have fulfilled inclusion criteria.

7.2.2.3. Sample size The sample size consists of 60 industrial workers in KMF cattle feed industry at Hassan .

7.2.2.4. Sampling technique probability simple random sampling technique will be used to select the samples.

7.2.2.5. Study setting

The study will be conducted in KMF cattle feed industry at Hassan.

7.2.2.6. Pilot study

Pilot study is planned with 10% of total samples and study will be conducted to find out the feasibility and practicability.

7.2.2.7 Variables:

Independent variable:

Structured Teaching Programme on prevention of bronchitis.

Dependent Variable: Knowledge of KMF cattle feed industrial workers regarding prevention of bronchitis.

Extraneous variable

Selected socio demographic variables such as age, sex, religion, type of family, type of house , year of service, area of residence, cooking fuel, smoking habit and income.

Section b: Structured interview schedule

7.2.2.8 Plan for data analysis

It includes descriptive and inferential statistics.

Descriptive statistics: - To describe demographic variables and level of knowledge, frequency, percentage, mean and standard deviation will be used.

Inferential statistics: -

▪ Paired‘t’ test value will be calculated to assess the effectiveness of structured teaching programme.

▪ The Chi Square test will be used to find the association between the demographic variables and knowledge scores.

7.3. Does the study require any investigation or intervention to be conducted on patients or other humans or animals?

Yes. The study requires interventions to be conducted on KMF cattle feed industrial workers regarding prevention of bronchitis.

7.4 Has the ethical clearance been obtained from your institution?

Yes,

Permission is obtained from the research committee of the Rajeev college of nursing.

Permission is obtained from the authorities of KMF cattle feed industry at Hassan.

.Before conducting the study permission will be obtained from the study participants.

8. LISTS OF REFERENCES

1. Harini ramesh, increasing burden of occupational lung diseases in India, CFI News: 2007 may, Chest Foundation of India

Basavanthapa. Community health nursing, jaypee publications, 2nd edition 2008:841

2. Bronchitis-Wikipedia, free encyclopedia (cited on 2001).Available at.URL: (bond).

3. Donna.D.Ignatavicius et al .Medical surgical nursing, A nursing process approach, vol 1, 2nd edition 2004:676.

4. Basanets A.V.Grain dust as a cause of occupational lung disease,2004 AUG

The nursing journal, article by Valencia higuera, how to prevent Bronchitis, 2009, Aug 19.

Park.K .Preventive and Social medicine. Banarsidas publishers. Jabalpur.17thedition.2002:575,588

5. The journal occupational and environmental medicine, W.K Post, A Burdorf, and T G Bruggeling Relations between respiratory symptoms and sickness among workers in the animal feed industry,1994 july; 51(7):440-446

The nursing journal, prognostic factors for respiratory sickness absence and return to work among blue collar workers and office personnel occup. Environ.med. 2001;58:246-252.

6. Teul I. Cohen RA, Patel A, Green FH. Lung disease caused by exposure to coal mine and silica dust. 2008 Dec;29(6):651-61. Epub 2009 Feb 16.

7. British journal of Industrial Medicine. Relationship between dust level and byssinosis and Bronchitis in Lancashire cotton mills, 2004 Jan; 31(1) URL:

8. Baran S, Swietlik K, Teul I. Lung function: occupational exposure to wood dust. Semin Respir Crit Care Med. Eur J Med Res. 2009 Dec 7;14 Suppl 4:14-7.

9. The internet journal of epidemiology ISSN. Respiratory disease burden in rural India- a review from multiple data sources 2001, available at URL

10. Budkar' LN, Bugaeva IV, Obukhova TIu, Tereshina LG, Karpova EA, mathematic.2010;(2):9-12.URL:

Shi J, Hang JQ, Mehta AJ, Zhang HX, Dai HL, Su L, Eisen EA. Long-term effects of work cessation on respiratory health of textile workers: a 25-year follow-up study.2010 Jul 15;182(2):200-6. Epub 2010 Mar 25.

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