RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES



RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES

KARNATAKA, BANGALORE-78

|1 |NAME OF THE CANDIDATE AND ADDRESS |Mr. ALBIN SEBASTIAN |

| | |1ST YEAR MSc NURSING, |

| | |N.D.R.K COLLEGE OF NURSING, |

| | |B.M ROAD , HASSAN |

| | |KARNATAKA. |

|2 |NAME OF THE INSTITUTION |N.D.R.K COLLEGE OF NURSING |

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

| | |MEDICAL SURGICAL NURSING. |

|4 |DATE OF ADMISSION TO THE COURSE |15-06- 2009 |

|5 |TITLE OF THE TOPIC/STATEMENT OF THE PROBLEM |“A STUDY TO EVALUATE THE EFFFECTIVENESS OF STRUCTURED TEACHING PROGRAM(STP) ON |

| | |KNOWLEDGE REGARDING PRIMARY PREVENTION OF ALLERGIC BRONCHITIS AMONG PRE UNIVERSITY|

| | |STUDENTS IN SELECTED PRE UNIVERSITY COLLEGES OF HASSAN.” |

PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION

INTRODUCTION

“INFECTIOUS DISEASES WILL LAST AS LONG AS HUMANITY ITSELF”

 

 

Today, there are millions of people suffering from different kinds of respiratory illness that can have a significant effect in the way they live their daily lives. Infections of respiratory tract are the most common human ailment. The respiratory illness are a source of discomfort, disability, and loss of time for most adults, they are a substantial cause of morbidity, and mortality, in young children and the elderly.

Respiratory illness can vary from being acute and chronic. Acute respiratory tract infections may cause inflammation of the respiratory tract any where from nose to alveoli, with a wide range of combination of symptoms and signs. Chronic conditions of respiratory illness are difficult to treat and can cause permanent damage to the respiratory system. An acute respiratory tract infection is often classified as upper respiratory tract infection and lower respiratory tract infection. Bronchitis is one of the most common lower respiratory tract infections1.

Bronchitis is the infection of the bronchus and it is a condition where main air passages to the lungs (bronchi) get inflamed it result into shortness of breath, cough and chest tightness. Yellow or green mucus is brought up due to coughing in bronchitis. The clinical features include running nose, cough, sore throat, difficulty breathing and ear problem. Fever is also common in acute respiratory infection. This condition is triggered by an overly active immune system that attacks harmless foreign substances that enters that enters the body. The immune system identifies the foreign substances as dangerous and release antibodies to fight the substances2

Low resource settings there disease are mainly attributed with exposure to indoor pollution, solid-cooking fuels, poor housing, low nutritional status and sanitary condition. The association of respiratory disorders with geographical region may be relevant with population density, industrial and textile pollutants, and tobacco consumption. The relationship between socio-economic developments, behavioral and environmental factors of these diseases will be premediatated3.

6. BRIEF RESUME OF INTENDED WORK

6.1. NEED FOR THE STUDY

Every year 3.9 million young children die due to bronchitis worldwide. It is estimated that Bangladesh, India, Nepal together accounts for 40%of global bronchitis mortality. Allergic bronchitis is a type of respiratory disorder. It is commonly referred to an allergic asthma. The immune system of a person suffering from allergic bronchitis is highly sensitive and so hyperactive that it attacks even harmless foreign substances that enter the body. In allergic bronchitis irritants and allergens inflame the bronchi and lower part of respiratory system. The condition lasts as long as the person is exposed to allergens. Allergic bronchitis is closely associated with asthma and respiratory allergy and can lead to conditions such as hay fever and allergic rhinitis. Allergic bronchitis causes mild to moderate suffering. Allergic bronchitis can become very dangerous and even cause death. This is because some people are extremely sensitive to allergens. This extreme sensitivity can lead to suffocation caused due to the blockage of airway by inflamed tissue. People in this condition are in great danger. They need immediate hospitalization and medical care. Treating mild to moderate symptoms of allergic bronchitis can include taking anti histamine medication and getting away from the allergens that caused the symptom4.

