“A STUDY TO ASSESS THE EFFECTIVENESS OF SELF …



/“A STUDY TO ASSESS THE EFFECTIVENESS OF STRUCTURED TEACHING PROGRAMME ON THE AWARENESS OF CATARACT AMONG CLIENTS BETWEEN 40-70 YEARS ATTENDING THE EYE DEPARTMENT IN SELECTED HOSPITALS OF BIDAR.”

 

 

 

 

 

  PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION

 

 

   

 

MR. MAHESHNATH

         MEDICAL-SURGICAL NURSING

 

 

 

 

SMT.M.C VASANTHA COLLEGE OF NURSING

NAUBAD BIDAR

2013-2014

 

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, BANGALORE,        

                                            KARNATAKA

 

PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION

 

 

1) NAME OF THE CANDIDATE:-    MR. MAHESHNATH

          AND ADDRESS                       SMT.M.C VASANTHA COLLEGE OF

NURSING BIDAR

                                                           

2) NAME OF THE                         : - SMT.M.C.VASANTHA COLLEGE OF

  INSTITUTION NURSING BIDAR

                                                                

 

3) COURSE OF STUDY                : - 1st YEAR M.SC. NURSING

   AND SUBJECT                            MEDICAL-SURGICAL NURSING

   

  4) DATE OF ADMISSION             : -  1.04.2013

    TO COURSE

 

5) TITLE OF THE TOPIC            : - “A STUDY TO ASSESS THE

EFFECTIVENESS OF STRUCTURED TEACHING PROGRAMME ON THE AWARENESS OF CATARACT AMONG CLIENTS BETWEEN 40-70 YEARS ATTENDING THE EYE DEPARTMENT IN SELECTED HOSPITALS OF BIDAR.”

   

                                                

6. BRIEF RESUME OF THE INTENDED WORK:-

6.1 INTRODUCTION:-

  A cataract is opacity, or clouding, of the lens of the eye. The lens of an eye is normally clear. If the lens becomes cloudy or is pacified, it is called a cataract. Having a cataract removed is one of the most common operations in the UK, with between 250,000 and 300,000 performed each year. Consultant ophthalmologist Mark Wilkins explains what's involved .Cataracts are cloudy patches or areas in the lens inside your eye. They can develop in one or both eyes. One eye can often be more affected than the other. The lens is normally clear. It allows light to pass through to the back of your eye, helping you to see sharp images. If parts of the lens become cloudy (opaque), light cannot pass through the cloudy patches. Over time, these patches usually become bigger, and more of them develop. As less light is able to pass through the lens, your vision may become blurry or cloudy. The cloudier the lens becomes, the more your sight will be affected. A cataract can be described as a clouding that develops in the lens of an eye. It varies in severity from slight to complete opacity. The opacity of the cataract obstructs the passage of light into the eye, thereby affecting the person's vision. Cataracts develop slowly to cause loss of vision, and can render the person completely blind if it is left untreated.1

Cataracts usually affect both eyes, but they will generally develop in one eye before the other. Senile cataracts (cataracts that develop in the elderly due to the ageing process) usually start with initial opacity in the lens, followed by swelling of the lens, and then shrinkage of the lens - resulting in a complete loss of transparency. An untreated cataract can cause theomorphic phacomorphic glaucoma. Cataract is an ocular condition characterized by opacification of crystalline lens in the eye ,which leads to blurring of vision .the neutral lens is a crystalline structure composed of water and protein arranged in precise structure to create a pleasant passage for light to pass through it ,but with aging the lens opaque thus reducing the amount of light reducing the retina. Cataract is a global problem globally cataract is a leading cause of blindness it was estimated to affect 20 million people worldwide and accounted for 47.8% of total blindness in the world 2002 .By the eight of decade half of the population had cataract and by the tenth decade everyone was affected by cataract Taylor et al.estimated that cataract was the most common cause for low vision in Australian population and accounted for 37%of visual impairment in 2004. This study was also demonstrated exponential increase in vision loss with increasing age .It was estimated that 1.67 million Australian aged over 50 years were affected by age related cataract in 2001 and this number projected to increase to 2.74 million by year 2021.2

 

  6.2 NEED FOR THE STUDY:-

 

A cataract is a clouding that develops in the crystalline lens of the eye or in its envelope, varying in degree from slight to complete opacity and obstructing the passage of light. Early in the development of age-related cataract the power of the lens may be increased, causing near-sightedness (myopia) and the gradual yellowing and opacification of the lens may reduce the perception of blue colours. Cataracts typically progress slowly to cause vision loss and are potentially blinding if untreated. The condition usually affects both the eyes, but almost always one eye is affected earlier than the other. A senile cataract, occurring in the aged, is characterized by an initial opacity in the lens, subsequent swelling of the lens and final shrinkage with complete loss of transparency. Moreover, with time the cataract cortex liquefies to form a milky white fluid in a Morgagnian cataract, which can cause severe inflammation if the lens capsule ruptures and leaks.3

       

  India, a developing country faces many challenges in rendering ophthalmic health needs. Awareness is determined by factors within the health system (e.g., are the services well-known to communities and first-line health workers?) as well as factors such as patient or family education level. It is likely that people who are literate or have access to sophisticated technology (e.g., television or cell phones) are more aware of small decreases in vision than people without these advantages. In Kuper and colleagues' study, the cases were not only poorer than controls; they were significantly less likely to be literate and educated. Could these factors have affected their awareness of cataract and cataract surgery? 4

 

Cataracts are very common, especially among people age 40 and older. A cataract is a clouding of the eye's clear lens. This prevents the passage of light needed for vision. Cataracts are a significant cause of blindness in some parts of the world; however, technological advances and the availability of new procedures mean that for many people, cataracts don't lead to vision loss. New advances and techniques have made cataract surgery one of the most successful and life-improving surgical procedures. The surgeon will make a tiny incision through which he or she removes the cloudy lens and replaces it with a permanent artificial lens. Lasers are not currently used to remove cataracts. But they are sometimes used after cataract surgery to remove a film that can grow on the lens implant. If you think you may have a cataract, you don't have to live with it. Talk to your eye doctor about your options. There are no medications or exercises that will prevent the formation or progression of cataracts or make a cataract disappear. Nutritional or vitamin supplements have been shown to be beneficial in populations with nutritional deficits, but due to the inconsistent results reported in clinical trials, recommendations cannot be made at this time. Although it is very safe and effective, cataract surgery is surgery and you need to carefully decide if it is right for you. If the cataract does not interfere with your life, you may decide surgery is not warranted. Talk to your eye doctor, if cataracts are interfering with your lifestyle.5

The people who are blind in the world today, 64% are female. There are three main reasons for this: in many countries, women live longer than men and are at greater risk of blindness from causes related to age (such as glaucoma and age-related macular degeneration) some blinding conditions, such as trachoma and cataract, are more likely to affect women than men, whatever their age women and girls do not access eye care services as often as men and boys. There have been efforts in some countries, such as Pakistan5 and Tanzania, which have been effective in increasing the use of services by women. However, most communities, political leaders, and even some eye care workers are not aware of this problem. Ensuring equal access to eye care services for women will require advocacy at all levels: national, district, and community. Although it is beyond the scope of eye care programmes to change gender roles and expectations, gender issues that affect vision 2020 goals need to be addressed.6

 

 India, as one of the biggest developing countries, has a large number of blind requiring sight-restoring cataract surgeries. Despite the increase in service availability and heightened outreach screening efforts, blindness has not decreased and uptake of offered cataract surgery services is suboptimal.  Barriers to access cataract surgery services in India have been investigated in several studies, which were reviewed after having been identified through a Medline and Pub med search and summarized by using a model of health care utilization. . Numerous barriers, such as financial reasons, distance, fear, lack of service awareness, lack of support, or other obligations, could be identified but have not been put into the wider context of health care utilization behavior. Financial barriers continue to be a major reason not to take up offered cataract surgery services.   More in-depth research of underlying factors is needed to increase self-motivated uptake of offered cataract surgery services. This would free resources currently invested into patient recruitment such as outreach screening. Freed resources could then be invested into treatment and further interventions such as health literacy promotion7.

A study was conducted to assess the effectiveness of STRUCTURED TEACHING PROGRAMME on the awareness of cataract among clients between 40-70   years attending the eye department. It is effective to increase knowledge of clients between 40-70   years. During the clinical experience, investigator observed that clients between 40-70   years have lack of knowledge regarding awareness of cataract and their own self-care management. Hence, the investigator felt that the self-instructional module is more effective to improve their awareness and knowledge regarding self-care management and minimize the complications.

6.2 REVIEW OF LITERATURE:-

          A literature review is a written summary of the state of existing knowledge on the research problem. The task of reviewing research literature involves the identification, selection, critical analysis and written description of the existing information on a topic. A review of related literature gives insight in to various aspect related to the study which in turn develops the link between the precisely existing knowledge and the current study and enables to study various problems encountered during the course of a study by its direction findings ways to increase the effectiveness of data analysis and their interpretation 8.  

         

A study was conducted by Aravind Eye Hospital in India on the awareness of cataract disease and treatment to determine the major barriers for patients who need cataract treatment in a rural area of India.  A total of 251 cataract patients were selected by means of eye disease screenings throughout Jiangyan County. Questionnaires were administered after the doctor determined that the patient needed cataract surgery. The patient's awareness questionnaire was developed by Fletcher and clinically validated at the Aravind Eye Hospital in India. . A total of 89.6% of patients had been aware of their condition for more than 1 year. Only 49.8% of all patients had known for more than 1 year that their eye disease could be treated. The major barriers for that seeking eye treatment included residual functional vision (49.0%), financial problems (36.7%), no demand for the operation (8.8%), and skepticism about the operation (8.8%). Poor vision function grade and female gender were two significant factors associated with a longer awareness (>3 years) of the existence of cataracts. Patients with a history of eye disease and a longer awareness of eye disease were more likely to have known about the potential treatments for a longer period of time (>1 year). The patients' awareness of the presence of cataract disease and potential treatment were unbalanced. The main treatment barriers were lower demand for vision improvement and financial problems. It is imperative to educate patients on eye health care and to provide low cost, but high quality, cataract surgery to these patients.9

 A study was conducted on causes of vision loss among the adults of Hong Kong Chinese population. Patients' knowledge and participation in their care are important in prevention of blindness from cataract; the aim of this study was to measure knowledge of these conditions in the Hong Kong Chinese population.  Subjects aged 40 and above in the Shatin district of Hong Kong were randomly selected as part of a larger study of causes of adult visual loss. The subjects received eye examinations in which the primary cause of visual disability was recorded. The respondents were asked by trained interviewers in a standardized fashion about their knowledge of cataract; their answers were rated for accuracy by a senior ophthalmologist.   Out of the 2538 eyes examined, 7.0% had visual acuity less than 6/18. Fully 69.6% of the visual disability for those aged 60 or above was caused by cataract, AMD, or glaucoma. Awareness of cataract in particular was high, in that over 90% of respondents had heard of it. However, only 22.9% of them could describe cataract symptoms correctly, and these percentages were even lower in glaucoma (10.2%) and AMD ( ................
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