A cross sectional survey done to investigate the current status of the, prevalence, prevention and management of chronic bronchitis in China. In that survey 9434 samples were selected by using cluster sampling. The result reveled that there was high prevalence and poor prevention and management for chronic bronchitis in rural areas .The prevalence rate of chronic bronchitis in rural was 8.8%, 12.8%in male and 5.4%in female. The percentage of smoking and exposure to biomass smoke in rural area was 43% and 83.1%respectively. The aggregate association rate was 17.5% and 12.4%of smoke had received advice to quite smoking, and 74.5% were current smoker and 7.9%of chronic bronchitis patients had received regular treatment. They recommend the need of an education process for the prevention and management of bronchitis5.

A study was conducted to find out the respiratory disorder burden of rural Indians by utilizing data on survey of cause of death in India. The result reveled that poverty and unhealthy environment are strongly related to the respiratory disorders. Bronchitis recorded as leading cause, pneumonia and tuberculosis of the lungs ranked one of the five causes of deaths in rural India. The respiratory disorders have shown a reduction from 24.7 -19.2 during the study period. Asthma and bronchitis prevalence rates in Karnataka, Haryana, Utter Pradesh, Kerala, and Madhya Pradesh are above national average. TB prevalence is high in Madhya Pradesh, Utter Pradesh AND Gujarat where Tamilnadu and Maharastra recorded lowest prevalence6.

Allergic bronchitis can effectively be treated by having the right information about the disease and also being informed on what kind of allergen is causing the irritation. Prevention of allergic bronchitis will include staying away from the allergens that causes the condition.

Therefore based on the above reviews and ground full evidences we came to know that allergic bronchitis is one of the most common respiratory tract infection affecting majority of population. So the researcher took interest in giving a structured teaching on primary prevention of allergic bronchitis among pre university students. Thus the pre university students will be able to pass this knowledge to the public so that they can understand the significance and different primary preventive measures of allergic bronchitis.

6.2 REVIEW OF LITERATURE

Review of literature is divided into three parts:

1. Literature related to incidence and prevalence of Allergic Bronchitis.

2. Literature related to knowledge regarding allergic bronchitis.

3. Literature related to Structured Teaching Program.

1. Literature related to incidence and prevalence of Allergic Bronchitis.

GLOBAL

A study was conducted to determine the variations in the prevalence of bronchitis among young adults across countries 17966 subjects were randomly selected from the general population .The median prevalence of bronchitis was 2.6% with wide variation across countries .Smoking allergens are the major risk factors for chronic bronchitis, especially in males. Only 30% of the geographical variability in prevalence could be explained by differences in smoking habits suggesting that other environmental and genetic factors play an important role7.

A study was conducted to asses the prevalence and severity of bronchitis in adolescents and their management among ninth grade students in NYC public school in USA. Survey method was used to categorize the question into four aspects,(1) if they were diagnosed with chronic bronchitis,(2) the frequency in the last 12months of chronic bronchitis, use of bronchitis medications and school absences due to bronchitis,(3) if they currently smoke cigarettes, (4) if they have environment allergies. The result revealed that out of996 samples, 334 had chronic bronchitis, and 8% of students had wheezing, 6% had four or more attack of wheeze in the last 12 months. The result also showed that some students with bronchitis were aware of their allergies and many of did not know if they were allergic to dust miles (22%), mold (22%), and roaches (15%). The 25% of all students with bronchitis missed 1-5 day of school, 5% students missed 6-10 days and 4% missed 11 or more days8.

A study was conducted to determine the prevalence of respiratory symptom, pulmonary function abnormality and allergic sensitization among 100 process and control subjects in Casablanca. The result revealed that Atopy was found in 22% of the grocers, in 18% of the controls. 67% of the grocers reported clinical respiratory symptoms compared to only 24%of the controls. Cough, expectoration, dyspnea, rhinitis, conjunctivitis, symptoms suggestive of asthma and chronic bronchitis were significantly more frequent in the grocers. Pulmonary function tests were abnormal in 39% of the grocers, more so in those who had worked longest. Skin tests were positive to at least one allergen in 53 %of the grocers and in 22% of the controls. Sensitivity to common inhalant allergens was found in 6%of the grocers and 12% of the controls. Sensitivity to occupational allergens was 31%among the grocers and 4% among the controls. Among the grocers, 7% were sensitive to spices, 5% to coffee, 5%to tea and 14% to wheat and rye flour9.

NATIONAL

A study conducted to determine the prevalence of bronchitis in Delhi, 2839 persons above the age of 15 has been utilized to estimate the prevalence of bronchitis, the prevalence has judged from the presence of symptoms appears to be between 3.9% and 5.6%.These study corroborates association between bronchitis and allergens. A study of fuel used in the household has shown significant correlation between bronchitis in females.10

A study was conducted to determine the prevalence of bronchitis in an industrial population in north India. The prevalence was 12.5% in 473 subjects between the age of 17 and 64.There is no age related rise in frequency of respiratory symptoms. The prevalence of bronchitis in smokers was 5 times the prevalence of non smokers. This study suggested that allergen is associated with development of bronchitis11.

REGIONAL

A recent report show that every ten patients visiting doctors are suffering from bronchitis, asthma, COPD and viral flu in Bangalore. Without proper precaution most of them have ended up catching secondary infection. The Bowring and Lady Curzon hospital has been receiving at least 130 cases of upper respiratory tract infection such as bronchitis and wheezing daily12.

A study conducted to determine the prevalence of bronchitis and other respiratory disorders in Mysore .900 adults were selected as samples, they were administered with knowledge and attitude questionnaire. Of the total 900 adults surveyed the total prevalence of bronchitis was 7.1% .Males had higher prevalence (11.1%) compared to females (4.5%).The prevalence of smoking was very high among men at 71.9% and all women were non smokers .The prevalence was 14.7% among smokers . Of the women exposed to biomass fuels the prevalence .was 3.9%, which increased to 4.8% on addition of regular passive smoking .In smoking male gender and age were significant associated with respiratory disorders. 13

6.2.2. Literature related to knowledge regarding allergic bronchitis.

A study was conducted to explore the attitudes, beliefs, and knowledge related to bronchitis recognition, diagnosis, and treatment from family physicians, and nurse practitioners(NPs) and physician assistants (PAs) working in primary care in USA. The method used was randomized control study and 284 samples were selected. The result reveled that the barriers to the recognition and diagnosis of bronchitis was the multiple morbidities of most bronchitis patient ,failure of patients to report bronchitis symptoms as well as lack of knowledge and inadequate training in bronchitis diagnosis and management14.

A study was conducted with an objective to study the effectiveness of intensive small group education on knowledge regarding bronchitis and respiratory disorders. Two groups were formed and randomized, datas are collected by a written questionnaire .Results shows that compared with control group there were significant changes for skills, practice and knowledge. No significant changes were found for provided care and patient outcome compared with control group 15 .

3. Literature related to Structured Teaching Program.

A study was conducted to evaluate the impact of teaching programme on the level of knowledge of bronchitis in subjects with or with out bronchitis in France A total of 860 samples with or at the risk of bronchitis were selected by using a phone questionnaire. Their knowledge on bronchitis was assessed during a telephone interview. They were randomized into 2 groups, with one group receiving the teaching programme, and were then contacted 3 months later for a second interview. The changes in the knowledge of bronchitis from baseline were compared between subjects who reported receiving teaching programme (true sensitized group) and the control group. The result revealed that at the follow up interview, the proportion of the patients who spontaneously mentioned respiratory difficulties when asked about the meaning of bronchitis significantly increased in the true sensitized group(+11.9%) compare with the control group (+2.6%, p ................
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